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Hiv treatment with renal failure

Gregory D Huhn, Pablo Tebas, Joel Gallant, Timothy Wilkin, Andrew Cheng, Mingjin Yan, Lijie Zhong, Christian Callebaut, Joseph M Custodio, Marshall W Fordyce, Moupali Das, Scott McCallister
BACKGROUND: HIV-infected, treatment-experienced adults with a history of prior resistance and regimen failure can be virologically suppressed but may require multi-tablet regimens associated with lower adherence and potential resistance development. METHODS: We enrolled HIV-infected, virologically suppressed adults with 2- to 3-class drug resistance and at least 2 prior regimen failures into this phase 3, open-label, randomized study. The primary endpoint was the percentage of participants with HIV-1 RNA <50 copies/mL at week 24 (FDA snapshot algorithm)...
October 6, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Jesús Troya, Pablo Ryan, Esteban Ribera, Daniel Podzamczer, Victor Hontañón, Jose Alberto Terrón, Vicente Boix, Santiago Moreno, Pilar Barrufet, Manuel Castaño, Ana Carrero, María José Galindo, Ignacio Suárez-Lozano, Hernando Knobel, Miguel Raffo, Javier Solís, María Yllescas, Herminia Esteban, Juan González-García, Juan Berenguer, Arkaitz Imaz
OBJECTIVES: Based on data from clinical practice, we evaluated the effectiveness and safety of switching to abacavir/lamivudine plus rilpivirine (ABC/3TC+RPV) treatment in virologically suppressed HIV-1-infected patients. METHODS: We performed a multicenter, non-controlled, retrospective study of HIV-1-infected patients who switched treatment to ABC/3TC+RPV. Patients had an HIV-RNA <50 copies/mL for at least 24 weeks prior to changing treatments. The primary objective was HIV-1 RNA <50 copies/mL at week 48...
2016: PloS One
Julius Chacha Mwita, Matthew J Dewhurst, Mgaywa G Magafu, Monkgogi Goepamang, Bernard Omech, Koketso Lister Majuta, Marea Gaenamong, Tommy Baboloki Palai, Mosepele Mosepele, Yohana Mashalla
INTRODUCTION: Heart failure is a common cause of hospitalisation and therefore contributes to in-hospital outcomes such as mortality. In this study we describe patient characteristics and outcomes of acute heart failure (AHF) in Botswana. METHODS: Socio-demographic, clinical and laboratory data were collected from 193 consecutive patients admitted with AHF at Princess Marina Hospital in Gaborone between February 2014 and February 2015. The length of hospital stay and 30-, 90- and 180-day in-hospital mortality rates were assessed...
August 24, 2016: Cardiovascular Journal of Africa
Marcel Doerflinger, Jason Glab, Christina Nedeva, Irvin Jose, Ann Lin, Lorraine O'Reilly, Cody Allison, Marc Pellegrini, Richard S Hotchkiss, Hamsa Puthalakath
Sepsis-induced lymphopenia is a major cause of morbidities in intensive care units and in populations with chronic conditions such as renal failure, diabetes, HIV and alcohol abuse. Currently, other than supportive care and antibiotics, there are no treatments for this condition. We developed an in vitro assay to understand the role of the ER-stress-mediated apoptosis process in lymphocyte death during polymicrobial sepsis, which was reproducible in in vivo mouse models. Modulating ER stress using chemical chaperones significantly reduced the induction of the pro-apoptotic protein Bim both in vitro and in mice...
October 3, 2016: Scientific Reports
Fanny Lanternier, Karima Amazzough, Loic Favennec, Marie-France Mamzer-Bruneel, Hendy Abdoul, Jérome Touret, Stéphane Decramer, Julien Zuber, Anne Scemla, Christophe Legendre, Olivier Lortholary, Marie-Elisabeth Bougnoux
BACKGROUND: Diarrhea is a frequent complication of solid organ transplantation. Cryptosporidiosis is classically reported in patients with acquired immunodeficiency syndrome and emerged as a cause of persistent diarrhea in solid organ transplant (SOT) patients. METHODS: Through the ANOFEL Cryptosporidium National Network and the French Transplantation Society, we collected all cryptosporidiosis cases identified in solid organ transplanted patients between 2006 and 2010 in France...
September 27, 2016: Transplantation
Juliana Ferreira Barbosa, Sônia Maria de Figueiredo, Sandra Lyon, Rachel Basques Caligiorne
Visceral leishmaniasis (VL) is azooanthroponosis affecting both rural and peri-urban areas, and can also spread into urban areas. Although more than 90% of new cases are reported from six countries: Bangladesh, Brazil, Ethiopia, India, South Sudan and Sudan, VL has emerged in many countries in the world, presenting new cases in new countries of occurrence. Thus, studies concerning epidemiological aspects in different world regions are very meaningful.In this purpose, this study aimed analyze 89 cases of VL, treated between June 2006 and June 2014 at Eduardo de Menezes Hospital (HEM), a Reference Center of Infectious Diseases situated in Belo Horizonte, in Minas Gerais state, Brazil...
September 21, 2016: Current Clinical Pharmacology
Jesús Troya, José Bascuñana
Following the introduction of triple combination therapy in 1996, the paradigm of HIV infection has been modified by its transformation into a chronic disease and thereby significantly reducing its morbidity and mortality. The spectrum of drugs in use since then has changed dramatically with the advent of more potent molecules, new classes of drugs aimed at novel therapeutic targets and their optimization and simplification through fixed-dose combinations that are more convenient for patients, and which, taken together, have led to sustained virologic response rates in treatment-naive patients of more than 90%...
July 2016: AIDS Reviews
Celia Oldenbuettel, Eva Wolf, Ayla Ritter, Sebastian Noe, Silke Heldwein, Rita Pascucci, Carmen Wiese, Ariane Von Krosigk, Eva Jaegel-Guedes, Hans Jaeger, Annamaria Balogh, Christine Koegl, Christoph D Spinner
BACKGROUND: The potential toxicity of long-term antiretroviral treatment (ART) requires ongoing investigation of novel strategies for treatment of HIV-infected patients. Monotherapy with the integrase inhibitor (INSTI) dolutegravir (DTG) may offer a favorable safety profile. Additionally, DTG has a high barrier of resistance, crucial for successful maintenance of virologic control. However, published data is sparse. METHODS: Retrospective, single-center cohort study...
September 2, 2016: Antiviral Therapy
Paolo Strati, Mark Lanasa, Timothy G Call, Jose F Leis, Danielle M Brander, Betsy R LaPlant, Adam M Pettinger, Wei Ding, Sameer A Parikh, Curtis A Hanson, Asher A Chanan-Khan, Deborah A Bowen, Michael Conte, Neil E Kay, Tait D Shanafelt
BACKGROUND: Although several consolidation strategies to prolong treatment-free survival (TFS) in chronic lymphocytic leukaemia have been investigated, most have proven either ineffective or toxic. Ofatumumab is a human type I anti-CD20 antibody approved by the US Food and Drug Administration as maintenance treatment of patients with recurrent or progressive chronic lymphocytic leukaemia who are in complete or partial response after at least two lines of treatment; higher efficacy might be observed if used as consolidation strategy than without consolidation in previously untreated patients...
September 2016: Lancet Haematology
Eva Aebert, Maike Büttner-Herold, Frederick Pfister, Thomas Mühlbacher, Christoph Berg, Martin Müller, Michael Haap, Ferruh Artunc
HISTORY AND ADMISSION FINDINGS: A 39-year-old male refugee from Gambia is admitted to the emergency room with fever, body aches and productive cough. INVESTIGATIONS: Laboratory, ultrasound and CT investigations show a sepsis due to Staphylcoccus aureus, a renal failure with the appearance of "snow-white" kidneys on ultrasound and a previously unknown acute HIV-infection. DIAGNOSIS, TREATMENT AND COURSE: Broad antibiotic treatment and an antiretroviral therapy (adapted to the impaired renal function) as well as hemodialysis are commenced...
August 2016: Deutsche Medizinische Wochenschrift
Yewulsew Mekuria, Daniel Yilma, Zeleke Mekonnen, Tesfaye Kassa, Lealem Gedefaw
BACKGROUND: Human immunodeficiency virus (HIV) infection and its treatment cause renal diseases. Renal disease is associated with an increasing cause of morbidity and mortality in HIV positive individuals than in the general population. It has been also associated with adverse outcomes, such as complications of decreased renal functions and progression to renal failure. OBJECTIVE: To determine the prevalence and factors associated with renal function impairment among highly active antiretroviral therapy (HAART) naive and HAART experienced adult HIV positive individuals...
2016: PloS One
Victor E Mulanovich, Parth A Desai, Uday R Popat
OBJECTIVE: HIV-positive patients with hematologic malignancies are frequently not considered for treatment with allogeneic hematopoietic stem cell transplantation (alloHSCT) because of reported high morbidity and mortality with this procedure and scant published experience. Advances in HIV care and supportive care for alloHSCT prompted us to review our experience since 2010, after we instituted multidisciplinary management of HIV-infected patients during the peri-transplant period. METHODS: We retrospectively reviewed the records of all HIV-positive patients who received alloHSCT at our institution since 2010...
August 17, 2016: AIDS
Karim R Saab, Sonia Elhadad, Dennis Copertino, Jeffrey Laurence
Before the modern era of HIV/AIDS therapeutics, which enabled a cascade of early recognition of infection, prompt initiation of effective antiretroviral therapies, and close follow-up, severe forms of microvascular clotting disorders known as thrombotic microangiopathies (TMAs) were frequent in the setting of advanced HIV disease. Their incidence was as high as 7% in the period 1984-1999, but fell dramatically, to <0.5%, by 2002. This profound change was predicated on one critical development: availability of new classes of anti-HIV drugs, enabling reduction and maintenance of HIV viral loads to undetectable levels...
August 2016: AIDS Patient Care and STDs
Rodolphe Malebranche, Christian Tabou Moyo, Paul-Henry Morisset, Nernst-Atwood Raphael, James Robert Wilentz
BACKGROUND: This study aimed to evaluate the clinical and epidemiologic profile of congestive heart failure at the principal free-care hospital in Haiti. Cardiovascular disease represents the most prevalent cause of admissions to the medical service of the University Hospital of the State of Haiti. No previous study has examined the demographics of congestive heart failure in urban Haiti. METHODS: Two hundred forty-seven patients presented to the inpatient service between May 2011 and May 2013...
August 2016: American Heart Journal
Bouchra Lify, G Dabo, O Nascimento, S Iraqui, S Elkhayat, M Zamd, G Medkouri, M Benghanem, B Ramdani, M M Sodqi, L Marih, A Chakib, K El FilaliMarhoum
Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor discovered in the USA in 2001. It is currently the treatment of choice for patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus. Its antiretroviral efficacy and good tolerance are responsible for the higher frequency of prescriptions compared with other nucleoside analogs. However, it can induce acute renal toxicity causing impairment of the proximal tubular function of the kidney. This is highly dependent on factors such as associated co-prescription didanosine or a protease inhibitor "boosted" with ritonavir, preexisting renal insufficiency, low body weight, or presence of associated diabetes...
July 2016: Saudi Journal of Kidney Diseases and Transplantation
Leopoldo Raij, Runxia Tian, Jenny S Wong, John Cijiang He, Kirk N Campbell
Podocytes are the key target for injury in proteinuric glomerular diseases that result in podocyte loss, progressive focal segmental glomerular sclerosis (FSGS) and renal failure. Current evidence suggests that the initiation of podocyte injury and associated proteinuria can be separated from factors that drive and maintain these pathogenic processes leading to FSGS. In nephrotic urine aberrant glomerular filtration of Plasminogen (Plg) is activated to the biologically active serine protease Plasmin by urokinase type plasminogen activator (uPA)...
June 22, 2016: American Journal of Physiology. Renal Physiology
Vincent Covelli, Dipen B Khanapara, Edgar R Naut
UNLABELLED: Penicillin encephalopathy is a rare, potentially reversible phenomenon of drug-induced neurotoxicity. CASE: A 65-year-old female with a history of HIV was admitted with a three-day history of worsening headache, confusion, and lethargy. On examination she was awake but confused. Cerebrospinal fluid (CSF) and serum venereal disease research laboratory (VDRL) test returned positive and the patient was started on intravenous penicillin G with probenecid...
March 2016: Connecticut Medicine
Fahime Bahri, Ali Kargar Kheirabad, Iman Ghasemzadeh, Saeed Shoja, Hamed Gouklani
BACKGROUND: Hepatitis B virus (HBV), hepatitis D virus (HDV), and human immunodeficiency virus (HIV) are transmitted by blood transfusion. Thus, hemodialysis (HD) patients are more prone to become the carriers of these infections due to their treatment demands. OBJECTIVES: The aim of this study was to assess the prevalence of HBV and HIV infections among HD patients in Bandar Abbas, Iran, 2015. PATIENTS AND METHODS: A total of 153 patients with chronic renal failure undergoing HD at Shahid Mohammadi hospital in Bandar Abbas were examined for hepatitis B surface antigen (HBsAg), anti- hepatitis C virus, and anti-HIV over a period of 2 months...
January 2016: Hepatitis Monthly
Joanne K Taylor, Neil Pendleton
BACKGROUND: Cachexia describes a complex pathological syndrome of muscle wasting, anorexia and weight loss. Progesterone therapies have been shown to improve appetite and promote weight gain in patients with cachexia; however, research has focused heavily on patients with cancer, and its effectiveness in other diseases remains unclear. AIMS: This systematic review aimed to present the evidence available for progesterone therapy as a treatment for non-cancer cachexia...
September 2016: BMJ Supportive & Palliative Care
Sandeep K Mallipattu, John C He
The Centers for Disease Control and Prevention estimates more than 10% of adults in the United States, over 20 million Americans, have chronic kidney disease (CKD). A failure to maintain the glomerular filtration barrier directly contributes to the onset of CKD. The visceral epithelial cells, podocytes, are integral to the maintenance of this renal filtration barrier. Direct podocyte injury contributes to the onset and progression of glomerular diseases such as minimal change disease (MCD), focal segmental glomerular sclerosis (FSGS), diabetic nephropathy, and HIV-associated nephropathy (HIVAN)...
July 1, 2016: American Journal of Physiology. Renal Physiology
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