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Hiv treatment with renal failure

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https://www.readbyqxmd.com/read/29668978/atazanavir-ritonavir-with-lamivudine-as-maintenance-therapy-in-virologically-suppressed-hiv-infected-patients-96-week-outcomes-of-a-randomized-trial
#1
Massimiliano Fabbiani, Roberta Gagliardini, Nicoletta Ciccarelli, Eugenia Quiros Roldan, Alessandra Latini, Gabriella d'Ettorre, Andrea Antinori, Antonella Castagna, Giancarlo Orofino, Daniela Francisci, Pierangelo Chinello, Giordano Madeddu, Pierfrancesco Grima, Stefano Rusconi, Barbara Del Pin, Francesca Lombardi, Alessandro D'Avino, Emanuele Focà, Manuela Colafigli, Roberto Cauda, Simona Di Giambenedetto, Andrea De Luca
Objectives: To investigate the long-term safety and efficacy of a treatment switch to dual ART with atazanavir/ritonavir + lamivudine versus continuing a standard regimen with atazanavir/ritonavir + 2NRTI in virologically suppressed patients. Methods: ATLAS-M is a 96 week open-label, randomized, non-inferiority (margin -12%) trial enrolling HIV-infected adults on atazanavir/ritonavir + 2NRTI, with stable HIV-RNA <50 copies/mL and CD4 counts >200 cells/mm3...
April 12, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29627709/rare-emergence-of-drug-resistance-in-hiv-1-treatment-na%C3%A3-ve-patients-receiving-elvitegravir-cobicistat-emtricitabine-tenofovir-alafenamide-for-144-weeks
#2
Nicolas Margot, Stephanie Cox, Moupali Das, Scott McCallister, Michael D Miller, Christian Callebaut
BACKGROUND: The single tablet regimen (STR) composed of elvitegravir (E), cobicistat (C), emtricitabine (F), and tenofovir alafenamide (TAF) (E/C/F/TAF) was compared to the STR composed of E, C, F, and tenofovir disoproxil fumarate (TDF) (E/C/F/TDF) in 2 phase 3 studies in 1733 HIV-1 infected treatment-naïve adults. Superior efficacy of E/C/F/TAF compared to E/C/F/TDF was demonstrated at Week 144 with 84% treatment success compared to 80%, respectively, along with significantly better outcomes of bone and renal safety...
April 2, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29573320/efficacy-and-tolerability-of-lamivudine-plus-dolutegravir-as-a-switch-strategy-in-a-multicentre-cohort-of-patients-with-suppressed-hiv-1-replication
#3
A Borghetti, G Baldin, F Lombardi, A Ciccullo, A Capetti, S Rusconi, G Sterrantino, A Latini, M V Cossu, R Gagliardini, A De Luca, S Di Giambenedetto
OBJECTIVES: We evaluated the efficacy and tolerability of lamivudine + dolutegravir in a cohort of HIV-1 infected, treatment-experienced patients with undetectable HIV-RNA. METHODS: Time to treatment discontinuation (TD) and virological failure (VF) and their predictors were assessed in a multicenter cohort of HIV-1 infected patients, starting lamivudine + dolutegravir after reaching viral suppression. Secondary objective was the evaluation of changes in lipid profile, renal and immunological functions at week 48...
March 24, 2018: HIV Medicine
https://www.readbyqxmd.com/read/29568552/prevalence-and-factors-associated-with-renal-dysfunction-in-patients-on-tenofovir-disoproxil-fumarate-based-antiretroviral-regimens-for-hiv-infection-in-southern-india
#4
EDITORIAL
Nagalingeswaran Kumarasamy, Sruthi Sundaram, Selvamuthu Poongulali, Chandrasekaran Ezhilarasi, Ambrose Pradeep, Devaraj Chitra
Objectives: Tenofovir disoproxil fumarate (TDF) is a nucleotide reverse transcriptase inhibitor commonly used in the treatment of HIV infection. This retrospective study aims to establish the prevalence of abnormal renal function among patients with HIV receiving TDF, and to investigate the risks for TDF-related renal dysfunction in this population. Methods: Patients at the YRGCARE Medical Centre, Voluntary Health Services, receiving TDF-containing antiretroviral (ART) regimens between January 2002 and March 2017, were assessed for renal dysfunction using creatinine level and eGFR (DAIDS/NIH) during continuum of care...
January 1, 2018: Journal of Virus Eradication
https://www.readbyqxmd.com/read/29528852/fixed-dose-darunavir-boosted-with-cobicistat-combined-with-emtricitabine-and-tenofovir-alafenamide-fumarate
#5
Muge Cevik, Chloe Orkin
PURPOSE OF REVIEW: In an era when virological efficacy approaches 100%, novel antiretroviral (ARV) therapies must deliver better tolerability, safety, and convenient coformulated regimens. We review the phase II and III clinical data on the fixed dose combination (FDC) darunavir (DRV) 800mg / cobicistat (COBI/C) 150 mg / emtricitabine (F/FTC) 200 mg / tenofovir alafenamide fumarate (TAF) 10mg (D/C/F/TAF) for the treatment of HIV-1 infection. RECENT FINDINGS: In an exploratory phase II study, D/C/F/TAF FDC demonstrated similar virological efficacy to darunavir/cobicistat FDC + F /tenofovir disoproxil fumarate (TDF) FDC in treatment-naive HIV-1-infected individuals with favorable bone and renal outcomes...
March 9, 2018: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/29500080/-nephrotoxicity-of-antiretrovirals-other-than-tenofovir
#6
Christopher Loens, Sabine Amet, Corinne Isnard-Bagnis, Gilbert Deray, Jérôme Tourret
The remarkable improvement of the outcome of HIV infection came with the price of substantial toxicity of some antiretrovirals. The first molecules used to treat HIV included an important nephrotoxicity. Zalcitabine, stavudine and didanosine can induce severe lactic acidosis. Lactate production is enhanced and the renal capacity to regulate pH is overwhelmed. However, this side effect is not due to a direct dysfunction of the kidneys. Zalcitabine was withdrawn from the market because of this risk. Indinavir, a protease inhibitor, is soluble only in very acidic solutions...
February 27, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29466917/cure-of-chronic-hepatitis-c-virus-infection-in-an-hiv-coinfected-patient-with-multiple-comorbidities-and-drug-interaction-challenges
#7
Hortensia Álvarez, Ana Mariño, Nieves Valcarce, Saye Khoo, Sanjay Bhagani, Jonathan Schapiro, Josep M Llibre
Curing hepatitis C virus (HCV) infection in patients harbouring multiple severe comorbidities is a medical challenge. Evidence-based data are lacking regarding HCV treatment with direct-acting antiviral regimens in particular populations of HCV/HIV-coinfected patients with cirrhosis and chronic kidney disease on haemodialysis. Here, we present the HCV treatment challenges facing a patient with HIV coinfection, prior failure of both HIV-1 and HCV therapy, cirrhosis, end-stage renal failure on haemodialysis, as well as management of drug-drug interactions, especially given the need to receive long-term amiodarone therapy...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29380288/ledipasvir-sofosbuvir-a-review-in-chronic-hepatitis-c
#8
Lesley J Scott
Oral once-daily, fixed-dose, ledipasvir/sofosbuvir (Harvoni® ) [± ribavirin] is approved in several countries for the treatment of chronic hepatitis C (CHC) in adults and adolescents aged 12 to < 18 years, with direct-acting antiviral (DAA) regimens resulting in a paradigm shift in the treatment of the disease. In the clinical trial and/or clinical practice setting, ledipasvir/sofosbuvir (± ribavirin) was associated with high sustained virological response rates 12 weeks post-treatment (SVR12) in treatment-naive and -experienced adults and adolescents with chronic hepatitis C virus (HCV) genotype (GT) 1 infection, including in those with compensated cirrhosis or who were co-infected with HIV...
February 2018: Drugs
https://www.readbyqxmd.com/read/29302827/colonic-perforation-due-to-severe-cytomegalovirus-disease-in-granulomatosis-with-polyangiitis-after-immunosuppression
#9
REVIEW
Alessandra Soriano, Nazareno Smerieri, Stefano Bonilauri, Loredana De Marco, Alberto Cavazza, Carlo Salvarani
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients...
January 4, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29299949/hiv-aids-related-hyponatremia-an-old-but-still-serious-problem
#10
Zhanjun Shu, Zimeng Tian, Jinglin Chen, Jianping Ma, Aihemaiti Abudureyimu, Qianqian Qian, Li Zhuo
Hyponatremia is the most common electrolyte disorder in hospitals. Many medical illnesses, including congestive heart failure, liver failure, renal failure and pneumonia, may be associated with hyponatremia. In addition, hyponatremia in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) was first reported in 1993. The evidence suggests that severe hyponatremia is associated with increased morbidity and mortality in human immunodeficiency virus (HIV)/AIDS patients; however, the incidence of hyponatremic syndrome in HIV/AIDS patients remains very high in clinical practice, as almost 40% of HIV/AIDS inpatients in Xinjiang, a developing region of China, are hyponatremic...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29251606/issues-in-access-to-end-of-life-care-in-low-resource-areas
#11
Yogesh Jain, Gajanan Phutke
Even though 1% of people require palliative and end-of-life care in low-resource situations, it remains an uncharted arena. Yet it is as important as curative care to alleviate suffering. Palliative care is not only a need in cancer and HIV disease; but is needed in a diverse group of illnesses ranging from tuberculosis, renal failures, paraplegia to chronic lung diseases. In a lower resource setting, the gaps in palliation may be the need for more technology and interventions or more healthcare professionals...
January 2018: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/29158864/-chronic-kidney-disease-associated-factors-etiologies-clinical-and-biological-parameters-at-lubumbashi-city-in-democratic-republic-of-congo
#12
Serge Muleka Ngoie, Philippe Mulenga, Olivier Mukuku, Christian Ngama Kakisingi, Cédrick Milindi Sangwa, Pascal Tshimwang Nawej, Claude Mulumba Mwamba, Dophra Nkulu Ngoy, Faustin Wa Pa Manda Muteta
Introduction: Chronic kidney disease is fast becoming a worldwide public health problem due to the increase of hypertension and diabetes mellitus, its main risk factors. In countries like DRC where majority of population are in the low income bracket, very few studies about this disease, usually diagnosed at a very advanced stage have been conducted. As a result of such, cases are not always properly taken care of and managed. Methods: We opted for a descriptive cross-sectional study and it was conducted during the period from July 2014 to July 2015 at CMDC dialysis service...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29109879/legionnaires-disease-complicated-with-rhabdomyolysis-and-acute-kidney-injury-in-an-aids-patient
#13
Karan Seegobin, Satish Maharaj, Cherisse Baldeo, Julio Perez Downes, Pramod Reddy
Objective: To present a case of an uncommon triad of Legionella pneumonia, rhabdomyolysis, and renal failure, with review of the relevant literature. Case: A 51-year-old with a history of human immunodeficiency virus (HIV), chronic obstructive pulmonary disease (COPD), and hypertension presented with fever, cough, and shortness of breath over four days. Chest X-ray showed consolidation in left lower lung field; urine was positive for Legionella antigen and myoglobin; creatine kinase was 51092U/L; creatine was 6...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29103079/effectiveness-of-kidney-transplantation-in-hiv-infected-recipients-under-combination-antiretroviral-therapy-a-single-cohort-experience-brescia-northern-italy
#14
Ilaria Izzo, Salvatore Casari, Nicola Bossini, Maria Antonia Forleo, Silvio Sandrini, Emanuele Focà, Nigritella Brianese, Giulia Zambolin, Claudia Chirico, Giovanni Cancarini, Francesco Castelli
PURPOSE: Kidney transplantation was recently introduced for the treatment of end stage renal disease (ESRD) in HIV-infected patients. We report the results of the first 28 procedures at our centre. METHODS: A retrospective study was conducted on HIV-infected patients evaluated for kidney transplantation between January 2005 and October 2016. Patients were selected and monitored by the kidney transplantation and infectious diseases teams, according to the national protocol...
February 2018: Infection
https://www.readbyqxmd.com/read/29021661/successful-renal-transplant-in-a-pediatric-patient-with-hiv-associated-nephropathy
#15
Anshuman Sood, David Hakim, Abhishek Bose
HIV-associated nephropathy (HIVAN) is a pathological state of the kidneys due to longstanding, uncontrolled HIV infection. With the rapid progression of HIVAN to end-stage kidney failure, there is a significant potential for renal transplantation to improve the quality of life in these patients. Numerous studies have been recently published documenting renal transplantation as a primary treatment for HIVAN. With the use of highly active antiretroviral therapy, allograft and patient survival rates of HIV-infected persons are nearly identical to those who are HIV negative...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28931369/acute-hiv-infection-presenting-as-hemophagocytic-lymphohistiocytosis-case-report-and-review-of-the-literature
#16
REVIEW
Farheen Manji, Evan Wilson, Etienne Mahe, John Gill, John Conly
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is an uncommon systemic inflammatory condition that can result from infections, autoimmune diseases and malignancies. It is a rarely reported life threatening complication of an acute HIV infection, with only ten documented case reports per our literature search. We present a case of HLH secondary to acute HIV infection with a negative HIV antibody-based assay and high plasma viral load. CASE PRESENTATION: A 45 year old male with a past medical history of well controlled hypertension presented with fever, dizziness and non-bloody diarrhea...
September 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28852479/collapsing-glomerulopathy-a-30-year-perspective-and-single-large-center-experience
#17
L Nicholas Cossey, Christopher P Larsen, Helen Liapis
Collapsing glomerulopathy (CGP) is a pattern of kidney injury seen on renal biopsy with multiple associations and etiologies. It is most commonly described in African-Americans and others with recent African ancestry. The disease is rapidly progressive and often presents with abrupt onset of renal failure and nephrotic-range proteinuria. Since its description 30 years ago, this entity has transformed from a morphologic diagnosis typically seen in the setting of HIV infection to a complicated diagnosis with numerous etiologies, many of which are associated with underlying apolipoprotein L1 (APOL1)-risk variants or other genetic disorders...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28774413/management-of-hepatitis-b-in-special-populations
#18
REVIEW
Kali Zhou, Norah Terrault
Special populations infected with chronic HBV include those with decompensated cirrhosis, coinfections (HIV, HCV, HDV), hemodialysis and renal failure, immunosuppressed including transplant patients, children and women in pregnancy. These populations differ in their natural history and risk for liver-related complications, the indications for anti-HBV therapy as well as the recommendations regarding the HBV drugs used, duration of therapy and anticipated endpoints. Reflecting the special populations with substantive changes in management in recent years, this review focuses on HBV-HIV coinfected patients, immunosuppressed patients at risk for reactivation, liver transplant recipients and pregnant women...
June 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28753040/evaluation-of-sofosbuvir-velpatasvir-plus-voxilaprevir-as-fixed-dose-co-formulation-for-treating-hepatitis-c
#19
REVIEW
Vicente Soriano, Laura Benítez-Gutiérrez, Ana Arias, Itziar Carrasco, Pablo Barreiro, Jose M Peña, Carmen de Mendoza
The fixed-dose combination of three direct-acting antivirals (DAA), namely sofosbuvir, velpatasvir and voxilaprevir is the first pangenotypic, single tablet regimen developed for the treatment of HCV infection. Areas covered: The pharmacokinetics, pharmacodynamics, efficacy and safety of the co-formulation are reviewed. Information on drug absorption, distribution, metabolism and excretion of each of the three antivirals is evaluated. Finally, antiviral activity, safety and potential for drug interactions in phase II/III clinical trials in distinct patient populations are discussed...
September 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28737291/nucleoside-reverse-transcriptase-inhibitor-reducing-strategies-in-hiv-treatment-assessing-the-evidence
#20
REVIEW
C Orkin, J M Llibre, S Gallien, A Antinori, Gmn Behrens, A Carr
Antiretroviral (ARV) therapy, comprising a backbone of two nucleos(t)ide reverse transcriptase inhibitors (NRTIs) plus another ARV, is the recognized standard of care (SOC), which has helped extend life expectancy in people living with HIV. In a quest to reduce lifelong drug exposure and minimize or avoid the toxicity of NRTIs, "NRTI-reducing" regimens have been investigated. This descriptive review assessing the results of NRTI-reducing strategies from the largest randomized trials focuses on virological efficacy, resistance, regimen safety (in terms of bone mineral density, renal function, lipids and central nervous system function) and simplicity...
January 2018: HIV Medicine
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