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https://www.readbyqxmd.com/read/28441147/can-the-generic-antiretroviral-industry-support-access-to-a-universal-antiretroviral-regimen
#1
Carolyn D Amole, Caroline Middlecote, Vineet R Prabhu, N Kumarasamy
PURPOSE OF REVIEW: The generic antiretroviral (ARV) industry played a critical role in the massive scale-up of HIV treatment in low-income and middle-income countries since 2000. As the global community looks ahead to a universal antiretroviral regimen, this article considers the industry's role in supporting universal access to affordable, simpler, more durable, and tolerable HIV treatment regimens. RECENT FINDINGS: Generic manufacturers made treatment scale-up in low-income and middle-income countries possible through reducing prices, combining molecules from different originator companies to develop optimal fixed-dose combinations, and investing in production capacity to meet escalating demand...
April 24, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28440036/a-tale-of-two-countries-all-cause-mortality-among-people-living-with-hiv-and-receiving-combination-antiretroviral-therapy-in-the-uk-and-canada
#2
S Patterson, S Jose, H Samji, A Cescon, E Ding, J Zhu, J Anderson, A N Burchell, C Cooper, T Hill, M Hull, M B Klein, M Loutfy, F Martin, N Machouf, Jsg Montaner, M Nelson, J Raboud, S B Rourke, C Tsoukas, R S Hogg, C Sabin
OBJECTIVES: We sought to compare all-cause mortality of people living with HIV and accessing care in Canada and the UK. METHODS: Individuals from the Canadian Observational Cohort (CANOC) collaboration and UK Collaborative HIV Cohort (UK CHIC) study who were aged ≥ 18 years, had initiated antiretroviral therapy (ART) for the first time between 2000 and 2012 and who had acquired HIV through sexual transmission were included in the analysis. Cox regression was used to investigate the difference in mortality risk between the two cohort collaborations, accounting for loss to follow-up as a competing risk...
April 24, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28440019/cervical-cancer-risk-and-impact-of-pap-based-screening-in-hiv-positive-women-on-antiretroviral-therapy-in-johannesburg-south-africa
#3
Eliane Rohner, Mazvita Sengayi, Bridgette Goeieman, Pamela Michelow, Cindy Firnhaber, Mhairi Maskew, Julia Bohlius
Data on invasive cervical cancer (ICC) incidence in HIV-positive women and the effect of cervical cancer screening in sub-Saharan Africa are scarce. We estimated i) ICC incidence rates in women (≥18 years) who initiated antiretroviral therapy (ART) at the Themba Lethu Clinic (TLC) in Johannesburg, South Africa, between 2004-2011; and ii) the effect of a Pap-based screening program. We included 10,640 women; median age at ART initiation: 35 years (interquartile range [IQR] 30-42), median CD4 count at ART initiation: 113 cells/µl (IQR 46-184)...
April 25, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28436334/acute-hiv-infection-advances-in-mechanisms-and-prophylactic-therapeutic-management
#4
Muhammad Imran Qadir, Amman Abid
Human infection by HIV is spreading rapidly. The spread of the virus is generally organized and transmission can be rectal, oral, or penile. Several types of cells are susceptible to viral invasion. The appearance of symptoms during infection can vary, but the presence of the virus can be confirmed by testing for the antigen p24. The ELISA test is used to detect viral p24 antigen and antiviral antibodies. This technique is approved for the purposes of clinical practice. Highly active antiretroviral therapy is usually a costly and lengthy treatment for HIV infection...
2017: Critical Reviews in Eukaryotic Gene Expression
https://www.readbyqxmd.com/read/28435691/interrupting-antiretroviral-treatment-in-hiv-cure-research-scientific-and-ethical-considerations
#5
EDITORIAL
Samual A Garner, Stuart Rennie, Jintanat Ananworanich, Karine Dube, David M Margolis, Jeremy Sugarman, Randall Tressler, Adam Gilbertson, Liza Dawson
Over the past several years there has been intense activity directed at the possibility of achieving remission or eradication of HIV infection. Current assays for the measurement of latent HIV are insufficient to demonstrate complete clearance of replication-competent HIV. Therefore, the ultimate test for assessing whether investigational interventions have resulted in HIV remission or eradication is to interrupt standard antiretroviral therapy (ART) in a carefully controlled clinical trial setting. These procedures, known as analytic treatment interruptions (ATIs), raise important scientific and ethical questions...
April 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#6
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28434169/inflammation-immune-activation-and-antiretroviral-therapy-in-hiv
#7
REVIEW
Corrilynn O Hileman, Nicholas T Funderburg
PURPOSE OF REVIEW: This review focuses on the differential effects of contemporary antiretrovirals on systemic inflammation as heightened immune activation is linked to important co-morbidities and mortality with HIV infection. RECENT FINDINGS: Antiretroviral therapy (ART) reduces dramatically systemic inflammation and immune activation, but not to levels synchronous with HIV-uninfected populations. In one ART initiation trial, integrase inhibitors appear to reduce inflammation to a greater degree than non-nucleoside reverse transcriptase inhibitors (NNRTIs); however, it is not clear that there are beneficial effects on inflammation resulting from treatment with integrase inhibitors compared to PIs, between PIs and NNRTIs, between specific nucleoside reverse transcriptase inhibitors, or with maraviroc in ART-naïve patients...
April 22, 2017: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/28433855/the-electrophysiology-of-neurohiv-a-systematic-review-of-eeg-and-meg-studies-in-people-with-hiv-infection-since-the-advent-of-highly-active-antiretroviral-therapy
#8
Ana Lucia Fernández-Cruz, Lesley K Fellows
OBJECTIVE: The Human Immunodeficiency Virus (HIV) has an impact on the brain, even when the infection is well-controlled with modern highly-active antiretroviral therapy (HAART). While dementia is rare in those on HAART, milder cognitive impairment is common. The causes, patterns, and evolution of brain dysfunction in people living with HIV remain uncertain. We evaluate whether electrophysiological methods provide informative measures of brain dysfunction in this population. METHODS: A systematic literature search identified studies that used EEG or MEG to evaluate persons living with HIV published between 1996 (when HAART became available) and 2016...
March 31, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28429679/mycobacterium-avium-complex-disease
#9
Charles L Daley
Despite the ubiqitous nature of Mycobacterium avium complex (MAC) organisms in the environment, relatively few of those who are infected develop disease. Thus, some degree of susceptibility due to either underlying lung disease or immunosuppression is required. The frequency of pulmonary MAC disease is increasing in many areas, and the exact reasons are unknown. Isolation of MAC from a respiratory specimen does not necessarily mean that treatment is required, as the decision to treatment requires the synthesis of clinical, radiographic, and microbiologic information as well as a weighing of the risks and benefits for the individual patient...
April 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28427339/cardiovascular-disease-risk-among-chinese-antiretroviral-na%C3%A3-ve-adults-with-advanced-hiv-disease
#10
Fuping Guo, Evelyn Hsieh, Wei Lv, Yang Han, Jing Xie, Yanling Li, Xiaojing Song, Taisheng Li
BACKGROUND: Cardiovascular disease (CVD) is an important cause of mortality among HIV-infected patients, however little is known about the burden of CVD among this population in Asia. We sought to quantify prevalence of CVD risk factors, 10-year CVD risk, and patterns of CVD risk factor treatment in a group of individuals with HIV in China. METHODS: We retrospectively analyzed baseline data from treatment-naïve HIV-infected adults enrolled in two multicenter clinical trials in China...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28426825/levels-of-hiv-1-persistence-on-antiretroviral-therapy-are-not-associated-with-markers-of-inflammation-or-activation
#11
Rajesh T Gandhi, Deborah K McMahon, Ronald J Bosch, Christina M Lalama, Joshua C Cyktor, Bernard J Macatangay, Charles R Rinaldo, Sharon A Riddler, Evelyn Hogg, Catherine Godfrey, Ann C Collier, Joseph J Eron, John W Mellors
Antiretroviral therapy (ART) reduces levels of HIV-1 and immune activation but both can persist despite clinically effective ART. The relationships among pre-ART and on-ART levels of HIV-1 and activation are incompletely understood, in part because prior studies have been small or cross-sectional. To address these limitations, we evaluated measures of HIV-1 persistence, inflammation, T cell activation and T cell cycling in a longitudinal cohort of 101 participants who initiated ART and had well-documented sustained suppression of plasma viremia for a median of 7 years...
April 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28426819/virological-success-after-12-and-24-months-of-antiretroviral-therapy-in-sub-saharan-africa-comparing-results-of-trials-cohorts-and-cross-sectional-studies-using-a-systematic-review-and-meta-analysis
#12
Fabien Taieb, Yoann Madec, Amandine Cournil, Eric Delaporte
BACKGROUND: UNAIDS recently defined the 90-90-90 target as a way to end the HIV epidemic. However, the proportion of virological success following antiretroviral therapy (ART) may not be as high as the anticipated 90%, and may in fact be highly heterogeneous. We aimed to describe the proportion of virological success in sub-Saharan Africa and to identify factors associated with the proportion of virological success. METHODS: We performed a systematic review and meta-analysis focusing on the proportion of patients in sub-Saharan Africa who demonstrate virological success at 12 and 24 months since ART initiation, as well as at 6 and 36 months, where possible...
2017: PloS One
https://www.readbyqxmd.com/read/28426533/hiv-dna-content-in-different-cd4-t-cell-subsets-correlates-with-cd4-cd8-ratio-or-length-of-efficient-treatment
#13
Lara Gibellini, Simone Pecorini, Sara de Biasi, Elena Bianchini, Margherita Digaetano, Marcello Pinti, Gianluca Carnevale, Vanni Borghi, Giovanni Guaraldi, Cristina Mussini, Andrea Cossarizza, Milena Nasi
OBJECTIVES: HIV establishes a latent infection at different degrees within naïve (TN) or central (TCM) and effector memory (TEM) CD4+ T cell. Studying patients in whom HIV production was suppressed by combined antiretroviral therapy (cART), our main aim was to find which factors are related or can influence intracellular viral reservoir in different CD4+ T cell subsets. METHODS: We enrolled 32 HIV+ patients successfully treated for > 2 years, with a CD4+ T cell count > 500 cells/μL and plasma viremia undetectable from at least one year...
April 19, 2017: AIDS
https://www.readbyqxmd.com/read/28426185/integrated-hiv-care-and-service-engagement-among-people-living-with-hiv-who-use-drugs-in-a-setting-with-a-community-wide-treatment-as-prevention-initiative-a-qualitative-study-in-vancouver-canada
#14
Alexandra B Collins, Surita Parashar, Robert S Hogg, Saranee Fernando, Catherine Worthington, Patrick McDougall, Rosalind Baltzer Turje, Ryan McNeil
INTRODUCTION: Social-structural inequities impede access to, and retention in, HIV care among structurally vulnerable people living with HIV (PLHIV) who use drugs. The resulting disparities in HIV-related outcomes among PLHIV who use drugs pose barriers to the optimization of HIV treatment as prevention (TasP) initiatives. We undertook this study to examine engagement with, and impacts of, an integrated HIV care services model tailored to the needs of PLHIV who use drugs in Vancouver, Canada - a setting with a community-wide TasP initiative...
February 3, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28424561/response-by-gender-of-hiv-1-infected-subjects-treated-with-abacavir-lamivudine-plus-atazanavir-with-or-without-ritonavir-for-144-weeks
#15
Kathleen E Squires, Benjamin Young, Lizette Santiago, Robin H Dretler, Sharon L Walmsley, Henry H Zhao, Gary E Pakes, Lisa L Ross, Mark S Shaefer
PURPOSE: The 144-week results of the open-label, multicenter Atazanavir/Ritonavir Induction with Epzicom Study (ARIES) were stratified by gender to compare treatment responses. METHODS: A total of 369 HIV-infected, antiretroviral-naïve subjects receiving once-daily abacavir/lamivudine + atazanavir/ritonavir (ATV/r) whose HIV-1 RNA was <50 copies/mL by week 30 were randomized 1:1 at week 36 to maintain or discontinue ritonavir for 108 subsequent weeks. Between- and within-treatment gender-related efficacy and safety differences were analyzed...
2017: HIV/AIDS: Research and Palliative Care
https://www.readbyqxmd.com/read/28424453/comorbid-human-immunodeficiency-virus-hiv-and-muscle-specific-kinase-musk-myasthenia-gravis-a-case-report-and-literature-review
#16
Michael Sherpa, Ravi K Metai, Viki Kumar, Tinu Hirachan, Kawser U Ahmed, Sharon J Atkinson
BACKGROUND HIV infections with concomitant immunologically-mediated disorders have been frequently described but there has been little research on the association between HIV and myasthenia gravis. MuSK myasthenia gravis coexisting with HIV is an even a rarer entity and can occur as a part of immune restoration disease. We report the case of a patient with asymptomatic HIV infection who presented with new-onset MuSK myasthenia gravis. CASE REPORT A 44-year-old African-American woman with HIV since 2004 and on highly active antiretroviral therapy (HAART) presented to the ED with complains of double vision and difficulty swallowing for 2 weeks...
April 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28424436/-dyslipidemia-and-cardiovascular-risk-assessment-in-hiv-positive-patients
#17
Serhat Uysal, Mürşide Tuncel Başoğlu, Bahar Boydak, Deniz Gökengin
OBJECTIVE: Dyslipidemia is a major complication of antiretroviral treatment. Aim of the present study was to screen baseline lipid levels and cardiovascular disease risk in HIV-positive patients and analyze change in those parameters after initiation of antiretroviral treatment (ART). METHODS: HIV-positive patients who presented at our clinic between April 2011 and August 2012 were included. Study included 19 female (22.1%) and 67 male (77.9%) patients (mean age 39...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28423949/intranasal-chitosan-g-hp%C3%AE-cd-nanoparticles-of-efavirenz-for-the-cns-targeting
#18
Aarti Belgamwar, Shagufta Khan, Pramod Yeole
Incompetence of antiretrovirals (ARV) in complete eradication of HIV from the CNS is the biggest issue in neuro-AIDS treatment. The ineffectiveness is largely due to the poor penetration of ARV. Hence, the present study is attempted to enhance the CNS uptake of efavirenz (EFV) by designing intranasal EFV nanoparticles (EFV-NPs). EFV-NPs were fabricated using chitosan-g-HPβCD by ionic gelation method and optimized using quadratic response surface methodology (RSM) employing two-factor, five-level circumscribed central composite design...
April 19, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28422610/joint-bent-cable-tobit-models-for-longitudinal-and-time-to-event-data
#19
Getachew A Dagne
In this article, we show how to estimate a transition period for the evolvement of drug resistance to antiretroviral (ARV) drug or other related treatments in the framework of developing a Bayesian method for jointly analyzing time to event and longitudinal data. For HIV/AIDS longitudinal data, developmental trajectories of viral loads tend to show a gradual change from a declining trend after initiation of treatment to an increasing trend without an abrupt change. Such characteristics of trajectories are also associated with a time-to-event process...
April 19, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/28421118/pattern-of-traditional-medicine-utilization-among-hiv-aids-patients-on-antiretroviral-therapy-at-a-university-hospital-in-northwestern-ethiopia-a-cross-sectional-study
#20
Abyot Endale Gurmu, Fitsum Sebsibe Teni, Wondmagegn Tamiru Tadesse
The objective of this study was to assess traditional, complementary, and alternative medicine (TCAM) utilization pattern among HIV/AIDS patients on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital. Materials and Methods. Data on sociodemographic profile and clinical and TCAM utilization were collected using a structured, pretested questionnaire from April 01 to May 28, 2014, through interviews with patients. Data on CD4 count, HIV stage, and ART regimen were collected from patient records...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
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