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Antiretroviral therapy

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https://www.readbyqxmd.com/read/29346443/exposure-to-previous-cart-is-associated-with-significant-liver-fibrosis-and-cirrhosis-in-human-immunodeficiency-virus-infected-patients
#1
Evrim Anadol, Kristina Lust, Christoph Boesecke, Carolynne Schwarze-Zander, Raphael Mohr, Jan-Christian Wasmuth, Jürgen Kurt Rockstroh, Jonel Trebicka
INTRODUCTION: Combined antiretroviral therapy (cART) has improved survival in HIV-patients. While the first antiretrovirals, which became available in particular D-drugs (especially didanosine and stavudine) and unboosted protease inhibitors, may impair liver function, the modern cART seems to decrease liver fibrosis. This study assessed the influence of exposure to previous antiretrovirals on liver fibrosis in HIV-infected patients. METHODS: This observational cross-sectional single-center study recruited 333 HIV patients and assessed liver fibrosis using transient elastography (TE)...
2018: PloS One
https://www.readbyqxmd.com/read/29346270/resistance-to-hiv-integrase-inhibitors-about-r263k-and-e157q-mutations
#2
REVIEW
Charlotte Charpentier, Diane Descamps
The use of integrase inhibitors (INI) is increasing in antiretroviral therapies (ART) and INI are not all equal regarding genetic barrier to resistance. The aim of this manuscript was to review main in vivo and in vitro knowledge about two particular integrase resistance-associated mutations: R263K and E157Q. The R263K mutation was the first mutation rarely found selected at time of virological failure in patients failing a first-line dolutegravir-based treatment. Further in vitro studies on R263K mutants showed a moderate increase in phenotypic resistance level and a drastic reduction in viral replicative capacity...
January 18, 2018: Viruses
https://www.readbyqxmd.com/read/29346185/higher-art-adherence-is-associated-with-lower-systemic-inflammation-in-treatment-na%C3%A3-ve-ugandans-who-achieve-virologic-suppression
#3
Jose R Castillo-Mancilla, Mary Morrow, Yap Boum, Helen Byakwaga, Jessica E Haberer, Jeffrey N Martin, David Bangsberg, Samantha Mawhinney, Nicholas Musinguzi, Yong Huang, Russell P Tracy, Tricia H Burdo, Kenneth Williams, Conrad Muzoora, Peter W Hunt, Mark J Siedner
BACKGROUND: Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence and inflammation in Ugandans living with HIV who were predominantly receiving nevirapine-based ART with a thymidine analog backbone and were virologically suppressed by conventional assays. METHODS: Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, the kynurenine/tryptophan (K/T) ratio, in addition to CD8 T-cell activation, were measured at baseline and 6 months after ART initiation in treatment-naïve adults who achieved an undetectable plasma HIV RNA (<400 copies/mL) at their 6-month visit...
January 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29346184/synergistic-impact-of-training-followed-by-on-site-support-on-hiv-clinical-practice-a-mixed-design-study-in-uganda-with-pre-post-and-cluster-randomized-trial-components
#4
Sarah Burnett, Norbert Mubiru, Peace Imani, Martin K Mbonye, Leigh Fisher, Robert Colebunders, Yukari C Manabe, Marcia R Weaver
BACKGROUND: Task-shifting can expand antiretroviral therapy access, but little is known about effective approaches to improve clinical practice among mid-level practitioners' (MLP) such as clinical officers, nurses, and midwives. The Integrated Infectious Diseases Capacity-Building Evaluation compared training alone to training combined with on-site support (OSS). METHODS: Two MLP each from 36 health facilities attended the five-week Integrated Management of Infectious Disease training...
January 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29345598/dolutegravir-related-neurological-adverse-events-a-case-report-of-successful-management-with-therapeutic-drug-monitoring
#5
Francois Parant, Patrick Miailhes, Florence Brunel, Marie-Claude Gagnieu
Dolutegravir (DTG), a highly effective second-generation HIV integrase inhibitor with high genetic barrier to resistance, has shown excellent tolerability and safety profiles in clinical trials. However, some patients may experience neurological or psychiatric adverse effects leading to DTG discontinuation. This report describes a case of 29-year-old woman who developed neurological adverse events after starting the DTG-based antiretroviral therapy. Serum DTG concentrations were supra-therapeutic which has required a dosing interval adjustment...
January 16, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29343582/hiv-replication-and-latency-in-a-humanized-nsg-mouse-model-during-suppressive-oral-combinational-art
#6
Sangeetha Satheesan, Haitang Li, John C Burnett, Mayumi Takahashi, Shasha Li, Shiny Xiaqin Wu, Timothy W Synold, John J Rossi, Jiehua Zhou
Although current combinatorial antiretroviral therapy (cART) is therapeutically effective in the majority of HIV patients, interruption of therapy can cause a rapid rebound in viremia, demonstrating the existence of a stable reservoir of latently infected cells. HIV latency is therefore considered a primary barrier to HIV eradication. Identifying, quantifying, and purging the HIV reservoir is crucial to effectively curing patients and relieving them from the lifelong requirement for therapy. Latently infected transformed cell models have been used to investigate HIV latency; however, they cannot accurately represent the quiescent cellular environment of primary latently infected cells in vivo...
January 17, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29343578/a-new-quinoline-brd4-inhibitor-targets-a-distinct-latent-hiv-1-reservoir-for-re-activation-from-other-shock-drugs
#7
Erik Abner, Mateusz Stoszko, Lei Zeng, Heng-Chang Chen, Andrea Izquierdo-Bouldstridge, Tsuyoshi Konuma, Eduard Zorita, Elisa Fanunza, Qiang Zhang, Tokameh Mahmoudi, Ming-Ming Zhou, Guillaume J Filion, Albert Jordan
Upon HIV-1 infection, a reservoir of latently infected resting T cells prevents the eradication of the virus from patients. To achieve complete depletion, the existing virus-suppressing antiretroviral therapy must be combined with drugs that reactivate the dormant viruses. We previously described a novel chemical scaffold compound, MMQO (8-methoxy-6-methylquinolin-4-ol) that is able to reactivate viral transcription in several models of HIV latency including J-Lat cells through an unknown mechanism. MMQO potentiates the activity of known latency-reversing agents (LRAs) or 'shock' drugs such as PKC agonists or HDAC inhibitors...
January 17, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29343268/time-homogeneous-markov-process-for-hiv-aids-progression-under-a-combination-treatment-therapy-cohort-study-south-africa
#8
Claris Shoko, Delson Chikobvu
BACKGROUND: As HIV enters the human body, its main target is the CD4 cell which it turns into a factory that produces millions of other HIV particles. These HIV particles target new CD4 cells resulting in the progression of HIV infection to AIDS. A continuous depletion of CD4 cells results in opportunistic infections, for example tuberculosis (TB). The purpose of this study is to model and describe the progression of HIV/AIDS disease in an individual on antiretroviral therapy (ART) follow up using a continuous time homogeneous Markov process...
January 18, 2018: Theoretical Biology & Medical Modelling
https://www.readbyqxmd.com/read/29343165/hiv-and-renal-disease-a-contemporary-review
#9
Joana Gameiro, Sofia Jorge, José A Lopes
The presence of human immunodeficiency virus (HIV)-related kidney disease is an important cause of mortality and morbidity. HIV infection induces renal injury by direct cytotoxicity or immune complex-mediated glomerulonephritis in patients with genetic susceptibility factors. In the last decades, with the development and diffusion of combination antiretroviral therapy, which has prolonged patient survival, there has been a shift in the spectrum of renal diseases in HIV-infected patients, with the decrease of glomerular diseases and increase in the role of nephrotoxicity and co-morbidities...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29343078/quality-of-life-among-hiv-infected-individuals-failing-first-line-antiretroviral-therapy-in-resource-limited-settings
#10
Thiago S Torres, Linda J Harrison, Alberto M La Rosa, Jeffrey A Lavenberg, Lu Zheng, Steven A Safren, McNeil Ngongondo, Selvamuthu Poongulali, Mitch Matoga, Wadzanai Samaneka, Ann C Collier, Michael D Hughes
We evaluated health-related quality of life (QoL) in HIV infection participants with virologic failure (VF) on first-line antiretroviral therapy (ART) in 9 resource-limited settings (RLS). ACTG SF-21 was completed by 512 participants at A5273 study entry; 8 domains assessed: general health perceptions (GHP), physical functioning (PF), role functioning (RF), social functioning (SF), cognitive functioning (CF), pain (P), mental health (MH), and energy/fatigue (E/F); each was scored between 0 (worst) to 100 (best)...
January 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29342259/false-starts-in-test-and-start-a-qualitative-study-of-reasons-for-delayed-antiretroviral-therapy-in-swaziland
#11
Christopher Pell, Eva Vernooij, Nelisiwe Masilela, Njabulo Simelane, Fortunate Shabalala, Ria Reis
Background: Test and start, antiretroviral therapy (ART) for all HIV-positive individuals, is a WHO-recommended treatment guideline. In Swaziland, test and start has been evaluated through the MaxART implementation study. This article examines why, in MaxART, some newly diagnosed HIV-positive clients delayed initiating ART. Methods: Thirteen HIV-positive clients who delayed ART for ≥90 d after testing were identified from the MaxART study database and interviewed...
January 12, 2018: International Health
https://www.readbyqxmd.com/read/29342180/increased-prevalence-of-pregnancy-and-comparative-risk-of-program-attrition-among-individuals-starting-hiv-treatment-in-east-africa
#12
Charles B Holmes, Constantin T Yiannoutsos, Batya Elul, Elizabeth Bukusi, John Ssali, Andrew Kambugu, Beverly S Musick, Craig Cohen, Carolyn Williams, Lameck Diero, Nancy Padian, Kara K Wools-Kaloustian
BACKGROUND: The World Health Organization now recommends initiating all pregnant women on life-long antiretroviral therapy (ART), yet there is limited information about the characteristics and program outcomes of pregnant women already on ART in Africa. Our hypothesis was that pregnant women comprised an increasing proportion of those starting ART, and that sub-groups of these women were at higher risk for program attrition. METHODS AND FINDINGS: We used the International Epidemiology Databases to Evaluate AIDS- East Africa (IeDEA-EA) to conduct a retrospective cohort study including HIV care and treatment programs in Kenya, Uganda, and Tanzania...
2018: PloS One
https://www.readbyqxmd.com/read/29342172/driving-factors-of-retention-in-care-among-hiv-positive-msm-and-transwomen-in-indonesia-a-cross-sectional-study
#13
Adi Nugroho, Vicki Erasmus, Robert W S Coulter, Sushil Koirala, Oranuch Nampaisan, Wirastra Pamungkas, Jan Hendrik Richardus
Little is known about the prevalence of and factors that influence retention in HIV-related care among Indonesian men who have sex with men (MSM) and transgender women (transwomen, or waria in Indonesian term). Therefore, we explored the driving factors of retention in care among HIV-positive MSM and waria in Indonesia. This cross-sectional study involved 298 self-reported HIV-positive MSM (n = 165) and waria (n = 133). Participants were recruited using targeted sampling and interviewed using a structured questionnaire...
2018: PloS One
https://www.readbyqxmd.com/read/29341953/lethality-among-patients-with-hiv-aids-monitored-in-the-clinic-of-infectious-diseases-in-st-george-university-hospital-plovdiv-2010-2014
#14
Mariyana V Stoycheva, Nikolay T Vatev, Vania B Georgieva, Antonina P Dineva, Maria V Atanasova, Tatiana A Popova
BACKGROUND: The introduction of complex antiretroviral therapy has resulted in signifi cant decrease in the mortality rate of HIV positive patients, but it still remains unacceptably high, especially in some groups of patients. AIM: To investigate the death rate in patients with HIV/AIDS, lethality and mortality in co-infection, and the most common causes and predictors of fatal outcome, focused on early diagnosis and appropriate therapy. MATERIALS AND METHODS: The study included 53 deceased patients with HIV/AIDS, monitored at the Clinic of Infectious Diseases in St George University Hospital, Plovdiv between 01...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29338735/mental-health-service-utilization-is-associated-with-retention-in-care-among-persons-living-with-hiv-at-a-university-affiliated-hiv-clinic
#15
Lauren A Saag, Ashutosh R Tamhane, D Scott Batey, Michael J Mugavero, Ellen F Eaton
BACKGROUND: Mental health (MH) comorbidities reduce retention in care for persons living with HIV (PLWH) and are associated with poor health outcomes. Optimizing retention in primary care is vital, as poor retention is associated with delayed receipt of antiretroviral (ARV) therapy, ARV non-adherence, and poor health outcomes, including failure to suppress viral load, decreased CD4 counts, and clinically significant ARV drug resistance. We hypothesized that MH service utilization would be associated with improved retention in care for patients with HIV and MH comorbidities...
January 16, 2018: AIDS Research and Therapy
https://www.readbyqxmd.com/read/29338331/the-impact-of-hiv-diagnosis-on-length-of-hospital-stay-in-new%C3%A2-york-city-ny-usa
#16
Tawandra L Rowell-Cunsolo, Jianfang Liu, Yanhan Shen, Amber Britton, Elaine Larson
While hospitalizations among people living with human immunodeficiency virus (PLWH) have been elevated in the past compared to their uninfected counterparts, the introduction of antiretroviral therapy (ART) has resulted in great strides in controlling symptomatic infection. However, research largely overlooks important differences among HIV-infected individuals, primarily PLWH who are symptomatic versus those who are asymptomatic. We conducted a retrospective study assessing the length of hospital stay among 717,237 admissions from three hospitals in the New York City area...
January 17, 2018: AIDS Care
https://www.readbyqxmd.com/read/29338328/avoidance-meaning-and-grief-psychosocial-factors-influencing-engagement-in-hiv-care
#17
Georgia J Michlig, Ryan P Westergaard, Yukyan Lam, Azal Ahmadi, Gregory D Kirk, Andrew Genz, Jeanne Keruly, Heidi Hutton, Pamela J Surkan
Although the introduction of antiretroviral therapy has rendered HIV a chronic illness, inconsistent engagement in HIV care by key populations limits its public health impact. Poor engagement in care is especially prevalent among vulnerable populations with mental health and substance use disorders. Beyond structural and health system considerations, psychosocial factors may present challenges to sustained engagement. We conducted a qualitative study using in-depth interviews with 31 primarily African American, urban-based individuals, many with past or current drug use and mental disorders, living with HIV...
January 17, 2018: AIDS Care
https://www.readbyqxmd.com/read/29337702/changing-concepts-of-hiv-infection-and-renal-disease
#18
Jean Hou, Cynthia C Nast
PURPOSE OF REVIEW: Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) was identified as the major renal manifestation of HIV infection early in the HIV epidemic. However, HIV infection now is associated with a different spectrum of renal lesions leading to chronic kidney disease. This review examines the changes in kidney injury occurring in the current HIV era and the factors involved in this transformation of disease expression. RECENT FINDINGS: The incidence of HIVAN and opportunistic infections in HIV-infected individuals has declined in concert with the use of effective combination antiretroviral agents...
January 13, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29337462/-antiretroviral-treatments-towards-simplified-regimens
#19
Olivier Nawej Tshikung, Alexandra Calmy
The chronicity of HIV infection and the use of antiretroviral therapy among all individuals living with HIV necessitate new treatment strategies. Alternatives to lifelong tri-therapy treatment are under investigation with the aim to improve the quality of life of patients. New therapies with longer half-lives or « biological » treatments are also under study in clinical trials in order to develop streamlined maintenance strategies. These simplified therapies represent the near future of HIV management both with regards to less toxic molecules and a change in the traditional dogma of tri-therapy, including the daily dose thanks to the possibility of dosage only on certain weekdays or via molecules under development with a long duration of action...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336591/adherence-to-antiretroviral-therapy-stigma-and-behavioral-risk-factors-in-hiv-infected-adolescents-in-asia
#20
Wasana Prasitsuebsai, Chuenkamol Sethaputra, Pagakrong Lumbiganon, Rawiwan Hansudewechakul, Kulkanya Chokephaibulkit, Khanh Huu Truong, Lam Van Nguyen, Kamarul Azahar Mohd Razali, Nik Khairulddin Nik Yusoff, Moy Siew Fong, Sirinya Teeraananchai, Jintanat Ananworanich, Nicolas Durier
We studied behavioral risks among HIV-infected and uninfected adolescents using an audio computer-assisted self-interview. A prospective cohort study was initiated between 2013 and 2014 in Malaysia, Thailand, and Vietnam. HIV-infected adolescents were matched to uninfected adolescents (4:1) by sex and age group (12-14 and 15-18 years). We enrolled 250 HIV-infected (48% male; median age 14.5 years; 93% perinatally infected) and 59 uninfected (51% male; median age 14.1 years) adolescents. At enrollment, HIV-infected adolescents were on antiretroviral therapy (ART) for a median (IQR) of 7...
January 16, 2018: AIDS Care
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