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Antiretroviral therapy

Stefanie Kroeze, Pascale Ondoa, Cissy M Kityo, Margaret Siwale, Sulaimon Akanmu, Maureen Wellington, Marleen de Jager, Prudence Ive, Kishor Mandaliya, Wendy Stevens, T Sonia Boender, Marieke E de Pundert, Kim C E Sigaloff, Peter Reiss, Ferdinand W Wit, Tobias F Rinke de Wit, Raph L Hamers
OBJECTIVE: To assess incidence, determinants and clinical consequences of suboptimal immune recovery in HIV-1 infected adults in sub-Saharan Africa with sustained viral suppression on antiretroviral therapy (ART). DESIGN: Multi-country prospective cohort. METHODS: Suboptimal immune recovery was defined as proportions of participants who failed to attain clinically relevant CD4 cell count thresholds (>200, >350 and >500 cells/μL) despite sustained viral suppression on continuous first-line ART...
March 15, 2018: AIDS
Maartje Dijkstra, Rik H W Van Lunsen, Katherine W Kooij, Udi Davidovich, Rosan A Van Zoest, Ferdinand W M N Wit, Maria Prins, Peter Reiss, Maarten F Schim Van Der Loeff
INTRODUCTION: HIV-1-infected men who have sex with men (MSM) more often experience sexual dysfunctions than the general population. We assessed associations between HIV-1 status and decreased sexual functioning among MSM. METHODS: We used cross-sectional data from 399 HIV-1-infected MSM mostly on combination antiretroviral therapy (cART) and 366 HIV-1-uninfected MSM aged ≥45 years participating in the AGEhIV Cohort Study. The study questionnaire included questions on erectile function, sexual satisfaction, and sexual desire...
March 15, 2018: AIDS
Laura Tarancon-Diez, Rebeca S De Pablo-Bernal, José Luis Jiménez, Ana I Álvarez-Ríos, Miguel Genebat, Isaac Rosado-Sánchez, María-Ángeles Muñoz-Fernández, Ezequiel Ruiz-Mateos, Manuel Leal
OBJECTIVE: Cardiovascular diseases (CVDs) are one of the main causes of morbimortality in HIV-infected patients on suppressive antiretroviral therapy. The objective of this work was to evaluate the role of single nucleotide polymorphisms (SNPs) in lipopolysaccharide (LPS) Toll-like receptor 4 (TLR4) and CVDs occurrence in HIV-infected patients. Additionally, the functional consequences of carrying these SNPs were analyzed. METHODS: The association of TLR4 SNPs, Asp299Gly/Thr399Ile with CVDs occurrence was analyzed using multivariate logistic regression models...
March 15, 2018: AIDS
Kiran T Thakur, Alexandra Boubour, Deanna Saylor, Mitashee Das, David R Bearden, Gretchen L Birbeck
: Neurological conditions associated with HIV remain major contributors to morbidity and mortality and are increasingly recognized in the aging population on long-standing combination antiretroviral therapy (cART). Importantly, growing evidence shows that the CNS may serve as a reservoir for viral replication, which has major implications for HIV eradication strategies. Though there has been major progress in the last decade in our understanding of the pathogenesis, burden, and impact of neurological conditions associated with HIV infection, significant scientific gaps remain...
March 15, 2018: AIDS
Elodie Alessandri-Gradt, Fabienne De Oliveira, Marie Leoz, Véronique Lemee, David L Robertson, Felix Feyertag, Paul-Alain Ngoupo, Philippe Mauclere, François Simon, Jean-Christophe Plantier
OBJECTIVES: HIV/1 group P (HIV-1/P) is the last HIV/1 group discovered and to date, comprises only two strains. To obtain new insights into this divergent group, we screened for new infections by developing specific tools, and analysed phenotypic and genotypic properties of the prototypic strain RBF168. In addition, the follow-up of the unique patient monitored so far, has raised the knowledge of the natural history of this infection and its therapeutic management. DESIGN/METHODS: We developed an HIV-1/P specific sero-molecular strategy and screened over 29,498 specimen samples...
March 15, 2018: AIDS
Allison A Lindgren, Adam R Filipowicz, Julian B Hattler, Soon Ok Kim, Hye Kyung Chung, Marcelo J Kuroda, Edward M Johnson, Woong-Ki Kim
OBJECTIVE: HIV-1 infection of the brain and related cognitive impairment remain prevalent in HIV-1-infected subjects despite combination antiretroviral therapy. Sterile alpha motif and histidine-aspartate domain-containing protein 1 (SAMHD1) is a newly identified host restriction factor that blocks the replication of HIV-1 and other retroviruses in myeloid cells. Cell-cycle-regulated phosphorylation at residue Thr592 and viral protein X (Vpx)-mediated degradation of SAMHD1 have been shown to bypass SAMHD1 restriction in vitro...
March 15, 2018: AIDS
Sumona Chaudhury, Gloria K Mayondi, Paige L Williams, Jean Leidner, Roger Shapiro, Modiegi Diseko, Gbolahan Ajibola, Penny Holding, Vicki Tepper, Joseph Makhema, Chipo Petlo, George R Seage, Shahin Lockman, Betsy Kammerer
OBJECTIVE: Conflicting data exist regarding the impact of in utero exposure to maternal combination antiretrovirals. We compared neurodevelopmental outcomes between HIV-exposed/uninfected (HEU) children exposed in utero to 3-drug combination antiretroviral therapy (ART) versus zidovudine (ZDV) monotherapy. DESIGN: Prospective study of child neurodevelopment, nested within two cohorts of HIV-infected mothers and their children in Botswana (one observational, one interventional)...
March 15, 2018: AIDS
Alison G Abraham, Long Zhang, Keri Calkins, Adrienne Tin, Andrew Hoofnagle, Frank J Palella, Michelle M Estrella, Lisa P Jacobson, Mallory D Witt, Lawrence A Kingsley, Todd T Brown
OBJECTIVE: Despite effective antiretroviral therapy (HAART) and durable viral suppression, many HIV-infected individuals still do not achieve CD4+ cell count (CD4) normalization. Vitamin D has immunoregulatory functions, including inducing the development of T cells, and higher levels may improve CD4 rebound. DESIGN: Longitudinal study of men from the Multicenter AIDS Cohort Study who virally suppressed following HAART initiation and had pre- and post-HAART 25[OH]D and 1,25[OH]2D measurements and repeated measures of CD4...
March 15, 2018: AIDS
Thomas Joshua Pasvol, Caroline Foster, Sarah Fidler
PURPOSE OF REVIEW: Successful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more 'flexible' immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution...
March 14, 2018: Current Opinion in HIV and AIDS
Patricia E Molina, Liz Simon, Angela M Amedee, David A Welsh, Tekeda F Ferguson
Alcohol's multisystemic effects impact HIV disease pathogenesis and increase the risk for comorbidities in persons living with HIV (PLWH). The increased number of aging PLWH increases the potential for alcohol to enhance the risk for comorbidities. Integration of epidemiological, preclinical and translational studies provide an overarching view of the impact of heavy alcohol consumption on HIV risk, pathogenesis, treatment and burden of disease. The combined insult of HIV infection, heavy alcohol consumption and toxic effects of antiretroviral therapy in aging PLWH poses a public health challenge through increased disease burden that also impacts quality of life and increases health care costs...
March 13, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Kelli N O'Laughlin, Shada A Rouhani, Julius Kasozi, Kelsy E Greenwald, Nicholas R Perkons, Zikama M Faustin, Ingrid V Bassett, Norma C Ware
Background: Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). Methods: To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART ( n  = 73) and HIV clinic staff ( n  = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data...
2018: Conflict and Health
Alain Bruno Tagne Nouemssi
Tuberculosis (TB) continues to represent an important public health challenge in the world and the USA, especially given its association with HIV infection and population migration. Cervical tuberculous lymphadenitis represents the most common extrapulmonary presentation of TB in the USA. Considerations for other causes of neck mass often contribute to delay in diagnosis. In this report, we describe the case of a 41-year-old man who presented with painful swelling of the neck and was diagnosed with tuberculous lymphadenitis, complicated by HIV therapy-associated immune reconstitution syndrome...
March 15, 2018: BMJ Case Reports
Rose Nabatanzi, Stephen Cose, Moses Joloba, Sarah Rowland Jones, Damalie Nakanjako
HIV infection causes upregulation of markers of inflammation, immune activation and apoptosis of host adaptive, and innate immune cells particularly monocytes, natural killer (NK) and innate lymphoid cells (ILCs). Although antiretroviral therapy (ART) restores CD4 T-cell counts, the persistent aberrant activation of monocytes, NK and ILCs observed likely contributes to the incomplete recovery of T-cell effector functions. A better understanding of the effects of HIV infection and ART on the phenotype and function of circulating monocytes, NK, and ILCs is required to guide development of novel therapeutic interventions to optimize immune recovery...
March 15, 2018: AIDS Research and Therapy
Mark N Belkin, Nir Uriel
PURPOSE OF REVIEW: Advancements in highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) has led to increased survival, approaching that of the general population. These patients are at an increased risk for heart disease, specifically HIV-associated cardiomyopathy. RECENT FINDINGS: Initially, HIV-associated cardiomyopathy was predominantly noted as systolic dysfunction, but diastolic dysfunction has become more common with increased use of HAART...
March 14, 2018: Current Opinion in Cardiology
Ornella Sortino, Elizabeth Richards, Joana Dias, Edwin Leeansyah, Johan K Sandberg, Irini Sereti
: Chronic HIV-1 infection is associated with lower frequencies and functional impairment of mucosa-associated invariant T (MAIT) cells. We evaluated IL-7 treatment to restore MAIT cells in peripheral blood of chronically HIV-1-infected individuals on antiretroviral therapy. IL-7 led to increased relative and absolute levels of MAIT cells, and this expansion occurred primarily in the CD8 subset. These results suggest that IL-7 may represent a therapeutic intervention for the restoration of MAIT cells in chronic HIV-1 infection...
March 27, 2018: AIDS
Münevver Demir, Sam Phiri, Eva Heger, Tom Heller, Rolf Kaiser, Thom Chaweza, Gerd Fätkenheuer, Hans-Michael Steffen, Florian Neuhann
No abstract text is available yet for this article.
March 13, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Kate S Wilson, George Wanje, Linnet Masese, Jane Simoni, Juma Shafi, Lucy Adala, Julie Overbaugh, Walter Jaoko, Barbra A Richardson, R Scott McClelland
BACKGROUND: Little is known about fertility desire in HIV-positive female sex workers (FSW). Fertility desire could increase HIV transmission risk if it were associated with condomless sex or lower adherence to antiretroviral therapy (ART). METHODS: A prospective cohort study was conducted among 255 HIV-positive FSWs in Mombasa, Kenya. Using generalized estimating equations, fertility desire was evaluated as a risk factor for semen detection in vaginal secretions by prostate specific antigen (PSA) test, a biomarker of condomless sex, detectable plasma viral load (VL), and HIV transmission potential, defined as visits with positive PSA and detectable VL...
March 13, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Arkaitz Imaz, Jordi Niubó, Alieu Amara, Saye Khoo, Elena Ferrer, Juan M Tiraboschi, Laura Acerete, Benito Garcia, Antonia Vila, Daniel Podzamczer
This study aimed to assess cerebrospinal fluid (CSF) drug concentrations and viral suppression in HIV-1-infected patients on ritonavir-boosted atazanavir (ATV/r) plus lamivudine (3TC) dual therapy. HIV-1-infected adults with suppressed plasma HIV-1 RNA who switched to ATV/r plus 3TC were studied. Total ATV and 3TC concentrations at the end of the dosing interval (C24h ), using a validated LC-MS/MS method, and HIV-1 RNA were measured in paired CSF and plasma samples 12 weeks after switching. Ten individuals were included...
March 14, 2018: Journal of Neurovirology
Catherine R Lesko, Bryan Lau, Geetanjali Chander, Richard D Moore
Persons with HIV who have entered care but have viral load > 1500 copies/mL may be the source of the majority of new HIV infections in the United States. We followed patients engaged in continuity care in the Johns Hopkins HIV Clinical Cohort between January 2010 and August 2015. We estimated person-time spent with viral load > 1500 copies/mL while in care after antiretroviral therapy (ART) initiation, while in care, and while alive. Person-time was classified according to the most recent viral load measurement...
March 14, 2018: AIDS and Behavior
Galateia J Kazakia, Julio Carballido-Gamio, Andrew Lai, Lorenzo Nardo, Luca Facchetti, Courtney Pasco, Chiyuan A Zhang, Misung Han, Amanda Hutton Parrott, Phyllis Tien, Roland Krug
Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...
February 2018: Quantitative Imaging in Medicine and Surgery
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