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HIV treatment failure

Leabaneng Tawe, Thato Motshoge, Pleasure Ramatlho, Naledi Mutukwa, Charles Waithaka Muthoga, Ghyslaine Bruna Djeunang Dongho, Axel Martinelli, Elias Peloewetse, Gianluca Russo, Isaac Kweku Quaye, Giacomo Maria Paganotti
Identification of inter-individual variability for drug metabolism through cytochrome P450 2B6 (CYP2B6) enzyme is important for understanding the differences in clinical responses to malaria and HIV. This study evaluates the distribution of CYP2B6 alleles, haplotypes and inferred metabolic phenotypes among subjects with different ethnicity in Botswana. A total of 570 subjects were analyzed for CYP2B6 polymorphisms at position 516 G > T (rs3745274), 785 A > G (rs2279343) and 983 T > C (rs28399499)...
March 20, 2018: Scientific Reports
Jolanta Parada-Turska, Monika Turska
Polyarteritis nodosa is a systemic necrotizing vasculitis which predominantly affects medium-sized arteries. It is a rare disease nowadays. Both the nomenclature and the classification of polyarteritis nodosa was amended several times in the past. Currently, there is a distinction between the primary form described as classical polyarteritis nodosa and other forms that are associated with their probable cause e.g. with viral hepatitis B, C or HIV infection. Moreover, polyarteritis-like necrotizing vasculitis can appear in the course of genetic diseases caused by mutations in single genes...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Setegn Eshetie, Mucheye Gizachew, Animut Alebel, Dick van Soolingen
BACKGROUND: Knowledge of tuberculosis (TB) treatment outcomes is substantially needed to assess the performance of national TB controls programs (NTPs). To date, the overall estimates of treatment outcomes have not been determined in Ethiopia. Therefore, this meta-analysis was undertaken to produce pooled estimates of TB treatment outcomes and to analyze the impact of prior anti-TB drug exposure and HIV co-infection. METHODS: Potentially relevant studies were retrieved from PubMed, EMBASE, and MEDLINE online databases...
2018: PloS One
Hsin-Yun Sun, Sui-Yuan Chang, Chien-Ching Hung
PURPOSE OF REVIEW: With prolonged life expectancy in HIV-positive patients on combination antiretroviral therapy, the quest for reducing lifelong drug exposure and minimizing or avoiding the toxicities of combination antiretroviral therapy while maintaining viral suppression has emerged when coformulations of antiretroviral agents with improved convenience, and better tolerability and efficacy became available. This review aims to update the current experience with the novel two-drug combination of dolutegravir (DTG) and rilpivirine (RPV) and elucidate the possible applications and limitations of coformulated DTG-RPV in the future...
March 16, 2018: Current Opinion in HIV and AIDS
Enrique Bernal, Jose Miguel Gómez, Inma Jarrín, Alfredo Cano, Angeles Muñoz, Antonia Alcaraz, Arkaitz Imaz, Jose Antonio Iribarren, María Rivero, Piedad Arazo, Félix Gutiérrez, CoRIS Study Group
BACKGROUND: The objetive was investigate the long-term impact of low level viremia (LLV) on all-cause mortality, AIDS and non-AIDS events (NAEs), and virological failure in patients receiving ART. METHODS: We analyzed ART-naïve adults from the cohort of the Spanish AIDS Research Network (CoRIS) who initiated ART from 2004 to 2015 and achieved plasma viral load (VL) below 50 copies/ml. LLV50-199 was defined as two consecutive VL between 50 and 199 copies/ml, and LLV200-499 as two consecutive VL between 50 and 499 copies/ml with at least one between 200 and 499 copies/ml...
March 13, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Stephanie M Topp, Chanda Mwamba, Anjali Sharma, Njekwa Mukamba, Laura K Beres, Elvin Geng, Charles B Holmes, Izukanji Sikazwe
BACKGROUND: Failure to keep people living with HIV engaged in life-long care and treatment has serious implications for individual and population-level health. Nested within a four-province study of HIV care and treatment outcomes, we explored the dynamic role of social and service-related factors influencing retention in HIV care in Zambia. METHODS: From a stratified random sample of 31 facilities, eight clinics were selected, one urban and one rural from each province...
2018: PloS One
Clarence S Yah, Geoffrey S Simate, Percy Hlangothi, Benesh M Somai
Objective: The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle-coated condoms as a means of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse...
April 2018: Annals of African Medicine
(no author information available yet)
Tetanus is an acute specific infection caused by obligate anaerobes, which is still a serious public health problem. Tetanus bacterium is an obligate anaerobic bacterium, widely distributed in nature, which can exist in dust, soil, human or animal excrement. The bacteria invade the body primarily through the skin or mucosal wounds, and most commonly in trauma and burn patients, unclean newborns, and unsafe surgical instruments. Exotoxin produced by tetanus bacteria can cause temporary changes in the central nervous system, manifested as systemic skeletal muscle persistence and paroxysmal spasm, severe cases of laryngospasm, asphyxia, lung infections and organ failure, which is a very serious and potentially fatal disease...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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
Yanink Caro-Vega, Pablo F Belaunzarán-Zamudio, Brenda E Crabtree-Ramírez, Bryan E Shepherd, Beatriz Grinsztejn, Marcelo Wolff, Jean W Pape, Denis Padgett, Eduardo Gotuzzo, Catherine C McGowan, Juan G Sierra-Madero
Background: Efavirenz (EFV) and boosted protease inhibitors (bPIs) are still the preferred options for firstline antiretroviral regimens (firstline ART) in Latin America and have comparable short-term efficacy. We assessed the long-term durability and outcomes of patients receiving EFV or bPIs as firstline ART in the Caribbean, Central and South America network for HIV epidemiology (CCASAnet). Methods: We included ART-naïve, HIV-positive adults on EFV or bPIs as firstline ART in CCASAnet between 2000 and 2016...
March 2018: Open Forum Infectious Diseases
Ketema Tafess, Teresa Kisi Beyen, Adugna Abera, Geremew Tasew, Shimelis Mekit, Solomon Sisay, Legesse Tadesse, Gilman K H Siu
Background: Directly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia. Methods: A retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry...
2018: Frontiers in Medicine
Janet Ousley, Aline Aurore Niyibizi, Stephen Wanjala, Alexandra Vandenbulcke, Beatrice Kirubi, Willis Omwoyo, Janthimala Price, Leon Salumu, Elisabeth Szumilin, Sofie Spiers, Gilles van Cutsem, Maria Mashako, Freddy Mangana, Ramzia Moudarichirou, Rebecca Harrison, Tony Kalwangila, Gisele Lumowo, Vincent Lambert, David Maman
Background: Human immunodeficiency virus (HIV) remains an important cause of hospitalization and death in low- and middle- income countries. Yet morbidity and in-hospital mortality patterns remain poorly characterized, with prior antiretroviral therapy (ART) exposure and treatment failure status largely unknown. Methods: We studied HIV-infected inpatients aged ≥13 years from cohorts in Kenya and the Democratic Republic of Congo (DRC), assessing clinical and demographic characteristics and hospitalization outcomes...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Christine Sekaggya-Wiltshire, Amrei von Braun, Mohammed Lamorde, Bruno Ledergerber, Allan Buzibye, Lars Henning, Joseph Musaazi, Ursula Gutteck, Paolo Denti, Miné de Kock, Alexander Jetter, Pauline Byakika-Kibwika, Nadia Eberhard, Joshua Matovu, Moses Joloba, Daniel Muller, Yukari C Manabe, Moses R Kamya, Natascia Corti, Andrew Kambugu, Barbara Castelnuovo, Jan S Fehr
Background: The relationship between concentrations of anti-tuberculosis (TB) drugs, sputum conversion and treatment outcome remains unclear. We sought to determine the association between anti-TB drug concentrations and sputum conversion among TB-HIV co-infected patients on first-line anti-TB drugs. Method: We enrolled HIV-infected Ugandans with pulmonary TB. Estimation of first-line anti-TB drug concentrations was performed 1, 2, and 4 hours after drug intake at 2, 8, and 24 weeks of TB treatment...
March 3, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jesús Rodríguez-Muñoz, Santiago Moreno
The disadvantages of the long-term administration of antiretroviral therapy as well as the huge number of affected persons have placed the cure of HIV as a primary goal of Public Health. HIV may persist in the organism by at least four mechanisms: a latently infected cellular reservoir, the persistent replication of HIV in spite of ART, anatomic sanctuaries, and the immune dysfunction. Several strategies directed against these mechanisms have been developed. With all this, a complete eradication of HIV has been achieved in a patient using the transplantation of haemopoietic stem cells that were resistant to HIV-infection, and there are examples of functional cure either spontaneously (elite controllers) or after antiretroviral therapy (post-treatment controllers)...
March 3, 2018: Enfermedades Infecciosas y Microbiología Clínica
Phan Vuong Khac Thai, Dang Thi Minh Ha, Nguyen Thi Hanh, Jeremy Day, Sarah Dunstan, Nguyen Thi Quynh Nhu, Vo Sy Kiet, Nguyen Huu Lan, Nguyen Huy Dung, Nguyen Thi Ngoc Lan, Nguyen Thuong Thuong, Nguyen Ngoc Lan, Phạm Thị Thúy Liễu, Nguyễn Thị Hồng, Đào Công Điệp, Nguyễn Thị Kim Thanh, Nguyễn Văn Hội, Nguyễn Văn Nghĩa, Trương Ngọc Đại, Hoàng Quang Minh, Nguyễn Văn Thơm, Jeremy Farrar, Maxine Caws
BACKGROUND: Drug resistant tuberculosis (TB) is increasing in prevalence worldwide. Treatment failure and relapse is known to be high for patients with isoniazid resistant TB treated with standard first line regimens. However, risk factors for unfavourable outcomes and the optimal treatment regimen for isoniazid resistant TB are unknown. This cohort study was conducted when Vietnam used the eight month first line treatment regimen and examined risk factors for failure/relapse among patients with isoniazid resistant TB...
March 6, 2018: BMC Infectious Diseases
Narendran Gopalan, Ramesh Kumar Santhanakrishnan, Alangudi Natarajan Palaniappan, Pradeep Aravindan Menon, Sekar Lakshman, Padmapriyadarsini Chandrasekaran, Gomathi Narayan Sivaramakrishnan, Devarajulu Reddy, Bhavani Perumal Kannabiran, Hemanth Kumar Kupparam Agiboth, Vijay Krishnamoorthy, Sridhar Rathinam, Chandrasekar Chockalingam, Tamizhselvan Manoharan, MahilMaran Ayyamperumal, Nalini Jayanthi, Kumar Satagopan, Ravichandran Narayanan, Raja Krishnaraja, Sekar Sathiyavelu, Bhanu Kesavamurthy, Chandra Suresh, Murugesan Selvachitiram, Gunasundari Arasan, Stella Susaimuthu, Prabhakaran Rathinam, Prabhakar Angamuthu, Lavanya Jayabal, Lakshmi Murali, Ranjani Ramachandran, Srikanth Prasad Tripathy, Soumya Swaminathan
Importance: The benefit of daily over thrice-weekly antituberculosis therapy among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy remains unproven. Objective: To compare the efficacy and safety of daily, part-daily, and intermittent antituberculosis therapy regimens in the treatment of HIV-associated pulmonary TB. Design, Setting, and Participants: This open-label, randomized clinical trial was conducted by the National Institute for Research in Tuberculosis, south India...
March 5, 2018: JAMA Internal Medicine
S Swindells, M Siccardi, S E Barrett, D B Olsen, J A Grobler, A T Podany, E Nuermberger, P Kim, C E Barry, A Owen, D Hazuda, C Flexner
Long-acting/extended-release drug formulations have proved very successful in diverse areas of medicine, including contraception, psychiatry and, most recently, human immunodeficiency virus (HIV) disease. Though challenging, application of this technology to anti-tuberculosis treatment could have substantial impact. The duration of treatment required for all forms of tuberculosis (TB) put existing regimens at risk of failure because of early discontinuations and treatment loss to follow-up. Long-acting injections, for example, administered every month, could improve patient adherence and treatment outcomes...
February 1, 2018: International Journal of Tuberculosis and Lung Disease
Wassim Chehadeh, Osama Albaksami, Sonia Elezebeth John, Widad Al-Nakib
OBJECTIVES: To investigate the prevalence of non-polymorphic resistance-associated mutations (RAMs) in HIV-1 patients on first-line antiretroviral therapy in Kuwait. SUBJECTS AND METHODS: Total ribonucleic acid (RNA) was isolated from plasma samples of 42 patients who received first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. HIV-1 protease and reverse transcriptase genetic regions were then amplified by nested reverse-transcription polymerase chain reaction (RT-PCR), and directly sequenced...
March 5, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
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
Elisa Colella, Dario Cattaneo, Laura Galli, Sara Baldelli, Emilio Clementi, Massimo Galli, Adriano Lazzarin, Antonella Castagna, Stefano Rusconi, Vincenzo Spagnuolo
The 96-week results of the Monotherapy Once a Day with Atazanavir/r (MODAt) study [NCT01511809] showed an inferior virological efficacy of atazanavir (ATV)/ritonavir monotherapy versus triple therapy, which was promptly retrieved by the reintroduction of nucleoside/nucleotide inhibitors of reverse transcriptase [N(n)RTIs]. We aimed to identify potential relationships between ATV exposure and clinical outcome in HIV-1 subjects treated with ATV/ritonavir monotherapy [ATV/r 300/100mg] versus ATV/ritonavir triple therapy [ATV/r 300/100mg+2NRTIs]...
March 2, 2018: New Microbiologica
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