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https://www.readbyqxmd.com/read/28808480/salvage-chemotherapy-for-adults-with-relapsed-or-refractory-lymphoma-in-malawi
#1
Bongani Kaimila, Toon van der Gronde, Christopher Stanley, Edwards Kasonkanji, Maria Chikasema, Blessings Tewete, Paula Fox, Satish Gopal
BACKGROUND: Lymphoma is highly associated with HIV in sub-Saharan Africa (SSA), which contributes to worse outcomes relative to resource-rich settings, and frequent failure of first-line chemotherapy. However, there are no second-line treatment descriptions for adults with relapsed or refractory lymphoma (RRL) in SSA. METHODS: We describe HIV+ and HIV- patients with RRL receiving salvage chemotherapy in Malawi. Patients were prospectively treated at a national teaching hospital in Lilongwe, with the modified EPIC regimen (etoposide, prednisolone, ifosfamide, cisplatin) between June 2013 and May 2016, after failing prior first-line chemotherapy...
2017: Infectious Agents and Cancer
https://www.readbyqxmd.com/read/28803167/igg4-related-disease-a-new-etiology-underlying-diffuse-intracranial-dilating-vasculopathy
#2
Evan S Marlin, Davis Dornbos, Daniel S Ikeda, Norman L Lehman, Ciarán J Powers
BACKGROUND: Diffuse intracranial aneurysmal vasculopathy is a rare condition, previously described in patients with human immunodeficiency virus (HIV) infection. IgG4 related disease (IgG4-RD) is a recognized inflammatory disease of systemic organs, leading to fibrosis of connective tissues. It has also been linked to inflammatory dilating aortic aneurysms, coronary vascular disease, hypophysitis, orbital pseudotumor and pachymeningitis. It has not yet been described as a cause of diffuse intracranial dilating vasculopathy...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28799999/features-of-cardiovascular-disease-in-low-income-and-middle-income-countries-in-adults-and-children-living-with-hiv
#3
Andrew W McCrary, Chidozie U Nduka, Saverio Stranges, Gerald S Bloomfield
PURPOSE OF REVIEW: The current article addresses crucial issues in identifying risk of cardiovascular disease (CVD) in people living with HIV in low-income and middle-income countries (LMICs). These issues are in need of urgent attention to advance our knowledge and inform actions to mitigate CVD in this population. We address CVDs in adults living with HIV as well as the unique aspects pertaining to children living with HIV (CLHIV), a group sorely under-represented in this field. RECENT FINDINGS: CVDs affecting adults such as hypertension, dyslipidemia, coronary artery disease, and heart failure, in addition to myocardial dysfunction, vascular diseases, and autoimmune phenomena are also being reported in CLHIV...
August 10, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28799920/3-year-efficacy-and-durability-of-simplification-to-single-tablet-regimens-a-comparison-between-co-formulated-efavirenz-emtricitabine-tenofovir-and-rilpivirine-emtricitabine-tenofovir
#4
Roberta Gagliardini, Alessandra Bandera, Mauro Zaccarelli, Gaetana Sterrantino, Alessandra Latini, Alessandro D'Avino, Giuseppe Lapadula, Andrea Antinori, Roberto Cauda, Andrea De Luca, Andrea Gori, Simona Di Giambenedetto, Massimiliano Fabbiani
BACKGROUND: Few data are available about efficacy and durability of simplification from multi-tablet antiretroviral regimens to co-formulated efavirenz(EFV)/emtricitabine(FTC)/tenofovir(TDF) versus rilpivirine(RPV)/emtricitabine/tenofovir in virologically-suppressed HIV-1-infected patients. METHODS: We retrospectively analyzed HIV-infected patients with HIV-RNA<50copies/mL switching to co-formulated EFV/FTC/TDF or RPV/FTC/TDF at 5 Italian centers. Patients were followed from time of switch until regimen discontinuation or a maximum of 3-years follow-up...
August 11, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28797860/palliative-care-for-tuberculosis
#5
Stephen R Connor
In 2014, 1.5 million people died of tuberculosis (TB) worldwide including 400,000 co-infected with HIV. TB remains a major cause of death and suffering globally, in spite of the fact that it is supposed to be a curable disease. Drug resistant forms of TB have developed as a result of poor treatment compliance including multi-drug and extreme drug resistant forms that take longer to treat and have higher likelihoods of treatment failure. In 2010, at the initiation of the TB community, a partnership was formed between the WHO Stop TB Program, the Worldwide Hospice Palliative Care Alliance, and the Open Society Foundation's International Palliative Care Initiative (OSF/IPCI) to explore how to improve the ability of TB professionals to deliver palliative care to their patients...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797170/analysis-of-clinical-hiv-1-strains-with-resistance-to-maraviroc-reveals-strain-specific-resistance-mutations-variable-degrees-of-resistance-and-minimal-cross-resistance-to-other-ccr5-antagonists
#6
Jacqueline Flynn, Paula Ellenberg, Renee Duncan, Anne Ellett, Jingling Zhou, Jasminka Sterjovski, Kieran Cashin, Katharina Borm, Lachlan Gray, Marilyn Lewis, Becky Jubb, Mike Westby, Benhur Lee, Sharon Ruth Lewin, Melissa Churchill, Michael Roche, Paul Gorry
Maraviroc (MVC) is an allosteric inhibitor of HIV-1 entry, and is the only CCR5 antagonist licensed for use as an anti-HIV-1 therapeutic. It acts by altering the conformation of the CCR5 extracellular loops, rendering CCR5 unrecognizable by the HIV-1 envelope glycoproteins (Env). This study aimed to understand the mechanisms underlying the development of MVC resistance in HIV-1-infected patients. To do this, we obtained longitudinal plasma samples from 8 subjects who experienced treatment failure with phenotypically verified, CCR5-tropic MVC resistance...
August 11, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28793019/cryptococcus-neoformans-and-c-gattii-isolates-from-both-hiv-infected-and-uninfected-patients-antifungal-susceptibility-and-outcome-of-cryptococcal-disease
#7
Erika Nascimento, Lucia Helena Vitali, Marcia Regina von Zeska Kress, Roberto Martinez
One of the factors causing treatment failure in cryptococcosis is the resistance of Cryptococcus spp. to antifungal drugs, which has motivated the susceptibility assessment of isolates from patients with cryptococcosis, different clinical conditions and infections outcomes. Clinical isolates of Cryptococcus spp. from three different groups of patients were studied in the present investigation: 19 HIV-positive patients with relapsing and/or refractory meningitis (Group 1), 30 HIV-positive patients who experienced a single and limited episode of cryptococcosis (Group 2), and 19 HIV-negative patients with cryptococcosis (Group 3)...
2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28782390/treatment-of-pneumocystis-jirovecii-pneumonia-in-hiv-infected-patients-a-review
#8
Yu-Shan Huang, Jen-Jia Yang, Nan-Yao Lee, Guan-Jhou Chen, Wen-Chien Ko, Hsin-Yun Sun, Chien-Ching Hung
Pneumocystis pneumonia is a potentially life-threatening pulmonary infection that occurs in immunocompromised individuals and HIV-infected patients with a low CD4 cell count. Trimethoprim-sulfamethoxazole has been used as the first-line agent for treatment, but mutations within dihydropteroate synthase gene render potential resistance to sulfamide. Despite advances of combination antiretroviral therapy (cART), Pneumocystis pneumonia continues to occur in HIV-infected patients with late presentation for cART or virological and immunological failure after receiving cART...
August 5, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28774413/management-of-hepatitis-b-in-special-populations
#9
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/28770599/effect-of-frequency-of-clinic-visits-and-medication-pick-up-on-antiretroviral-treatment-outcomes-a-systematic-literature-review-and-meta-analysis
#10
Tsitsi Mutasa-Apollo, Nathan Ford, Matthew Wiens, Maria Eugenia Socias, Eyerusalem Negussie, Ping Wu, Evan Popoff, Jay Park, Edward J Mills, Steve Kanters
INTRODUCTION: Expanding and sustaining antiretroviral therapy (ART) coverage may require simplified HIV service delivery strategies that concomitantly reduce the burden of care on the health system and patients while ensuring optimal outcomes. We conducted a systematic review to assess the impact of reduced frequency of clinic visits and drug dispensing on patient outcomes. METHODS: As part of the development process of the World Health Organization antiretroviral (ARV) guidelines, we systematically searched medical literature databases for publications up to 30 August 2016...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28770589/implications-of-differentiated-care-for-successful-art-scale-up-in-a-concentrated-hiv-epidemic-in-yangon-myanmar
#11
REVIEW
Anita Mesic, Julie Fontaine, Theingy Aye, Jane Greig, Thin Thin Thwe, Laura Moretó-Planas, Jarmila Kliesckova, Khin Khin, Nana Zarkua, Lucia Gonzalez, Erwin Lloyd Guillergan, Daniel P O'Brien
INTRODUCTION: National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28763473/efficacy-and-safety-of-switching-from-branded-to-generic-antiretrovirals-in-virologically-suppressed-hiv-infected-patients
#12
Nicola Gianotti, Andrea Poli, Laura Galli, Michela Franzin, Patrizia Tadini, Nadia Galizzi, Alessia Carbone, Marco Merli, Camilla Muccini, Chiara Oltolini, Andrea Andolina, Vincenzo Spagnuolo, Adriano Lazzarin, Antonella Castagna
BACKGROUND: Aim of this study was to evaluate the efficacy and the safety of switching from branded to generic antiretrovirals in patients with HIV-RNA <50 copies/mL. METHODS: Matched-cohort study of patients followed at a single clinical center. Since September 2014, all patients with HIV-RNA <50 copies/mL who were receiving branded lamivudine or zidovudine/lamivudine or efavirenz were switched to the generic compound (switchers) and matched, in a ratio 1:1, for age (±5 years), gender, anti-HCV antibodies, nadir and (±50 cells/μL) baseline CD4+ count (±100 cells/μL), duration of antiretroviral therapy (±1 year), with patients with HIV-RNA <50 copies/mL, on treatment with unavailable generic compounds (non-switchers)...
2017: PloS One
https://www.readbyqxmd.com/read/28763465/antiretroviral-resistance-following-immunological-monitoring-in-a-resource-limited-setting-of-western-india-a-cross-sectional-study
#13
Santosh K Karade, Smita S Kulkarni, Manisha V Ghate, Ajit A Patil, Rajkumar Londhe, Sonali P Salvi, Dileep B Kadam, Rajneesh K Joshi, Bharat B Rewari, Raman R Gangakhedkar
BACKGROUND: The free antiretroviral therapy (ART) program in India still relies on the clinico-immunological monitoring for diagnosis of treatment failure. As the nucleoside reverse transcriptase inhibitor (NRTI) backbone is shared in first- and second-line regimens, accumulation of drug resistant mutations (DRMs) can compromise the efficacy of NRTI. This study was undertaken to describe the pattern of HIV DRMs following immunological monitoring and investigate its impact on the cycling of NRTI between first- and second-line ART...
2017: PloS One
https://www.readbyqxmd.com/read/28760729/using-digital-technologies-in-clinical-hiv-research-real-world-applications-and-considerations-for-future-work
#14
Jessica Andriesen, Sheana Bull, Janan Dietrich, Jessica E Haberer, Barbara Van Der Pol, Yegor Voronin, Kristin M Wall, Christopher Whalen, Frances Priddy
BACKGROUND: Digital technologies, especially if used in novel ways, provide a number of potential advantages to clinical research in trials related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and may greatly facilitate operations as well as data collection and analysis. These technologies may even allow answering questions that are not answerable with older technologies. However, they come with a variety of potential concerns for both the participants and the trial sponsors...
July 31, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28757763/immune-reconstitution-inflammatory-syndrome-associated-disseminated-kaposi-s-sarcoma-in-a-patient-infected-with-human-immunodeficiency-virus-report-of-an-autopsy-case
#15
Chiu-Hsuan Cheng, Yung-Hsiang Hsu
Immune reconstitution inflammatory syndrome is a collection of inflammatory disorders associated with paradoxical worsening of preexisting infectious processes following the initiation of highly active antiretroviral therapy (HAART) in individuals infected with human immunodeficiency virus (HIV). It involves a wide range of pathogens, neoplasms such as Kaposi's sarcoma (KS) and some autoimmune diseases. We describe an autopsy report of a 40-year-old man infected with HIV. He experienced a rapid dissemination of KS resulting in death within 6 months after starting HAART...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28753040/evaluation-of-sofosbuvir-velpatasvir-plus-voxilaprevir-as-fixed-dose-co-formulation-for-treating-hepatitis-c
#16
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...
July 28, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28750935/long-acting-intramuscular-cabotegravir-and-rilpivirine-in-adults-with-hiv-1-infection-latte-2-96-week-results-of-a-randomised-open-label-phase-2b-non-inferiority-trial
#17
David A Margolis, Juan Gonzalez-Garcia, Hans-Jürgen Stellbrink, Joseph J Eron, Yazdan Yazdanpanah, Daniel Podzamczer, Thomas Lutz, Jonathan B Angel, Gary J Richmond, Bonaventura Clotet, Felix Gutierrez, Louis Sloan, Marty St Clair, Miranda Murray, Susan L Ford, Joseph Mrus, Parul Patel, Herta Crauwels, Sandy K Griffith, Kenneth C Sutton, David Dorey, Kimberly Y Smith, Peter E Williams, William R Spreen
BACKGROUND: Cabotegravir and rilpivirine are antiretroviral drugs in development as long-acting injectable formulations. The LATTE-2 study evaluated long-acting cabotegravir plus rilpivirine for maintenance of HIV-1 viral suppression through 96 weeks. METHODS: In this randomised, phase 2b, open-label study, treatment-naive adults infected with HIV-1 initially received oral cabotegravir 30 mg plus abacavir-lamivudine 600-300 mg once daily. The objective of this study was to select an intramuscular dosing regimen based on a comparison of the antiviral activity, tolerability, and safety of the two intramuscular dosing regimens relative to oral cabotegravir plus abacavir-lamivudine...
July 21, 2017: Lancet
https://www.readbyqxmd.com/read/28750322/longitudinal-sequencing-of-hiv-1-infected-patients-with-low-level-viremia-for-years-while-on-art-shows-no-indications-for-genetic-evolution-of-the-virus
#18
Leen Vancoillie, Laura Hebberecht, Kenny Dauwe, Els Demecheleer, Sylvie Dinakis, Dries Vaneechoutte, Virginie Mortier, Chris Verhofstede
HIV-infected patients on antiretroviral therapy (ART) may present low-level viremia (LLV) above the detection level of current viral load assays. In many cases LLV is persistent but does not result in overt treatment failure or selection of drug resistant viral variants. To elucidate whether LLV reflects active virus replication, we extensively sequenced pol and env genes of the viral populations present before and during LLV in 18 patients and searched for indications of genetic evolution. Maximum likelihood phylogenetic trees were inspected for temporal structure both visually and by linear regression analysis of root-to-tip and pairwise distances...
July 24, 2017: Virology
https://www.readbyqxmd.com/read/28745207/hiv-drug-resistance-testing-in-a-resource-limited-setting-with-high-viral-diversity-the-first-twenty-eight-months-experience
#19
Elodie Teclaire Ngo-Malabo, Paul Alain Ngoupo, Serge Alain Sadeuh-Mba, Emmanuel Akongnwi, Robert Banaï, Laure Ngono, Richard Njouom, Charles Felix Bilong-Bilong, Anfumbom Kfutwah
BACKGROUND: First line antiretroviral therapy in a resource-limited setting consists of nucleotide and non-nucleotide reverse transcriptase inhibitors. Protease inhibitors are the hub of second line therapy. The decision to change antiretroviral therapy for a patient is frequently presumptive because of the lack of genotypic resistance tests in routine follow-up. We describe here the resistance profiles observed in patients with varying terms of antiretroviral therapy in Cameroon after implementation of HIV genotypic resistance testing in routine practice...
July 25, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28744106/evaluating-patient-preference-and-satisfaction-for-human-immunodeficiency-virus-therapy-in-france
#20
Sylvie Brégigeon-Ronot, Antoine Cheret, André Cabié, Thierry Prazuck, Alain Volny-Anne, Shehzad Ali, Catherine Bottomley, Laurent Finkielsztejn, Caroline Philippe, Jean-Jacques Parienti
OBJECTIVES: The objectives were 1) to elicit relative preferences for attributes of antiretroviral therapies (ART) in people living with HIV (PLWH) and 2) to explore satisfaction and adherence with current ART. PATIENTS AND METHODS: We conducted a multicenter cross-sectional study, consecutively enrolling PLWH receiving an ART. The quantitative part estimated the strength of preference for different attributes using an online discrete choice experiment (DCE). DCE data were analyzed using a mixed logit regression model...
2017: Patient Preference and Adherence
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