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HIV treatment failure

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https://www.readbyqxmd.com/read/28329393/virological-outcomes-of-second-line-protease-inhibitor-based-treatment-for-human-immunodeficiency-virus-type-1-in-a-high-prevalence-rural-south-african-setting-a-competing-risks-prospective-cohort-analysis
#1
Dami Collier, Collins Iwuji, Anne Derache, Tulio de Oliveira, Nonhlanhla Okesola, Alexandra Calmy, Francois Dabis, Deenan Pillay, Ravindra K Gupta
Background.: Second-line antiretroviral therapy (ART) based on ritonavir-boosted protease inhibitors (bPIs) represents the only available option after first-line failure for the majority of individuals living with human immunodeficiency virus (HIV) worldwide. Maximizing their effectiveness is imperative. Methods.: This cohort study was nested within the French National Agency for AIDS and Viral Hepatitis Research (ANRS) 12249 Treatment as Prevention (TasP) cluster-randomized trial in rural KwaZulu-Natal, South Africa...
March 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329053/sofosbuvir-plus-ribavirin-without-interferon-for-treatment-of-acute-hepatitis-c-virus-infection-in-hiv-1-infected-individuals-swift-c
#2
Susanna Naggie, Kristen M Marks, Michael Hughes, Daniel S Fierer, Christine Macbrayne, Arthur Kim, Kimberly Hollabaugh, Jhoanna Roa, Bill Symonds, Diana M Brainard, John G McHutchison, Marion G Peters, Jennifer J Kiser, Raymond Chung
Background.: Historically, acute hepatitis C virus (HCV) infection was treated with shorter durations of interferon-containing therapies. In the era of direct-acting antivirals (DAAs), it is unclear whether the efficacy of treatment achieved in chronic infection can be maintained with abbreviated courses of therapy during the acute phase. Methods.: The sofosbuvir-containing regimens without interferon for treatment of acute HCV in HIV-1 infected individuals (SWIFT-C) is an open-label, 2-cohort clinical trial in which the first cohort assessed for the safety and efficacy of 12 weeks of sofosbuvir plus ribavirin for the treatment of acute HCV infection in participants with chronic human immunodeficiency virus type 1 (HIV-1) infection...
February 27, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#3
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321282/challenges-with-targeted-viral-load-testing-for-medical-inpatients-at-queen-elizabeth-central-hospital-in-blantyre-malawi
#4
Alison Craik, Priyanka Patel, Pratiksha Patel, Jane Mallewa, Ken Malisita, Joseph Bitilinyu-Bangoh, Joep J van Oosterhout, Christine Kelly
BACKGROUND: Approximately 75% of medical inpatients at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi are HIV seropositive, and a third of these patients are on antiretroviral therapy (ART). Malawi guidelines recommend targeted viral load (VL) testing for patients on ART for at least one year who report excellent adherence and present with a WHO clinical stage 3 or 4 HIV disease. A switch to second-line ART is only indicated if a VL result >5000 copies/mL confirms treatment failure...
December 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28303545/low-prevalence-of-dhfr-and-dhps-mutations-in-pneumocystis-jirovecii-strains-obtained-from-a-german-cohort
#5
Isabelle Suárez, Lisa Roderus, Edeltraud van Gumpel, Norma Jung, Clara Lehmann, Gerd Fätkenheuer, Pia Hartmann, Georg Plum, Jan Rybniker
BACKGROUND: Pneumocystis pneumonia (PCP) is an opportunistic and potentially life-threatening infection of immunocompromised individuals. A combination of trimethoprim-sulfamethoxazole is widely used for prophylaxis and treatment of PCP. Polymorphisms in the drug targets, the dihydropteroate synthase (DHPS) or the dihydrofolate reductase (DHFR) are presumably a reason for treatment failure. METHODS: We retrospectively examined the prevalence of DHPS and DHFR mutations in Pneumocystis jirovecii isolates obtained from HIV-infected and non-HIV-infected PCP patients...
March 16, 2017: Infection
https://www.readbyqxmd.com/read/28302065/lamivudine-dolutegravir-dual-therapy-in-hiv-infected-virologically-suppressed-patients
#6
Franco Maggiolo, Roberto Gulminetti, Layla Pagnucco, Margherita Digaetano, Simone Benatti, Daniela Valenti, Annapaola Callegaro, Diego Ripamonti, Cristina Mussini
BACKGROUND: Little is known about the applicability of dual treatments based on integrase inhibitors. We explored the combination of lamivudine + dolutegravir as an option when switching from standard cART in virologically suppressed patients. METHODS: In this prospective cohort we enrolled patients previously switched to 3TC + DTG who were 18 years or older, with no previous resistance mutations to the used drugs, having a HIV-RNA <50 copies/ml for 6 months or longer, negative for HBsAg and on a stable (>6 months) cART...
March 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28298145/genotypic-characterization-of-human-immunodeficiency-virus-type-1-derived-from-antiretroviral-drug-treated-individuals-residing-in-earthquake-affected-areas-in-nepal
#7
Bharat Singh Negi, Tomohiro Kotaki, Sunil Kumar Joshi, Anup Bastola, Minato Nakazawa, Masanori Kameoka
Molecular epidemiological data on human immunodeficiency virus type 1 (HIV-1) are limited in Nepal, and has not been available in areas affected by the April 2015 earthquake. Therefore, we conducted a genotypic study on HIV-1 genes derived from individuals on antiretroviral therapy residing in 14 districts in Nepal highly affected by the earthquake. HIV-1 genomic fragments were amplified from 40 blood samples of HIV treatment-failure individuals, and a sequencing analysis was performed on these genes. In the 40 samples, 29 protease, 32 reverse transcriptase, 25 gag and 21 env genes were sequenced...
March 16, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28291052/first-line-antiretroviral-treatment-outcomes-and-durability-in-hiv-infectedchildren-treatedthrough-theuniversal-coverage-health-program-in-thailand
#8
Sirinya Teeraananchai, Torsak Bunupuradah, Thanyawee Puthanakit, Stephen J Kerr, Kiat Ruxrungtham, Suchada Chaivooth, Sorakij Bhakeecheep, Matthew G Law, Kulkanya Chokephaibulkit
BACKGROUND: We assessed the treatment outcomes on first-line antiretroviral therapy (ART), and factors associated with switching regimen in HIV-infected children treated through the universal coverage health program (UC) in Thailand. METHODS: Children aged <15 years at ART initiation who had been receiving ART for at least 6 months between 2008 and 2014 through UC were included in the analysis. The Kaplan-Meier method was used to estimate immunological recovery (IMR), immunologic failure (IMF) and virologic failure (VF)...
March 10, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28280375/budget-impact-analysis-of-the-simplification-to-atazanavir-ritonavir-lamivudine-dual-therapy-of-hiv-positive-patients-receiving-atazanavir-based-triple-therapies-in-italy-starting-from-data-of-the-atlas-m-trial
#9
Umberto Restelli, Massimiliano Fabbiani, Simona Di Giambenedetto, Carmela Nappi, Davide Croce
BACKGROUND: This analysis aimed at evaluating the impact of a therapeutic strategy of treatment simplification of atazanavir (ATV)+ ritonavir (r) + lamivudine (3TC) in virologically suppressed patients receiving ATV+r+2 nucleoside reverse transcriptase inhibitors (NRTIs) on the budget of the Italian National Health Service (NHS). METHODS: A budget impact model with a 5-year time horizon was developed based on the clinical data of Atlas-M trial at 48 weeks (in terms of percentage of patients experiencing virologic failure and adverse events), from the Italian NHS perspective...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28272247/high-levels-of-virological-failure-with-major-genotypic-resistance-mutations-in-hiv-1-infected-children-after-5-years-of-care-according-to-who-recommended-1st-line-and-2nd-line-antiretroviral-regimens-in-the-central-african-republic-a-cross-sectional-study
#10
Christian Diamant Mossoro-Kpinde, Jean-Chrysostome Gody, Ralph-Sydney Mboumba Bouassa, Olivia Mbitikon, Mohammad-Ali Jenabian, Leman Robin, Mathieu Matta, Kamal Zeitouni, Jean De Dieu Longo, Cecilia Costiniuk, Gérard Grésenguet, Ndèye Coumba Touré Kane, Laurent Bélec
A large cohort of 220 HIV-1-infected children (median [range] age: 12 [4-17] years) was cared and followed up in the Central African Republic, including 198 in 1st-line and 22 in 2nd-line antiretroviral regimens. Patients were monitored clinically and biologically for HIV-1 RNA load and drug resistance mutations (DRMs) genotyping. A total of 87 (40%) study children were virological responders and 133 (60%) nonresponders. In children with detectable viral load, the majority (129; 97%) represented a virological failure...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267790/cigarette-smoking-is-associated-with-high-hiv-viral-load-among-adults-presenting-for-antiretroviral-therapy-in-vietnam
#11
Todd M Pollack, Hao T Duong, Thuy T Pham, Cuong D Do, Donn Colby
High HIV viral load (VL >100,000 cp/ml) is associated with increased HIV transmission risk, faster progression to AIDS, and reduced response to some antiretroviral regimens. To better understand factors associated with high VL, we examined characteristics of patients presenting for treatment in Hanoi, Vietnam. We examined baseline data from the Viral Load Monitoring in Vietnam Study, a randomized controlled trial of routine VL monitoring in a population starting antiretroviral therapy (ART) at a clinic in Hanoi...
2017: PloS One
https://www.readbyqxmd.com/read/28261274/assessment-of-antiretroviral-treatment-adherence-among-children-attending-care-at-a-tertiary-hospital-in-southeastern-nigeria
#12
Cletus Akahara, Emeka Nwolisa, Kelechi Odinaka, Seline Okolo
Background. Adherence is the strongest predictor of successful treatment outcome among children infected with HIV. Our aim was to assess the antiretroviral drugs adherence status of HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria. Method. The study involved a cross-sectional survey of 210 HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria using self-report method of assessment. Optimal ART adherence is defined as patient taking not missing more than 1 dose of combined antiretroviral therapy medication in the preceding 2 weeks prior to the study...
2017: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28255456/evaluating-adherence-to-antiretroviral-therapy-using-pharmacy-refill-records-in-a-rural-treatment-site-in-south-africa
#13
George Gachara, Lufuno G Mavhandu, Elizabeth T Rogawski, Cecile Manhaeve, Pascal O Bessong
Optimal adherence to combination antiretroviral therapy (cART) is critical to maintain virologic suppression, thereby ensuring the global success of HIV treatment. We evaluated adherence to cART using pharmacy refill records and determined the adherence threshold resulting in >90% virologic suppression in a community run treatment site in South Africa. Additionally, we analysed factors associated with adherence using univariable and multivariable logistic regression models. Logistic regression was also performed to determine the relationship between adherence and virologic suppression and the adherence threshold resulting in <10% virologic failure...
2017: AIDS Research and Treatment
https://www.readbyqxmd.com/read/28249999/utility-of-second-generation-line-probe-assay-hain-mtbdrplus-directly-on-2-month-sputa-specimens-to-monitor-tuberculosis-treatment-response
#14
Neesha Rockwood, Justyna Wojno, Yonas Ghebrekristos, Mark P Nicol, Graeme Meintjes, Robert J Wilkinson
The utility of line probe assay (Genotype MTBDRplus) performed directly on 2-month sputa to monitor tuberculosis treatment response is unknown. We assessed if direct testing of 2-month sputa with MTBDRplus can predict 2-month culture conversion and long-term treatment outcome. Xpert® MTB/RIF-confirmed rifampicin-susceptible tuberculosis cases were recruited at tuberculosis diagnosis and followed up at 2 and 5-6 months. MTBDRplus was performed directly on 2-month sputa and on all positive culture isolates at 2 and 5-6 months...
March 1, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28246135/cohort-profile-improving-treatment-of-hiv-infected-ethiopian-children-through-better-detection-of-treatment-failure-in-southern-ethiopia
#15
Birkneh Tilahun Tadesse, Byron Alexander Foster, Degu Jerene, Andrea Ruff
PURPOSE: The Ethiopian Paediatric HIV Cohort (EPHIC) was established to identify clinical and laboratory predictors of virological treatment failure to ultimately develop a clinical-immunological prediction rule with area under the curve of >0.80 for detecting first-line antiretroviral therapy failure (ARTF). It will also assess the performance of the current WHO guidelines for detection of first-line ARTF in children. PARTICIPANTS: Using a prospective cohort design, HIV-infected children and adolescents below the age of 18 years are followed every 6 months with a set of clinical and laboratory parameters at 6 hospitals in southern Ethiopia...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28242151/-viral-failure-in-infants-perinatally-infected-with-hiv-a-double-punishment
#16
N Trocmé, M-F Courcoux, M-D Tabone, F Hervé, E Bui, P Faucher, L Selleret, M-G Lebrette, G Leverger, C Dollfus
BACKGROUND: Considering the remarkable efficacy of the strategies for preventing mother-to-child transmission of HIV infection (PMTCT), failures are rare in high-resource countries and deserve further investigation. Moreover, infants have been found to be at increased risk of viral failure. We analyzed the factors related to the children's environment, including maternal psychological factors that may be associated with viral failure in children diagnosed before the age of 1 year. PATIENTS AND METHODS: Retrospective study of all HIV-infected infants, born in France between July 2003 and July 2013, diagnosed before the age of 1 year, cared for in a single reference center, comparing the group of children in viral success to the group of children presenting at least one episode of viral failure, using data available in their medical, psychological and social files...
February 24, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28225342/outcomes-from-the-first-multidrug-resistant-tuberculosis-programme-in-kenya
#17
H Huerga, M Bastard, M Kamene, S Wanjala, A Arnold, N Oucho, I Chikwanha, F Varaine
SETTING: In March 2006, the first multidrug-resistant tuberculosis (MDR-TB) treatment programme was implemented in Kenya. OBJECTIVE: To describe patients' treatment outcomes and adverse events. DESIGN: A retrospective case note review of patients started on MDR-TB treatment at two Médecins Sans Frontières-supported sites and the national referral hospital of Kenya was undertaken. Sites operated an ambulatory model of care. Patients were treated for a minimum of 24 months with at least 4-5 drugs for the intensive phase of treatment, including an injectable agent...
March 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28220792/immunologic-treatment-failure-among-hiv-infected-adult-patients-in-jiangsu-province-china
#18
Tao Qiu, Ping Ding, Gengfeng Fu, Xiping Huan, Xiaoqin Xu, Zhi Zhang, Xiaoyan Liu, Haitao Yang, Jeff Mandel, Chongyi Wei, Willi McFarland, Hongjing Yan
The National Free Antiretroviral Treatment Program was implemented in Jiangsu Province, China in 2005. We conducted a retrospective, open cohort study to determine treatment failure rates and associated risk factors. Data were obtained from the national web-based antiretroviral treatment database. WHO criteria were used to define immunologic treatment failure. Kaplan-Meier methods were used to determine treatment failure rates and Cox proportional hazards modeling was used to identify risk factors. A total of 5,083 (87...
February 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28215175/cd4-t-cell-count-may-not-be-a-useful-strategy-to-monitor-antiretroviral-therapy-response-in-htlv-1-hiv-co-infected-patients
#19
Alain Vandormael, Filipe Rego, Siva Danaviah, Luiz Alcantara, David Boulware, Tulio de Oliveira
BACKGROUND: HTLV-1/HIV co-infection is known to elevate the CD4+ T-cell counts of treatment-naïve persons. We investigated whether HTLV-1/HIV co-infected patients continued to have elevated CD4+ T-cell counts after developing virologic failure on antiretroviral therapy (ART). METHODS: The data comes from a drug resistance study located in the KwaZulu-Natal province of South Africa. All participants (N=383) presented for repeated CD4+ T-cell count and HIV viral load level testing between January 2006 and March 2014...
February 16, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28212411/lack-of-impact-of-pre-existing-t97a-hiv-1-integrase-mutation-on-integrase-strand-transfer-inhibitor-resistance-and-treatment-outcome
#20
Michael E Abram, Renee R Ram, Nicolas A Margot, Tiffany L Barnes, Kirsten L White, Christian Callebaut, Michael D Miller
T97A is an HIV-1 integrase polymorphism associated with integrase strand transfer inhibitor (INSTI) resistance. Using pooled data from 16 clinical studies, we investigated the prevalence of T97A (pre-existing and emergent) and its impact on INSTI susceptibility and treatment response in INSTI-naive patients who enrolled on elvitegravir (EVG)- or raltegravir (RAL)-based regimens. Prior to INSTI-based therapy, primary INSTI resistance-associated mutations (RAMs) were absent and T97A pre-existed infrequently (1...
2017: PloS One
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