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HIV treatment failure

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https://www.readbyqxmd.com/read/29772028/randomized-phase-i-trial-hiv-core-003-depletion-of-serum-amyloid-p-component-and-immunogenicity-of-dna-vaccination-against-hiv-1
#1
Nicola J Borthwick, Thirusha Lane, Nathifa Moyo, Alison Crook, Jung Min Shim, Ian Baines, Edmund G Wee, Philip N Hawkins, Julian D Gillmore, Tomáš Hanke, Mark B Pepys
BACKGROUND: The failure of DNA vaccination in humans, in contrast to its efficacy in some species, is unexplained. Observational and interventional experimental evidence suggests that DNA immunogenicity may be prevented by binding of human serum amyloid P component (SAP). SAP is the single normal DNA binding protein in human plasma. The drug (R)-1-[6-[(R)-2-carboxypyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid (CPHPC, miridesap), developed for treatment of systemic amyloidosis and Alzheimer's disease, depletes circulating SAP by 95-99%...
2018: PloS One
https://www.readbyqxmd.com/read/29771793/the-association-of-chronic-pain-and-long-term-opioid-therapy-with-hiv-treatment-outcomes
#2
Jessica S Merlin, Dustin Long, William C Becker, Edward R Cachay, Katerina A Christopolous, Kasey Claborn, Heidi M Crane, E Jennifer Edelman, Richard Harding, Stefan G Kertesz, Jane M Liebschutz, W Christopher Mathews, Michael J Mugavero, Sonia Napravnik, Connall O'Cleirigh, Michael S Saag, Joanna L Starrels, Robert Gross
BACKGROUND: Chronic pain occurs in up to 85% of persons living with HIV (PLWH) and is commonly treated with long-term opioid therapy (LTOT). We investigated the impact of chronic pain and LTOT on HIV outcomes. METHODS: This was prospective cohort study conducted between 7/2015-7/2016 in five HIV primary care clinics. Chronic pain was defined as ≥moderate pain for ≥3 months on the Brief Chronic Pain Questionnaire and ≥4/10 on the Pain Enjoyment of life and General activity (PEG) questionnaire...
May 4, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29771783/hiv-1-drug-resistance-among-ugandan-adults-attending-an-urban-out-patient-clinic
#3
Amrei von Braun, Christine Sekaggya-Wiltshire, Nadine Bachmann, Deogratius Ssemwanga, Alexandra U Scherrer, Maria Nanyonjo, Anne Kapaata, Pontiano Kaleebu, Huldrych F Günthard, Barbara Castelnuovo, Jan Fehr, Andrew Kambugu
BACKGROUND: Little is known about prevalence of drug resistance among HIV-infected Ugandans, a setting with over 15 years of public-sector access to antiretroviral therapy (ART) and where virological monitoring was only recently introduced. SETTING: This study was conducted in the adults' out-patient clinic of the Infectious Diseases Institute, Kampala, Uganda. METHODS: HIV genotyping was performed in ART naïve patients and in treatment experienced patients on ART for ≥ six months with virological failure (≥1000 copies/mL)...
April 27, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29771694/fostemsavir-a-new-cd4-attachment-inhibitor
#4
Pedro Cahn, Valeria Fink, Patricia Patterson
PURPOSE OF REVIEW: Even in the era of modern HAART, antiretroviral (ARV) failure and emergence of drug resistance is still a problem worldwide. New classes with different mechanisms of action are needed to overcome this challenge. After the integrase inhibitors were launched, more than a decade ago, no new classes were added to the ARV armamentarium. RECENT FINDINGS: Fostemsavir (FTR) is an attachment inhibitor, active regardless of viral tropism, without cross-resistance to any of the existing ARV compounds...
May 15, 2018: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/29771296/nationwide-cohort-study-of-antiretroviral-therapy-timing-treatment-dropout-and-virological-failure-in-china-2011-2015
#5
Yan Zhao, Zunyou Wu, Jennifer M McGoogan, Yiyi Sha, Decai Zhao, Ye Ma, Ron Brookmeyer, Roger Detels, Julio S G Montaner
Background: People living with HIV (PLWH) are still being diagnosed late, rendering the benefits of "early" antiretroviral therapy (ART; based on CD4 count) unattainable. Therefore, we aimed to evaluate the benefits of "immediate" ART (based on the time interval between diagnosis and treatment, regardless of CD4 count). Methods: A nationwide cohort of PLWH in China who initiated ART January 1, 2011 to December 31, 2014 and had baseline CD4 results >200 cells/μL were censored at 12 months, dropout, or death, whichever was first...
May 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29767684/ultrasensitive-hiv-1-viral-load-as-a-marker-of-treatment-choice-for-simplification-strategies
#6
Sidonie Lambert-Niclot, Maxime Grude, Jean-Luc Meynard, Anne-Geneviève Marcelin, Marc-Antoine Valantin, Philippe Flandre, Jacques Izopet, Laetitia Moinot, Vincent Bouteloup, Vincent Calvez, Christine Katlama, Pierre-Marie Girard, Laurence Morand-Joubert
Background: We pooled the results of three randomized trials that compared the efficacy of PI/r monotherapy and standard triple therapy as maintenance therapy and evaluated: 1) the distribution of ultrasensitive viral load (USVL) at week 96 (W96), 2) factors associated with virological success (VL<50 copy/mL) at W96, and 3) factors associated with USVL<1 copy/ml (c/ml) at W96. Methods: Virological failure was defined as two consecutive measurements of HIV-1 RNA viral load >50 copies/mL and was analyzed in intention-to-treat...
May 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29765082/pretreatment-drug-resistance-in-a-large-countrywide-ethiopian-hiv-1c-cohort-a-comparison-of-sanger-and-high-throughput-sequencing
#7
Nigus Fikrie Telele, Amare Worku Kalu, Solomon Gebre-Selassie, Daniel Fekade, Samir Abdurahman, Gaetano Marrone, Ujjwal Neogi, Belete Tegbaru, Anders Sönnerborg
Baseline plasma samples of 490 randomly selected antiretroviral therapy (ART) naïve patients from seven hospitals participating in the first nationwide Ethiopian HIV-1 cohort were analysed for surveillance drug resistance mutations (sDRM) by population based Sanger sequencing (PBSS). Also next generation sequencing (NGS) was used in a subset of 109 baseline samples of patients. Treatment outcome after 6- and 12-months was assessed by on-treatment (OT) and intention-to-treat (ITT) analyses. Transmitted drug resistance (TDR) was detected in 3...
May 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29754142/cholestatic-jaundice-a-unique-presentation-leading-to-the-diagnosis-of-hlh-with-hodgkin-lymphoma-hiv-and-ebv
#8
Hira Shaikh, Soorih Shaikh, Amir Kamran, Prerna Mewawalla
Haemophagocytic lymphohistiocytosis (HLH) is a syndrome of dysregulated immune activity with macrophage activation that can manifest as pancytopenia, coagulopathy and other laboratory abnormalities, usually progressing to multiorgan failure and death. This report documents the rarely reported association between HLH and Hodgkin's lymphoma (HL) with simultaneous HIV and Epstein-Barr virus (EBV) and complete resolution with chemotherapy. The patient initially presented with cholestatic jaundice. He was then found to have HL associated with HLH with coexistent HIV and EBV viraemia...
May 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29746299/suppressive-antiretroviral-therapy-associates-with-effective-treatment-of-high-grade-cervical-intraepithelial-neoplasia
#9
Christina Carlander, Philippe Wagner, Astrid van Beirs, Aylin Yilmaz, Kristina Elfgren, Joakim Dillner, Anders Sönnerborg, Pär Sparén
OBJECTIVES: To assess if women living with HIV (WLWH) have poorer outcome after treatment of cervical intraepithelial neoplasia (CIN2+) than HIV-negative women and to identify predictors of CIN2+ treatment failure and recurrence in WLWH. DESIGN: Population-based cohort study with follow-up between 1983 and 2015. METHODS: The Swedish National HIV Registry, the Swedish Population Registry and the Swedish National Cervical Screening Registry were linked to identify all women in Stockholm and Gothenburg counties (Sweden) living with HIV and diagnosed with CIN2+ (n = 179) sometime between 1983 and 2014...
May 8, 2018: AIDS
https://www.readbyqxmd.com/read/29746294/a-maintenance-three-day-per-week-schedule-with-the-single-tablet-regimen-efavirenz-emtricitabine-tenofovir-disoproxil-fumarate-is-effective-and-decreases-sub-clinical-toxicity-the-a-tri-week-pilot-trial
#10
Jhon Rojas, Jose L Blanco, Sonsoles Sanchez-Palomino, Maria A Marcos, Alberto C Guardo, Ana Gonzalez-Cordon, Montserrat Lonca, Amparo Tricas, Ana Rodriguez, Anabel Romero, Jose M Miro, Josep Mallolas, Jose M Gatell, Montserrat Plana, Esteban Martinez
BACKGROUND: Antiretroviral drugs contained in single tablet Atripla® have pharmacokinetic properties that could allow for longer than once-daily (OD) dosing. We hypothesized that simplifying Atripla® OD to 3-day per week would be feasible, able to maintain viral suppression and less toxic. METHODS: Virologically suppressed (≥2 years) HIV+ adults on Atripla® OD, CD4 >350/mm at inclusion, and no prior documented virological failure or evidence of resistance mutations to efavirenz, tenofovir, or emtricitabine were randomized to maintain their OD regimen or to reduce it to 3 days (Mondays, Wednesdays, and Fridays) a week (3W)...
May 9, 2018: AIDS
https://www.readbyqxmd.com/read/29737273/treatment-outcomes-of-brazilian-inmates-with-treponema-pallidum-and-human-immunodeficiency-virus-infection-a-prospective-cohort-study
#11
Graciela Mendonça Dos Santos Bet, Gleyce Hellen de Almeida de Souza, Júlio Croda, Maísa Estopa Correa, Romário Oliveira de Sales, Ruthe Aline da Silva Santos, Renata Viebrantz Enne Sgarbi, Renata Terumi Shiguematsu Yassuda, Ana Rita Castro Mota Coimbra, Maurício Antônio Pompílio, Simone Simionatto
A prospective cohort study was conducted to evaluate the incidence and treatment outcomes of syphilis and human immunodeficiency virus (HIV) in inmates from Central Brazil. In 2013, 3,363 inmates from 12 prisons in the state of Mato Grosso do Sul were recruited, and 1,614 remained incarcerated after 1 year. The inmates were interviewed, and blood samples were collected for serological testing for Treponema pallidum and HIV infections. Inmates infected with T. pallidum or HIV within the first year were assessed for treatment using prison medical record data, based on Venereal Disease Research Laboratory test results, HIV-1 viral load, and CD4 counts...
May 7, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29735575/acute-and-persistent-hepatitis-e-virus-genotype-3-and-4-infection-clinical-features-pathogenesis-and-treatment
#12
Nassim Kamar, Sven Pischke
Hepatitis E virus (HEV) genotype (gt)3 and 4 infections are prevalent in industrialized and high-income countries. Although most HEV gt3 and gt4 infections are clinically silent, acute infection may be symptomatic in some patients. In persons with underlying liver disease and in elderly men, HEV infections may present as acute or acute-on-chronic liver failure. Chronic hepatitis may develop in immunosuppressed individuals, including transplant recipients, human immunodeficiency virus (HIV)-infected patients, and persons with hematologic malignancy undergoing chemotherapy, and may progress to life-threatening liver cirrhosis...
May 7, 2018: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/29732907/prevalence-of-rilpivirine-and-etravirine-resistance-mutations-in-hiv-1-subtype-c-infected-patients-failing-nevirapine-or-efavirenz-based-combination-antiretroviral-therapy-in-botswana
#13
Thabo Diphoko, Simani Gaseitsiwe, Ishmael Kasvosve, Sikhulile Moyo, Harriet Okatch, Rosemary Musonda, Mark A Wainberg, Joseph Makhema, Richard Marlink, Vladimir Novitsky, M Essex
BACKGROUND: Rilpivirine (RPV) and Etravirine (ETR) are approved second-generation non-nucleoside reverse transcriptase inhibitors (NNRTI) for HIV treatment. There is a cross-resistance HIV mutation profile between first- and second-generation NNRTI drugs. We determined the prevalence of HIV-1drug-resistance mutations (DRM) to RPV and ETR in Botswana. METHODS: A total of 168 HIV-1 polymerase gene sequences from participants failing nevirapine or efavirenz-containing regimens were analysed for drug resistance mutations using the Stanford University HIV drug resistance database...
May 6, 2018: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29731407/cardiovascular-disease-and-use-of-contemporary-protease-inhibitors-the-d-a-d-international-prospective-multicohort-study
#14
Lene Ryom, Jens D Lundgren, Wafaa El-Sadr, Peter Reiss, Ole Kirk, Matthew Law, Andrew Phillips, Rainer Weber, Eric Fontas, Antonella d' Arminio Monforte, Stéphane De Wit, Francois Dabis, Camilla I Hatleberg, Caroline Sabin, Amanda Mocroft
BACKGROUND: Although earlier protease inhibitors have been associated with increased risk of cardiovascular disease, whether this increased risk also applies to more contemporary protease inhibitors is unknown. We aimed to assess whether cumulative use of ritonavir-boosted atazanavir and ritonavir-boosted darunavir were associated with increased incidence of cardiovascular disease in people living with HIV. METHODS: The prospective Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study consists of people living with HIV-1 from 11 cohorts in Australia, Europe, and the USA...
May 3, 2018: Lancet HIV
https://www.readbyqxmd.com/read/29722904/renal-complications-of-lipodystrophy-a-closer-look-at-the-natural-history-of-kidney-disease
#15
Baris Akinci, Sadiye Mehtat Unlu, Ali Celik, Ilgin Yildirim Simsir, Sait Sen, Banu Nur, Fatma Ela Keskin, Basak Ozgen Saydam, Nilufer Ozdemir Kutbay, Banu Sarer Yurekli, Bekir Ugur Ergur, Melda Sonmez, Tahir Atik, Atakan Arslan, Tevfik Demir, Canan Altay, Ulku Aybuke Tunc, Tugba Arkan, Ramazan Gen, Erdal Eren, Gulcin Akinci, Aslihan Arasli Yilmaz, Habip Bilen, Samim Ozen, Aygul Celtik, Senay Savas Erdeve, Semra Cetinkaya, Huseyin Onay, Sulen Sarioglu, Elif Arioglu Oral
OBJECTIVES: Lipodystrophy syndromes are a group of heterogeneous disorders characterized by adipose tissue loss. Proteinuria is a remarkable finding in previous reports. STUDY DESIGN: In this multi-center study, prospective follow-up data were collected from 103 subjects with non-HIV associated lipodystrophy registered in the Turkish Lipodystrophy Study Group database to study renal complications in treatment naïve patients with lipodystrophy. METHODS: Main outcome measures included ascertainment of chronic kidney disease (CKD) by studying the level of proteinuria and the estimated glomerular filtration rate (eGFR)...
May 3, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29722497/-travelers-exposure-to-hiv-and-hiv-infected-travelers
#16
Noémie Boillat-Blanco, Matthias Cavassini, Blaise Genton
In Switzerland, 20 % of the population travel to the tropics every year and many have unprotected sexual practices during their stay. A third of newly diagnosed HIV infections among Swiss citizens are acquired abroad. Travel clinics are probably important partners in the fight against sexually transmitted infections and HIV. People living with HIV often travel to the tropics but rarely attend a travel clinic before leaving. Travels are a risk factor of HIV viral rebound and antiretroviral treatment failure, particularly in sub-Saharan African patients...
May 2, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29717402/assessing-the-effect-of-recent-incarceration-in-prison-on-hiv-care-retention-and-viral-suppression-in-two-states
#17
Michael Costa, Brian T Montague, Liza Solomon, Cara Sammartino, Roee Gutman, Chava Zibman, David Rosen, Josiah D Rich
The prevalence of HIV among people in correctional facilities remains much higher than that of the general population. Numerous studies have demonstrated the effectiveness and acceptability of HIV treatment for individuals incarcerated in US prisons and jails. However, the period following incarceration is characterized by significant disruptions in HIV care. These disruptions include failure to link in a timely manner (or at all) to community care post-release, as well as not being retained in care after linking...
May 1, 2018: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/29716569/delays-to-treatment-initiation-is-associated-with-tuberculosis-treatment-outcomes-among-patients-on-directly-observed-treatment-short-course-in-southwest-ethiopia-a-follow-up-study
#18
Abyot Asres, Degu Jerene, Wakgari Deressa
BACKGROUND: Despite reported long delays to initiate anti-TB treatment and poor outcomes in different parts of Ethiopia and elsewhere, evidences on association between the delay and treatment outcomes are scanty. METHODS: A follow up study among 735 new TB cases registered at health facilities in districts of southwest Ethiopia was conducted from January 2015 to June 2016. Patients reported days elapsed between onset of illness and treatment commencement of 30 days cutoff was considered to ascertain exposure...
May 2, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29710471/recent-therapeutic-approaches-for-the-management-of-tuberculosis-challenges-and-opportunities
#19
REVIEW
Kiran Patil, Shashikant Bagade, Smita Bonde, Sanjay Sharma, Gaurav Saraogi
Tuberculosis is a highly contagious disease spread by Mycobacterium tuberculosis. It is responsible for highest numbers of death and soon will surpass the deaths caused by HIV. The pandemic disease causes, estimated 10.4 million new infections, among which 5.9 million were men, 3.5 million were women, 1.0 million were children and the HIV patients co-infected with tuberculosis accounted for 1.2 million of all new cases in 2015, alone. The increased number of drug resistant (MDR/XDR) strains and the failure of the conventional regimens against this strain are the challenges of the coming decades...
March 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29710177/economics-of-palliative-care-for-hospitalized-adults-with-serious-illness-a-meta-analysis
#20
Peter May, Charles Normand, J Brian Cassel, Egidio Del Fabbro, Robert L Fine, Reagan Menz, Corey A Morrison, Joan D Penrod, Chessie Robinson, R Sean Morrison
Importance: Economics of care for adults with serious illness is a policy priority worldwide. Palliative care may lower costs for hospitalized adults, but the evidence has important limitations. Objective: To estimate the association of palliative care consultation (PCC) with direct hospital costs for adults with serious illness. Data Sources: Systematic searches of the Embase, PsycINFO, CENTRAL, PubMed, CINAHL, and EconLit databases were performed for English-language journal articles using keywords in the domains of palliative care (eg, palliative, terminal) and economics (eg, cost, utilization), with limiters for hospital and consultation...
April 30, 2018: JAMA Internal Medicine
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