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Tenofovir in childrens

Brent M Hanson, Jessie A Dorais
Special considerations must be taken when patients with human immunodeficiency virus (HIV), Hepatitis B, or Hepatitis C desire to achieve pregnancy. Patients with chronic viral illnesses desire children at rates similar to the general population, and options are available to decrease both vertical transmission and viral transmission between partners. Preconception counseling or consultation with fertility specialists is imperative in patients with HIV, Hepatitis B, and Hepatitis C so that reproductive goals can be addressed and optimized...
February 13, 2017: American Journal of Obstetrics and Gynecology
Beatriz Jiménez, Talía Sainz, Laura Díaz, María José Mellado, María Luisa Navarro, Pablo Rojo, María Isabel González-Tomé, Luis Prieto, Jorge Martínez, María Isabel de José, José Tomás Ramos, María Ángeles Muñoz-Fernandez
BACKGROUND: Our aim was to determine the prevalence and risk factors associated with low bone mineral density (BMD) in vertically HIV-infected patients; and to investigate whether low BMD is related to immune activation and senescence induced by HIV infection. METHODS: A cross-sectional study was performed in 98 vertically HIV-infected patients. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine. Height adjustment of BMD Z-score was performed using height-for-age Z-score...
December 21, 2016: Pediatric Infectious Disease Journal
Alasdair Bamford, Gareth Tudor-Williams, Caroline Foster
UK guidelines for HIV post-exposure prophylaxis (PEP) in adults have recently been updated. Indications for PEP have been modified and there has been a change in the recommended antiretroviral therapy for adults to a combination of raltegravir with tenofovir and emtricitabine (Truvada). Raltegravir and tenofovir are now available in paediatric formulations and offer improved safety and tolerability over previously recommended ritonavir-boosted lopinavir with zidovudine. This guideline provides recommendations for those caring for children potentially exposed to HIV and other bloodborne viruses in primary care, emergency departments, secondary care and specialist paediatric HIV centres...
January 2017: Archives of Disease in Childhood
Stanzi M le Roux, Jennifer Jao, Kirsty Brittain, Tamsin K Phillips, Seun Olatunbosun, Agnes Ronan, Allison Zerbe, Elaine J Abrams, Landon Myer
OBJECTIVE: Tenofovir (TDF) affects bone health and is widely used in pregnancy but data are limited on the effects of TDF exposure in utero. We examined the association between duration of in-utero TDF exposure and linear growth in HIV-exposed, uninfected (HEU) infants. DESIGN: A prospective cohort of pregnant women initiating TDF-containing regimens at primary care services in Cape Town, South Africa, were enrolled and followed with their breastfeeding infants through 12 months postpartum...
January 2, 2017: AIDS
Pierre O Sellier, Sarah Maylin, Béatrice Berçot, Dorothée Chopin, Amanda Lopes, Guy Simoneau, John Evans, Véronique Delcey, Jean-Louis Bénifla, François Simon, Jean-François Bergmann
BACKGROUND: The risk of vertical transmission of hepatitis B virus (HBV) increases as maternal HBV DNA increase, despite serovaccination to newborns. METHODS: From 1 July 2012 to 1 January 2016, all pregnant women in Lariboisiere Hospital, Paris, France, with HBV DNA of 5 log10 IU/ml and above were administered tenofovir from week 28 of pregnancy until delivery. HBV DNA was measured at months 1, 2 of tenofovir and at delivery. The newborns were serovaccinated, tested for hepatitis B surface antigen, hepatitis B core antibody (HBcAb)±HBV DNA, and hepatitis B surface antibody (HBsAb) when aged 9 months, and then 24 months...
March 2017: European Journal of Gastroenterology & Hepatology
Denise L Jacobson, Kunjal Patel, Paige L Williams, Mitchell E Geffner, George K Siberry, Linda A Dimeglio, Marilyn J Crain, Ayesha Mirza, Janet S Chen, Elizabeth McFarland, Deborah Kacanek, Margarita Silio, Kenneth Rich, William Borkowsky, Russell B Van Dyke, Tracie L Miller
BACKGROUND: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at one year of age in HIV-exposed uninfected (HEU) US children. METHODS: We studied 509 HEU children in the US-based Surveillance Monitoring of ART Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART-initiators)...
October 27, 2016: Pediatric Infectious Disease Journal
Aditya H Gaur, Hilda Kizito, Wasana Prasitsueubsai, Natella Rakhmanina, Mohammed Rassool, Rana Chakraborty, Jagmohan Batra, Pope Kosalaraksa, Wicharn Luesomboon, Danielle Porter, Yongwu Shao, Michael Myers, Lillian Ting, Devi SenGupta, Erin Quirk, Martin S Rhee
BACKGROUND: The prodrug tenofovir alafenamide is associated with improved renal and bone safety compared with tenofovir disoproxil fumarate. We aimed to assess safety, pharmacokinetics, and efficacy of this single-tablet, fixed-dose combination of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide in HIV-infected, treatment-naive adolescents. METHODS: We did a 48 week, single-arm, open-label trial in treatment-naive adolescents with HIV from ten hospital clinics in South Africa, Thailand, Uganda, and the USA...
December 2016: Lancet HIV
Stanzi M le Roux, Jennifer Jao, Kirsty Brittain, Tamsin K Phillips, Seun Olatunbosun, Agnes Ronan, Allison Zerbe, Elaine J Abrams, Landon Myer
OBJECTIVE: Tenofovir (TDF) affects bone health and is widely used in pregnancy but data are limited on the effects of TDF exposure in utero. We examined the association between duration of in utero TDF exposure and linear growth in HIV-exposed, uninfected (HEU) infants. DESIGN: A prospective cohort of pregnant women initiating TDF-containing regimens at primary care services in Cape Town, South Africa were enrolled and followed with their breastfeeding infants through 12 months postpartum...
October 14, 2016: AIDS
Noella Maria Delia Pereira, Ira Shah, Shilpa Kulkarni
Opsoclonus-myoclonus-ataxia (OMA) syndrome typically presents with chaotic eye movements and myoclonus with some patients exhibiting ataxia and behavioural disturbances. The pathogenesis may be inflammatory with an infectious or paraneoplastic trigger. We present a 13-year-old HIV-infected girl who was initially started on highly active antiretroviral therapy (HAART) in March 2013 with a CD4 count of 79 cells/cumm. Initially, the patient did not comply with treatment, resulting in a CD4+ count of 77 cells/mm(3) in November 2015 and prompting a new HAART scheme comprising lamivudine, tenofovir and ritonavir-boosted atazanavir...
October 2016: Oxford Medical Case Reports
Kenneth K Mugwanya, Craig W Hendrix, Nelly R Mugo, Mark Marzinke, Elly T Katabira, Kenneth Ngure, Nulu B Semiyaga, Grace John-Stewart, Timothy R Muwonge, Gabriel Muthuri, Andy Stergachis, Connie L Celum, Jared M Baeten
BACKGROUND: As pre-exposure prophylaxis (PrEP) becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women. METHODS AND FINDINGS: We conducted a prospective short-term, open-label study of daily oral emtricitabine-tenofovir disoproxil fumarate PrEP among 50 HIV-uninfected breastfeeding African mother-infant pairs between 1-24 wk postpartum (ClinicalTrials...
September 2016: PLoS Medicine
Chet Raj Ojha, Geeta Shakya, Shyam Prakash Dumre
Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4(+) T-lymphocyte (CD4(+)) counts were estimated by flow cytometry. The mean CD4(+) count of patients was 501 (95% CI = 325-579) cells/cumm, but about 35% of patients had CD4(+) T cell counts below 350 cells/cumm...
2016: BioMed Research International
Marco Floridia, Giuseppe Liotta, Mauro Andreotti, Clementina M Galluzzo, Roberta Amici, Haswell Jere, Jean-Baptiste Sagno, Maria C Marazzi, Ersilia Buonomo, Paola Scarcella, Sandro Mancinelli, Stefano Vella, Marina Giuliano, Leonardo Palombi
OBJECTIVES: No data are available on bone metabolism in infants exposed to tenofovir during breastfeeding. We investigated bone metabolism markers in the first year of life in infants from mothers who received tenofovir, lamivudine and efavirenz during pregnancy and 12 months of breastfeeding in a national Option B+ programme in Malawi. METHODS: Serum samples collected at 6 and 12 months in tenofovir-exposed infants and in a small sample of tenofovir-unexposed infants from the same clinical centre were analysed in batches for levels of bone-specific alkaline phosphatase (BAP; marker of bone formation) and of C-terminal telopeptide of type I collagen (CTX; marker of bone resorption)...
November 2016: Journal of Antimicrobial Chemotherapy
Wasana Prasitsuebsai, Sirinya Teeraananchai, Thida Singtoroj, Khanh Huu Truong, Jintanat Ananworanich, Viet Chau Do, Lam Van Nguyen, Pope Kosalaraksa, Nia Kurniati, Tavitiya Sudjaritruk, Kulkanya Chokephaibulkit, Stephen J Kerr, Annette H Sohn
BACKGROUND: Data on pediatric treatment outcomes and drug resistance while on second-line antiretroviral therapy (ART) are needed to guide HIV care in resource-limited countries. METHODS: HIV-infected children <18 years who were switched or switching to second-line ART after first-line failure were enrolled from 8 sites in Indonesia, Thailand, and Vietnam. Genotyping was performed at virologic failure (VF; HIV-RNA >1000 copies/mL). Cox proportional hazards regression was used to evaluate factors predicting VF...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Lola Falcon-Neyra, Claudia Palladino, María Luisa Navarro Gómez, Pere Soler-Palacín, María Isabel González-Tomé, Santiago J De Ory, Marie Antoinette Frick, Clàudia Fortuny, Antoni Noguera-Julian, Elena Bermúdez Moreno, Juan Luis Santos, Peter Olbrich, Luis F López-Cortés, Verónica Briz, Olaf Neth
To assess the safety and efficacy of rilpivirine in combination with emtricitabine and tenofovir (RPV/FTC/TDF) as a once-daily single-tablet regimen (STR) in HIV-1-infected children and adolescents we performed a multicenter case series study of HIV-1-infected patients. Inclusion criteria were initiation of therapy with RPV/FTC/TDF before the age of 18. Patients were divided into undetectable viral load (uVL) group, HIV-1 RNA < 20 copies/mL on stable combined antiretroviral therapy (cART), and detectable viral load (dVL) group, HIV-1 RNA ≥ 20 copies/mL at RPV/FTC/TDF initiation...
June 2016: Medicine (Baltimore)
Russell B Van Dyke, Ellen Gould Chadwick, Rohan Hazra, Paige L Williams, George R Seage
The Surveillance Monitoring for ART Toxicities (SMARTT) cohort of the Pediatric HIV/AIDS Cohort Study includes over 3,500 HIV-exposed but uninfected infants and children at 22 sites in the US, including Puerto Rico. The goal of the study is to determine the safety of in utero exposure to antiretrovirals (ARVs) and to estimate the incidence of adverse events. Domains being assessed include metabolic, growth and development, cardiac, neurological, neurodevelopmental (ND), behavior, language, and hearing. SMARTT employs an innovative trigger-based design as an efficient means to identify and evaluate adverse events...
2016: Frontiers in Immunology
Rose I Okonkwo, Anita E Weidmann, Emmanuel E Effa
No abstract text is available yet for this article.
April 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Allison R Eckard, Stefano Mora
PURPOSE OF REVIEW: Chronic HIV infection and exposure to antiretroviral therapy compromises bone health in children and adolescents, potentially impacting their long-term quality of life. Thus, the purpose of this article is to review the most recent literature on this topic in HIV-infected children and adolescents. RECENT FINDINGS: Recent studies continue to demonstrate bone abnormalities in HIV-infected children and adolescents, whether HIV is acquired perinatally or during adolescence...
May 2016: Current Opinion in HIV and AIDS
Pierre O Sellier, Nathalie Schnepf, Rishma Amarsy, Sarah Maylin, Amanda Lopes, Marie-Christine Mazeron, Clara Flateau, Marjolaine Morgand, Nicole Ciraru-Vigneron, Aurore Berthe, Guy Simoneau, John Evans, Safia Souak, Sophie Matheron, Jean-Louis Benifla, François Simon, Jean-François Bergmann
OBJECTIVES: We assessed hepatitis B virus (HBV) status in children born to HIV/HBV coinfected women with large access to antiretroviral therapy. METHODS: All HIV/HBV coinfected pregnant women from 01 January 2000 to 01 January 2012 were included in the retrospective study (NCT02044068). Antiretroviral therapy during pregnancy and injection of HBV immunoglobulin/vaccine to newborns was recorded. We assessed HBV status of children aged at least 2 years. RESULTS: Twenty-one women (35 children) were studied...
March 2016: European Journal of Gastroenterology & Hepatology
Rose I Okonkwo, Anita E Weidmann, Emmanuel E Effa
INTRODUCTION: Tenofovir disoproxil fumarate (TDF)-containing regimens in the treatment of HIV-infected children have safety concerns with respect to renal and bone toxicity. OBJECTIVE: The aim of this study was to systematically review and critically appraise the literature relating to the reported renal and bone adverse effects of TDF-based regimens in the treatment of HIV-infected children from 2 to 19 years old. METHODS: Searches were performed using the Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, OvidSP, ScienceDirect and Web of Science databases and platforms...
March 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Leonardo Palombi, Maria F Pirillo, Emilia Marchei, Haswell Jere, Jean-Baptiste Sagno, Richard Luhanga, Marco Floridia, Mauro Andreotti, Clementina Maria Galluzzo, Simona Pichini, Ruben Mwenda, Sandro Mancinelli, Maria Cristina Marazzi, Stefano Vella, Giuseppe Liotta, Marina Giuliano
OBJECTIVES: To evaluate antiretroviral drug concentrations in mothers and infants enrolled under the Option B-Plus approach for the prevention of HIV mother-to-child transmission in Malawi and to assess the maternal virological response after 1 year of treatment. PATIENTS AND METHODS: Forty-seven women and 25 children were studied. Mothers were administered during pregnancy a combination of tenofovir, lamivudine and efavirenz and continued it during breastfeeding (up to 2 years) and thereafter...
April 2016: Journal of Antimicrobial Chemotherapy
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