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Antiretroviral side effects

Tamsin Phillips, Annibale Cois, Robert H Remien, Claude A Mellins, James A McIntyre, Greg Petro, Elaine J Abrams, Landon Myer
BACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy...
2016: PloS One
Janneke P Bil, Wendy M van der Veldt, Maria Prins, Ineke G Stolte, Udi Davidovich
Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM).Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach...
September 2016: Medicine (Baltimore)
Raktim K Ghosh, Somedeb Ball, Avash Das, Dhrubajyoti Bandyopadhyay, Samhati Mondal, Debjit Saha, Anjan Gupta
Pulmonary arterial hypertension (PAH) is a relatively rare disease which due to its chronic nature has always been difficult to treat effectively. Selexipag is an oral prostacyclin (PGI2) agonist, which was approved by US Food and Drug Administration (US FDA) in December 2015 for the treatment of PAH. After its success in Phase 1 and Phase 2 clinical trials regarding the convenient oral twice daily dosing and low side-effect profile, selexipag raised the hope of controlling the disease progression in PAH patients...
September 27, 2016: Journal of Clinical Pharmacology
Andrea Calcagno, Jessica Cusato, Antonio D'Avolio, Stefano Bonora
BACKGROUND: Antiretroviral treatment is highly effective in enhancing HIV-positive patients' survival and quality of life. Despite an increased tolerability in recent years, a substantial amount of patients experience side effects. Antiretrovirals' efficacy and tolerability have been associated with plasma concentrations and single nucleotide polymorphisms in selected genes involved in drug disposition. OBJECTIVE: Our aim was to review the current knowledge in genetic polymorphisms affecting plasma, intracellular or compartmental concentrations of antiretrovirals...
September 19, 2016: Clinical Pharmacokinetics
Paul Curley, Marco Siccardi, Darren M Moss, Andrew Owen
AIM: The non-nucleoside reverse transcriptase inhibitor efavirenz is one of the most prescribed antiretroviral therapeutics. Efavirenz-containing therapy has become associated with the occurrence of CNS side effects, including sleep disturbances, depression and even psychosis. RESULTS: The investigation of efavirenz distribution required the development of a versatile and sensitive method. In addition to plasma, quantification was required in brain tissue and phosphate-buffered saline...
October 2016: Bioanalysis
Adrian Curran, Jhon Rojas, Alfonso Cabello, Jesús Troya, Arkaitz Imaz, Pere Domingo, Esteban Martinez, Pablo Ryan, Miguel Górgolas, Daniel Podzamczer, Hernando Knobel, Félix Gutiérrez, Esteban Ribera
OBJECTIVES: To describe the effectiveness and safety of an abacavir/lamivudine + rilpivirine regimen in naive HIV-1-infected patients, as there is a lack of data with this combination. METHODS: This was an observational, retrospective, multicentre study in eight Spanish hospitals. All antiretroviral-naive patients ≥18 years old and starting abacavir/lamivudine + rilpivirine were included. Effectiveness (ITT and on-treatment) and safety (adverse events and laboratory parameters) were assessed during follow-up...
September 2, 2016: Journal of Antimicrobial Chemotherapy
Ling Ye, Chuqi Hou, Shuwen Liu
Patients with human immunodeficiency virus (HIV) receive antiretroviral therapy (ART) through the use of antiretroviral drugs. A combination of at least three drugs that suppreses HIV replication is used as standard treatment, and this is often called "highly active antiretroviral therapy" (HAART). Virus resistance is less likely when three or more drugs are used. A complication of anti-HIV drugs has a complex pharmacokinetic profile which is involved with extensive metabolism and transport by drug metabolizing enzymes (e...
August 29, 2016: Current Topics in Medicinal Chemistry
T L Hartman, L Yang, A N Helfrick, M Hassink, N I Shank, K George Rosenker, M T Scerba, M Saha, E Hughes, A Q Wang, X Xu, P Gupta, R W Buckheit, D H Appella
Although the effective use of highly active antiretroviral therapy results in the suppression of virus production in infected individuals, it does not eliminate the infection and low level virus production in cells harboring virus in sanctuary sites. Thus, the continued search for new antiretroviral agents with unique and different mechanisms of HIV inhibition remains critical, and compounds that can reduce the level of virus production from cells already infected with HIV, as opposed to preventing de novo infection, would be of great benefit...
October 2016: Antiviral Research
Anders Boyd, Patrick Miailhes, Caroline Lascoux-Combe, Hayette Rougier, Pierre-Marie Girard, Emmanuelle Plaisier, Karine Lacombe
BACKGROUND: Renal toxicity is a common side-effect during tenofovir (TDF)-use in human immunodeficiency virus (HIV)-infected, but not necessarily hepatitis B virus (HBV)-infected, patients. Nevertheless, little is known regarding TDF-use on renal impairment during HIV-HBV co-infection. We aimed to evaluate the progression and determinants of renal impairment in co-infected patients undergoing TDF. METHODS: 175 co-infected patients initiating TDF-containing antiretroviral therapy (ART) were prospectively followed...
August 24, 2016: Antiviral Therapy
J Nadel, C J Holloway
HIV infection is now considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). Increased risk of CAD in HIV-infected patients has been associated with the inflammatory sequelae of the infection as well as the greater prevalence of cardiac risk factors in HIV-positive populations and the side effects of life-prolonging antiretroviral therapies. Patients with HIV infection now have a 1.5 to 2-fold greater risk of developing CAD compared with noninfected individuals, raising the independent risk of CAD in HIV infection to levels similar to those in diabetes...
August 24, 2016: HIV Medicine
Eric M Maiese, Phaedra T Johnson, Tim Bancroft, Alyssa Goolsby Hunter, Albert W Wu
OBJECTIVE: The objective of this study was to investigate changes in health-related quality of life (HRQOL) among HIV patients following switch from a first- to second-line antiretroviral therapy (ART) regimen. RESEARCH DESIGN AND METHODS: This was an observational study of adult HIV patients in the US at 35 academic and community health centers. Patients were required to be switching an antiretroviral regimen for the first time at the enrollment visit. Patients were assigned to a study cohort based on whether the switch was due to treatment-related side effects or for any other reason as reported by their physician...
August 23, 2016: Current Medical Research and Opinion
Andrew J Chetwynd, Amanda Samarawickrama, Jaime H Vera, Stephen A Bremner, Alaa Abdul-Sada, Yvonne Gilleece, Stephen G Holt, Elizabeth M Hill
BACKGROUND: The use of combination antiretroviral therapy (cART) has substantially improved the outlook for patients with HIV infection. However, lifelong exposure to cART is also associated with adverse metabolic changes and an enhanced risk of renal, hepatic and cardiovascular dysfunction. This study investigated disruptions of the urinary metabolome of cART-exposed patients, thereby furthering our understanding of some of the side effects of pharmaceutical intervention. METHODS: HIV-positive patients were recruited from an HIV clinic and divided into cART-naïve and cART-exposed groups...
August 16, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Douglas de Sousa Soares, Malena Gadelha Cavalcante, Samille Maria Vasconcelos Ribeiro, Rayana Café Leitão, Ana Patrícia Freitas Vieira, Roberto da Justa Pires Neto, Geraldo Bezerra da Silva Junior, Elizabeth de Francesco Daher
OBJECTIVE: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. METHODS: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared. RESULTS: Sixty-three patients were included. Mean age was 5.3±4.27 years; 55...
August 16, 2016: Jornal de Pediatria
Shannon A McMahon, Caitlin E Kennedy, Peter J Winch, Miriam Kombe, Japhet Killewo, Charles Kilewo
Millions of children are living with HIV in sub-Saharan Africa, and the primary mode of these childhood infections is mother-to-child transmission. While existing interventions can virtually eliminate such transmission, in low- and middle-income settings, only 63 % of pregnant women living with HIV accessed medicines necessary to prevent transmission. In Tanzania, HIV prevalence among pregnant women is 3.2 %. Understanding why HIV-positive women disengage from care during and after pregnancy can inform efforts to reduce the impact of HIV on mothers and young children...
August 17, 2016: AIDS and Behavior
Shilpa Hakre, Jason M Blaylock, Peter Dawson, Charmagne Beckett, Eric C Garges, Nelson L Michael, Patrick J Danaher, Paul T Scott, Jason F Okulicz
Providers are central to effective implementation of HIV pre-exposure prophylaxis (PrEP). Primary care providers (PCP) and infectious disease physicians (ID) in the US Air Force (USAF) participated in a cross-sectional survey regarding knowledge, attitudes, and beliefs toward HIV PrEP. Characteristics associated with PrEP knowledge were assessed in univariate and multivariate analyses.Among 403 (40% of 1015 providers) participants, 9% (PCP 383, ID 20) ever prescribed PrEP. In univariate analysis, years in practice, number of HIV-infected patients treated in the past 12 months, past prescription of antiretrovirals for HIV prevention, frequency of prescribing PrEP in the past 12 months, and ever being questioned by a patient about PrEP were associated with PrEP knowledge (P < 0...
August 2016: Medicine (Baltimore)
Begashaw Melaku Gebresillassie, Minaleshewa Biruk Gebeyehu, Tadesse Melaku Abegaz, Daniel Asfaw Erku, Abebe Basazn Mekuria, Yokabd Dechassa Tadesse
PURPOSE: Cotrimoxazole preventive therapy (CPT) is a feasible, inexpensive, and well-tolerated way of using cotrimoxazole intervention for patients living with HIV/AIDS to reduce HIV/AIDS-related morbidities and mortalities caused by various bacteria, fungi, and protozoa. The aim of this study was to evaluate the use of cotrimoxazole as a prophylaxis therapy among patients living with HIV/AIDS at Gondar University Referral Hospital (GURH), northwestern Ethiopia. MATERIALS AND METHODS: A retrospective cross-sectional study was used to evaluate the use of cotrimoxazole as a prophylaxis therapy among people living with HIV/AIDS at GURH, northwestern Ethiopia from September 2013 to October 2015...
2016: HIV/AIDS: Research and Palliative Care
Victoria I Dudina, Darja I Judina, Elizabeth J King
The purpose of this research was to identify different types of fear related to starting and adhering to antiretroviral therapy (ART) among people living with HIV (PLHIV) in Russia. Data were collected from the Russian-language internet forum for PLHIV ( Qualitative data analysis focused on the sections of the forum where users discussed health-related issues in order to identify fears related to HIV treatment. The following types of fear were revealed: fear of the illness, fear to learn negative information about one's health, fear of side effects, fear of therapy to be ineffective, fear that the appropriate medications will become unavailable, fear of lifestyle changes, and fear for the well-being of significant others...
July 22, 2016: AIDS Care
Catherine E Oldenburg, Bao Le, Hoang Thi Huyen, Dinh Duc Thien, Nguyen Hoang Quan, Katie B Biello, Amy Nunn, Philip A Chan, Kenneth H Mayer, Matthew J Mimiaga, Donn Colby
Background: The HIV/AIDS epidemic in Vietnam is concentrated in subgroups of the population, including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods: In 2015, an online survey was conducted with recruitment via social networking websites for MSM and peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants...
July 22, 2016: Sexual Health
Marilou Gagnon, Dave Holmes
Each of the antiretroviral drugs that are currently used to stop the progression of HIV infection causes its own specific side effects. Despite the expansion, multiplication, and simplification of treatment options over the past decade, side effects continue to affect people living with HIV. Yet, we see a clear disconnect between the way side effects are normalized, routinized, and framed in clinical practice and the way they are experienced by people living with HIV. This paper builds on the premise that new approaches are needed to understand side effects in a manner that is more reflective of the subjective accounts of people living with HIV...
October 2016: Nursing Philosophy: An International Journal for Healthcare Professionals
Guannan Geng, Bingfeng Liu, Cancan Chen, Kang Wu, Jun Liu, Yijun Zhang, Ting Pan, Jun Li, Yue Yin, Junsong Zhang, Feng Huang, Fei Yu, Jingliang Chen, Xiancai Ma, Jie Zhou, Ersheng Kuang, Chao Liu, Weiping Cai, Hui Zhang
Although combined antiretroviral therapy (cART) successfully decreases plasma viremia to undetectable levels, the complete eradication of human immunodeficiency virus type 1 (HIV-1) remains impractical because of the existence of a viral reservoir, mainly in resting memory CD4(+) T cells. Various cytokines, protein kinase C activators, and histone deacetylase inhibitors (HDACi) have been used as latency-reversing agents (LRAs), but their unacceptable side effects or low efficiencies limit their clinical use...
September 2016: Molecular Therapy: the Journal of the American Society of Gene Therapy
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