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Antiretroviral side effects

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https://www.readbyqxmd.com/read/29218008/improving-the-adherence-to-antiretroviral-therapy-a-difficult-but-essential-task-for-a-successful-hiv-treatment-clinical-points-of-view-and-practical-considerations
#1
REVIEW
Simona A Iacob, Diana G Iacob, Gheorghita Jugulete
HIV infection is responsible for one the most devastating human pandemics. The advent of antiretroviral therapy has changed the course of the pandemic and saved millions of lives. Complex therapeutic regimens have been introduced since 1996 and have contributed to the transformation of HIV infection into a treatable chronic diseases. New types of potent antiretrovirals and their combinations, including "once daily" treatment, have simplified the regimens and diminished side effects. Nevertheless the adherence to antiretroviral therapy remains unsatisfactory and varies between 27 and 80% across different population in various studies, compared with the required level of 95%...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29181714/discontinuation-of-efavirenz-in-paediatric-patients-why-do-children-switch
#2
Elke Wynberg, Eleri Williams, Gareth Tudor-Williams, Hermione Lyall, Caroline Foster
BACKGROUND: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents...
November 27, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29132279/-i-will-take-arvs-once-my-body-deteriorates-an-analysis-of-swazi-men-s-perceptions-and-acceptability-of-test-and-start
#3
Alfred K Adams, Agostino M Zamberia
Swaziland has the highest HIV prevalence in the world. To mitigate the spread and devastation caused by HIV and to improve the wellbeing of people living with HIV, the country has adopted the latest available HIV prevention campaigns, including "Test and Start". Because evidence from randomised controlled trials has demonstrated a significant risk reduction in HIV transmission when HIV-positive people start antiretroviral therapy (ART) early, Swaziland aims to find these people and link them to treatment. This study presents findings regarding the perceptions of this promising HIV-prevention intervention among men aged 17-69 years...
December 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/29105160/strength-in-amalgamation-newer-combination-agents-for-hiv-and-implications-for-practice
#4
Christopher McCoy, Melissa Badowski, Elizabeth Sherman, Rustin Crutchley, Ethan Smith, Daniel B Chastain
Antiretroviral (ART) therapy for treatment of human immunodeficiency virus (HIV) infection has undergone significant changes over the past 30 years. Many single tablet regimens (STR), including newer fixed dose combination (FDC) tablets, are available, offering patients several options for choosing a treatment regimen that works best for them. Given these changes, patients are more likely to adhere to treatment, achieve better clinical outcomes, and experience both fewer side effects and drug-drug interactions...
November 3, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29095883/patterns-of-patient-and-healthcare-provider-viewpoints-regarding-participation-in-hiv-cure-related-clinical-trials-findings-from-a-multicentre-french-survey-using-q-methodology-anrs-apsec
#5
Christel Protière, Bruno Spire, Marion Mora, Isabelle Poizot-Martin, Marie Préau, Marjolaine Doumergue, Philippe Morlat, David Zucman, Cécile Goujard, François Raffi, Olivier Lambotte, Marie Suzan-Monti
CONTEXT: Despite huge advances in the fight against HIV concerning diagnosis, clinical efficacy of antiretroviral treatments (ART), patient survival and quality of life, there is still no cure. Recent developments in HIV cure research have opened the way for clinical trials which could lead to a temporary or definitive end to ART. However, ethical questions exist about related trial-participation risks. The main goal of the ANRS-APSEC survey was, using Q-methodology, to investigate the viewpoints of people living with HIV (PLWH) and HIV healthcare providers (HHP) regarding motivations for and barriers to participation in HIV Cure-related clinical trials (HCRCT)...
2017: PloS One
https://www.readbyqxmd.com/read/29075137/high-prevalence-of-pain-among-adult-hiv-infected-patients-at-university-of-gondar-hospital-northwest-ethiopia
#6
Abere Woretaw Azagew, Hiwot Kassa Woreta, Ambaye Dejen Tilahun, Degefaye Zelalem Anlay
BACKGROUND: HIV/AIDS are pressing global health problems. Pain is a common symptom reported by patients living with HIV/AIDS. The exact cause of pain in HIV patients has not been thoroughly described, but it may, due to a symptom of HIV itself, result from opportunistic infections, as a side effect of antiretroviral drugs, concurrent neoplasia or other causes. In addition, pain perception of HIV-infected patients is highly variable and may vary based on cultural context and patient demographics...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29066858/rilpivirine-the-key-for-long-term-success
#7
Pompeyo Viciana
During the past 30 years of antiretroviral therapy, continuous improvements in drug discovery have provided increasingly potent and safer antivirals that have transformed HIV infection in a chronic illness, rarely fatal. Non-nucleoside reverse-transcriptase inhibitors (NNRTIs) are frequently used as part of any antiretroviral combination therapy. Side effects and low resistance barrier of fi rst-generation NNRTIs (e.g., nevirapine and efavirenz) have been overcome with rilpivirine (RPV), and the last NNRTI approved for the treatment of HIV infection...
October 2017: AIDS Reviews
https://www.readbyqxmd.com/read/29033481/adverse-drug-reaction-monitoring-in-patients-on-antiretroviral-therapy-in-a-tertiary-care-hospital-in-eastern-india
#8
Shatavisa Mukherjee, Nikhil Era, Bibhuti Saha, Santanu Kumar Tripathi
BACKGROUND: Besides unparalleled benefits, highly active antiretroviral therapy is also associated with wide range of potential adverse drug reactions (ADRs), which hinders treatment adherence. The present study was thus designed to monitor and explore the pattern of occurrence of ADRs to various antiretroviral therapy (ART) regimens in a tertiary care ART setup. MATERIALS AND METHODS: A prospective, observational clinical study was carried out in the outpatient setting of nodal ART center of Eastern India...
May 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29027607/developing-a-patient-reported-outcome-measure-for-hiv-care-on-perceived-barriers-to-antiretroviral-adherence-assessing-the-needs-of-hiv-clinicians-through-qualitative-analysis
#9
Isabelle Toupin, Kim Engler, David Lessard, Leo Wong, Andràs Lènàrt, Bruno Spire, François Raffi, Bertrand Lebouché
PURPOSE: To identify HIV clinicians' needs for the clinical use of a new patient-reported outcome measure (PRO) on barriers to antiretroviral therapy (ART) adherence. METHODS: In 2015, five focus groups with 31 clinicians from France were transcribed, coded with Atlas.ti, and submitted to a typological analysis. RESULTS: The analysis identified seven patient profiles, each tied to distinct barriers to adherence and to specific needs for the PRO's content, data collection and transmission...
October 13, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28994660/pharmacokinetics-of-rilpivirine-and-24-week-outcomes-after-switching-from-efavirenz-in-virologically-suppressed-hiv-1-infected-adolescents
#10
Watsamon Jantarabenjakul, Suvaporn Anugulruengkitt, Naruporn Kasipong, Narukjaporn Thammajaruk, Jiratchaya Sophonphan, Torsak Bunupuradah, Tim R Cressey, Angela Colbers, David M Burger, Wanatpreeya Phongsamart, Thanyawee Puthanakit, Chitsanu Pancharoen
BACKGROUND: Rilpivirine (RPV), a non-nucleoside reverse transcriptase inhibitor drug, could be a favorable drug for maintenance therapy in HIV-infected adolescents because it has few long-term side effects. However, data among adolescents switching from efavirenz (EFV) to RPV are limited. This study investigated the pharmacokinetics (PK), safety and efficacy of RPV in virologically-suppressed HIV-1-infected adolescents after switching from EFV. METHODS: Adolescents aged 12-18 years on EFV-based antiretroviral therapy (ART) were switched from EFV to RPV (25 mg, once daily)...
October 10, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28994443/role-of-raltegravir-in-patients-co-infected-with-hiv-and-hcv-in-the-era-of-direct-antiviral-agents
#11
Lucia Taramasso, Giovanni Cenderello, Niccolò Riccardi, Simone Tunesi, Antonio Di Biagio
Integrase strand transfer inhibitors (INSTIs) are the preferred third agent in first-line antiretroviral therapies. Raltegravir (RAL) was the first INSTI to be approved and used in naïve and experienced patients. Due to its good tolerability and low side effects, RAL has been largely used also in hepatitis co-infected patients. Many years of experience in RAL use now allow literature evidence to be gathered on its safety in HIV/HCV-co-infected patients pre, during and post direct acting agents (DAA) treatment, at all possible stages...
October 10, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28993180/efficacy-and-safety-of-switching-from-boosted-protease-inhibitors-plus-emtricitabine-and-tenofovir-disoproxil-fumarate-regimens-to-single-tablet-darunavir-cobicistat-emtricitabine-and-tenofovir-alafenamide-at-48-weeks-in-adults-with-virologically-suppressed
#12
Chloe Orkin, Jean-Michel Molina, Eugenia Negredo, José R Arribas, Joseph Gathe, Joseph J Eron, Erika Van Landuyt, Erkki Lathouwers, Veerle Hufkens, Romana Petrovic, Simon Vanveggel, Magda Opsomer
BACKGROUND: Simplified regimens with reduced pill burden and fewer side-effects are desirable for people living with HIV. We investigated the efficacy and safety of switching to a single-tablet regimen of darunavir, cobicistat, emtricitabine, and tenofovir alafenamide versus continuing a regimen of boosted protease inhibitor, emtricitabine, and tenofovir disoproxil fumarate. METHODS: EMERALD was a phase-3, randomised, active-controlled, open-label, international, multicentre trial, done at 106 sites across nine countries in North America and Europe...
October 5, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28969567/long-term-treatment-with-raltegravir-is-associated-with-lowering-triglycerides-and-platelets-count-in-the-older-hiv-population-results-from-the-ral-age-study
#13
Paolo Pavone, Noemi Giustini, Caterina Fimiani, Francesca Paoletti, Mario Falciano, Alessandra Salotti, Fiorella Di Sora, Samir Al Moghazi, Ivano Mezzaroma, Vincenzo Vullo, Gabriella D'Ettorre
BACKGROUND: Raltegravir (RAL) is considered one of the better-tolerated antiretroviral medications, due to limited side effects and minimal drug-drug interactions. Matherials and Methods: We retrospectively evaluated 96 HIV+, over 60 years old, experienced patients who had switched from any antiretroviral drug to raltegravir-based nuc-sparing or standard nucleoside-backbone regimens. RESULTS: The median age of the patients was 66 years (IQR 10.5) (77 M, 19 F); the median time horizon of follow-up was 4 years (IQR 5)...
September 27, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28929260/preferences-for-injectable-prep-among-young-u-s-cisgender-men-and-transgender-women-and-men-who-have-sex-with-men
#14
Katie B Biello, Sybil Hosek, Morgan T Drucker, Marvin Belzer, Matthew J Mimiaga, Elliot Marrow, Julia Coffey-Esquivel, Jennifer Brothers, Kenneth H Mayer
Young men who have sex with men account for approximately 20% of incident HIV infections in the U.S. Antiretroviral pre-exposure prophylaxis (PrEP) administered as a daily pill has been shown to decrease HIV acquisition in at-risk individuals. New modalities for PrEP are being developed and tested, including injectable PrEP; however, acceptability of these emerging modalities has not yet been examined in youth. We conducted six focus groups with 36 young men and transgender men and women who have sex with men in Boston, Chicago, and Los Angeles in 2016 to assess interest in and preference for different PrEP modalities...
September 19, 2017: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/28922979/a-review-of-drug-drug-interactions-in-older-hiv-infected-patients
#15
Aarthi Chary, Nancy N Nguyen, Kimberly Maiton, Mark Holodniy
The number of older HIV-infected people is growing due to increasing life expectancies resulting from the use of antiretroviral therapy (ART). Both HIV and aging increase the risk of other comorbidities, such as cardiovascular disease, osteoporosis, and some malignancies, leading to greater challenges in managing HIV with other conditions. This results in complex medication regimens with the potential for significant drug-drug interactions and increased morbidity and mortality. Area covered: We review the metabolic pathways of ART and other medications used to treat medical co-morbidities, highlight potential areas of concern for drug-drug interactions, and where feasible, suggest alternative approaches for treating these conditions as suggested from national guidelines or articles published in the English language...
September 19, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28904745/genome-editing-of-the-hiv-co-receptors-ccr5-and-cxcr4-by-crispr-cas9-protects-cd4-t-cells-from-hiv-1-infection
#16
Zhepeng Liu, Shuliang Chen, Xu Jin, Qiankun Wang, Kongxiang Yang, Chenlin Li, Qiaoqiao Xiao, Panpan Hou, Shuai Liu, Shaoshuai Wu, Wei Hou, Yong Xiong, Chunyan Kong, Xixian Zhao, Li Wu, Chunmei Li, Guihong Sun, Deyin Guo
BACKGROUND: The main approach to treat HIV-1 infection is combination antiretroviral therapy (cART). Although cART is effective in reducing HIV-1 viral load and controlling disease progression, it has many side effects, and is expensive for HIV-1 infected patients who must remain on lifetime treatment. HIV-1 gene therapy has drawn much attention as studies of genome editing tools have progressed. For example, zinc finger nucleases (ZFN), transcription activator like effector nucleases (TALEN) and clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 have been utilized to successfully disrupt the HIV-1 co-receptors CCR5 or CXCR4, thereby restricting HIV-1 infection...
2017: Cell & Bioscience
https://www.readbyqxmd.com/read/28893759/values-and-preferences-of-women-living-with-hiv-who-are-pregnant-postpartum-or-considering-pregnancy-on-choice-of-antiretroviral-therapy-during-pregnancy
#17
Lyubov Lytvyn, Reed A Siemieniuk, Sophie Dilmitis, Allyson Ion, Yaping Chang, Malgorzata M Bala, Veena Manja, Reza Mirza, Rene Rodriguez-Gutierrez, Hassan Mir, Laura Banfield, Per Olav Vandvik, Susan Bewley
OBJECTIVE: To investigate women's values and preferences regarding antiretroviral therapy (ART) during pregnancy to inform a BMJ Rapid Recommendation. SETTING: Primary studies reporting patient-reported outcomes relevant to decision-making regarding ART in any clinical and geographical setting. PARTICIPANTS: Women living with HIV who are pregnant, postpartum or considering pregnancy. OUTCOME MEASURES: Quantitative measurements and qualitative descriptions of values and preferences in relation to ART during pregnancy...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28876170/transgender-women-living-with-hiv-frequently-take-antiretroviral-therapy-and-or-feminizing-hormone-therapy-differently-than-prescribed-due-to-drug-drug-interaction-concerns
#18
Hannan M Braun, Jury Candelario, Courtney L Hanlon, Eddy R Segura, Jesse L Clark, Judith S Currier, Jordan E Lake
PURPOSE: Both hormone therapy (HT) and antiretroviral therapy (ART) can be lifesaving for transgender women (TW) living with HIV, but each has side effects and potential drug-drug interactions (DDI). We assessed how concerns about HT-ART interactions affect treatment adherence. METHODS: This study used a cross-sectional survey of TW (n = 87) in Los Angeles, CA. RESULTS: Fifty-four percent were living with HIV; 64% used HT. Only 49% of TW living with HIV discussed ART-HT DDI with their provider; 40% reported not taking ART (12%), HT (12%), or both (16%) as directed due to DDI concerns...
October 2017: LGBT Health
https://www.readbyqxmd.com/read/28865281/design-strategies-in-the-prodrugs-of-hiv-1-protease-inhibitors-to-improve-the-pharmaceutical-properties
#19
REVIEW
Murugaiah A M Subbaiah, Nicholas A Meanwell, John F Kadow
Combination antiretroviral therapy (cART) is currently the most effective treatment for HIV-1 infection. HIV-1 protease inhibitors (PIs) are an important component of some regimens of cART. However, PIs are known for sub-optimal ADME properties, resulting in poor oral bioavailability. This often necessitates high drug doses, combination with pharmacokinetic enhancers and/or special formulations in order to effectively deliver PIs, which may lead to a high pill burden and reduced patient compliance. As a remedy, improving the ADME properties of existing drugs via prodrug and other approaches has been pursued in addition to the development of next generation PIs with improved pharmacokinetic, resistance and side effect profiles...
October 20, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28853677/reasons-for-switching-art-comparison-of-data-collected-in-2012-2013-and-2014-2015-in-florence-italy
#20
Francesco Maria Fusco, Maria Chiara Burla, Anna Degli Esposti, Piera Pierotti, Loredana Rabatti, Francesca Vichi
Persons living with HIV should remain on antiretroviral therapy (ART) indefinitely; however, a switch in the drug regimen is often necessary. In order to investigate if reasons for switching ART changed over time, we retrospectively analyzed reasons for switching and characteristics of switches among patients at Santa Maria Annunziata Hospital (OSMA), Florence area, Tuscany, Italy, over two periods (November 2012-October 2013 and November 2014-October 2015). The reasons for switching were classified as: simplification; virologic failure; occurrence of co-morbidities; and drug tolerability/toxicity issues...
January 1, 2017: International Journal of STD & AIDS
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