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https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#1
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28435886/discovery-of-a-novel-antifungal-agent-in-the-pathogen-box
#2
François L Mayer, James W Kronstad
Human fungal pathogens cause over 2 million infections per year and are major drivers of morbidity and mortality. Cryptococcus neoformans and Candida albicans are two of the most common fungal pathogens of humans, together accounting for a staggering 1.4 million infections annually, with very high mortality rates. Patients with dysfunctional immune systems, such as individuals with HIV/AIDS, are particularly susceptible to fungal infections. Unfortunately, relatively few antifungal drugs are currently available and fungi frequently develop resistance, further complicating treatment approaches...
March 2017: MSphere
https://www.readbyqxmd.com/read/28434936/defining-a-research-agenda-to-address-the-converging-epidemics-of-tuberculosis-and-diabetes-part-1-epidemiology-and-clinical-management
#3
REVIEW
Julia A Critchley, Blanca I Restrepo, Katharina Ronacher, Anil Kapur, Andrew A Bremer, Larry S Schlesinger, Randall Basaraba, Hardy Kornfeld, Reinout van Crevel
There is growing interest in the interaction between type 2 diabetes (DM) and tuberculosis (TB), but many research questions remain unanswered. Epidemiologists, basic scientists and clinical experts recently convened and identified priorities. This is the first of two reviews on this topic, summarising priority areas of research with regard to epidemiology, clinical management and public health. First, from an epidemiological point of view, more study is needed to determine the importance of transient hyperglycemia in TB patients, and on the importance of DM for the global epidemic of multi-drug resistant (MDR)-TB...
April 19, 2017: Chest
https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#4
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28427454/cryptosporidium-and-giardia-in-africa-current-and-future-challenges
#5
REVIEW
Sylvia Afriyie Squire, Una Ryan
Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development...
April 20, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28422610/joint-bent-cable-tobit-models-for-longitudinal-and-time-to-event-data
#6
Getachew A Dagne
In this article, we show how to estimate a transition period for the evolvement of drug resistance to antiretroviral (ARV) drug or other related treatments in the framework of developing a Bayesian method for jointly analyzing time to event and longitudinal data. For HIV/AIDS longitudinal data, developmental trajectories of viral loads tend to show a gradual change from a declining trend after initiation of treatment to an increasing trend without an abrupt change. Such characteristics of trajectories are also associated with a time-to-event process...
April 19, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/28419314/adverse-drug-reactions-during-drug-resistant-tb-treatment-in-high-hiv-prevalence-settings-a-systematic-review-and-meta-analysis
#7
Kathryn Schnippel, Cynthia Firnhaber, Rebecca Berhanu, Liesl Page-Shipp, Edina Sinanovic
Objectives: To estimate the prevalence of adverse drug reactions or events (ADR) during drug-resistant TB (DR-TB) treatment in the context of settings with high HIV prevalence (at least 20% of patients). Methods: We conducted a systematic review and meta-analysis of articles in PubMed and Scopus. Pooled proportions of patients experiencing adverse events and relative risk with 95% CI were calculated. Results: The search yielded 24 studies, all observational cohorts...
April 16, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28418652/design-and-development-of-highly-potent-hiv-1-protease-inhibitors-with-a-crown-like-oxotricyclic-core-as-the-p2-ligand-to-combat-multidrug-resistant-hiv-variants
#8
Arun K Ghosh, Kalapala Venkateswara Rao, Prasanth R Nyalapatla, Heather L Osswald, Cuthbert D Martyr, Manabu Aoki, Hironori Hayashi, Johnson Agniswamy, Yuan-Fang Wang, Haydar Bulut, Debananda Das, Irene T Weber, Hiroaki Mitsuya
Design, synthesis, and evaluation of a new class of exceptionally potent HIV-1 protease inhibitors are reported. Inhibitor 5 displayed superior antiviral activity and drug-resistance profiles. In fact, this inhibitor showed several orders of magnitude improved antiviral activity over the FDA approved drug darunavir. This inhibitor incorporates an unprecedented 6-5-5 ring-fused crown-like tetrahydropyranofuran as the P2 ligand and an aminobenzothiazole as the P2' ligand with the (R)-hydroxyethylsulfonamide isostere...
April 18, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28407682/genetic-characterization-and-antiretroviral-resistance-mutations-among-treatment-naive-hiv-infected-individuals-in-jiaxing-china
#9
Jinlei Guo, Yong Yan, Jiafeng Zhang, Jimei Ji, Zhijian Ge, Rui Ge, Xiaofei Zhang, Henghui Wang, Zhongwen Chen, Jianyong Luo
The aim of this study was to characterize HIV-1 genotypes and antiretroviral resistance mutations among treatment-naive HIV-infected individuals in Jiaxing, China. The HIV-1 partial polymerase (pol) genes in 93 of the 99 plasma samples were successfully amplified and analyzed. Phylogenetic analysis revealed the existence of five HIV-1 genotypes, of which the most prevalent genotype was CRF01_AE (38.7%), followed by CRF07_BC (34.4%), CRF08_BC (16.1%), subtype B/B' (5.4%), and CRF55_01B (2.1%). Besides, three types of unique recombination forms (URFs) were also observed, including C/F2/A1, CRF01_AE/B, and CRF08_BC/CRF07_BC...
March 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/28406247/hba1c-level-cannot-predict-the-treatment-outcome-of-smear-positive-non-multi-drug-resistant-hiv-negative-pulmonary-tuberculosis-inpatients
#10
Ken Tashiro, Nobuyuki Horita, Kenjiro Nagai, Misako Ikeda, Masaharu Shinkai, Masaki Yamamoto, Takashi Sato, Yu Hara, Hideyuki Nagakura, Yuji Shibata, Hiroki Watanabe, Kentaro Nakashima, Ryota Ushio, Akimichi Nagashima, Atsuya Narita, Nobuaki Kobayashi, Makoto Kudo, Takeshi Kaneko
We conducted a single-center retrospective cohort study to evaluate whether the HbA1c level on admission could predict the in-hospital treatment outcome of smear-positive non-multi-drug-resistant HIV-negative culture-proven pulmonary tuberculosis inpatients. Our standard regimens under the direct observation were HRZE or HRE for the first two months followed by combination therapy with isoniazid and rifampicin. Our cohort consisted of consecutive 239 patients consisted of 147 men and 92 women with a median age of 73 years...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28404672/increased-tuberculosis-patient-mortality-associated-with-mycobacterium-tuberculosis-mutations-conferring-resistance-to-second-line-antituberculous-drugs
#11
Sophia B Georghiou, Marva Seifert, Donald G Catanzaro, Richard S Garfein, Timothy C Rodwell
Rapid molecular diagnostics have great potential to limit the spread of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). These technologies detect mutations in the Mycobacterium tuberculosis (Mtb) genome that confer phenotypic drug resistance. However, there is little data published regarding the relationships between the detected Mtb resistance mutations and M/XDR-TB treatment outcomes, limiting our current ability to exploit the full potential of molecular diagnostics. We analyzed clinical, microbiological and sequencing data for 451 patients and their clinical isolates collected in a multinational, observational cohort study to determine if there was an association between Mtb resistance mutations and patient mortality...
April 12, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28403828/lower-genetic-variability-of-hiv-1-and-antiretroviral-drug-resistance-in-pregnant-women-from-the-state-of-par%C3%A3-brazil
#12
Luiz Fernando Almeida Machado, Iran Barros Costa, Maria Nazaré Folha, Anderson Levy Bessa da Luz, Antonio Carlos Rosário Vallinoto, Ricardo Ishak, Marluisa Oliveira Guimarães Ishak
BACKGROUND: The present study aimed to describe the genetic diversity of HIV-1, as well as the resistance profile of the viruses identified in HIV-1 infected pregnant women under antiretroviral therapy in the state of Pará, Northern Brazil. METHODS: Blood samples were collected from 45 HIV-1 infected pregnant to determine the virus subtypes according to the HIV-1 protease (PR) gene and part of the HIV-1 reverse transcriptase (RT) gene by sequencing the nucleotides of these regions...
April 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28403692/severe-hypokalemia-due-to-a-possible-drug-drug-interaction-between-vinblastine-and-antiretrovirals-in-a-hiv-infected-patient-with-hodgkin-s-lymphoma
#13
Ezequiel Cordova, Laura Morganti, Andrea Odzak, Florencia Arcondo, Mariana Silva, Marcelo Zylberman, Claudia Rodriguez
A 60-year-old HIV-1 infected woman on antiretroviral therapy (emtricitabine/tenofovir, and ritonavir-boosted atazanavir) developed Hodgkin's lymphoma. The patient initiated ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) chemotherapy and presented with neutropenia and severe hypokalemia. Hypokalemia was considered as part of a proximal tubular renal dysfunction, and other causes of hypokalemia were excluded. Due to suspicion of drug--drug interactions between antiretrovirals and vinblastine, ritonavir-boosted atazanavir was switched to dolutegravir and the patient continued emtricitabine/tenofovir...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28403027/candidates-for-inclusion-in-a-universal-antiretroviral-regimen-tenofovir-alafenamide
#14
Dzintars Gotham, Andrew Hill, Anton L Pozniak
PURPOSE OF REVIEW: Tenofovir disoproxil fumarate (TDF) is a standard first-line therapy for HIV. Recently, tenofovir alafenamide (TAF), a different prodrug for the same active moiety, has been approved. In this review, we have conducted a meta-analysis comparing efficacy and safety data for TDF and TAF, to inform a discussion of which drug would be best for a proposed 'universal antiretroviral (ARV) regimen'. RECENT FINDINGS: We identified 10 randomized controlled trials comparing TDF with TAF (6969 patients, 8043 patient-years of follow-up)...
April 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28402975/frequent-pul27-variations-in-hiv-infected-patients
#15
Azam Mirarab, Alireza Mohebbi, Abdolvahab Moradi, Naeme Javid, Mohammad Ali Vakili, Alijan Tabarraei
OBJECTIVE: Drug-resistant isolates of human cytomegalovirus (HCMV) have led to the development of new anti-HCMV drugs. Maribavir (MBV) is a novel inhibitor of the HCMV viral kinase. Resistance to MBV is mapped to gene UL27, a viral nuclear protein. In this study, we investigated UL27 polymorphisms in MBV-naive HIV-positive and HCMV congenitally infected clinical samples. METHODS: DNA was extracted from 20 CMV-positive HIV (9/20) and congenitally infected (11/20) patients and used for UL27 polymerase chain reaction amplification...
April 13, 2017: Intervirology
https://www.readbyqxmd.com/read/28399968/tuberculosis-resistance-conferring-mutations-with-fitness-cost-among-hiv-positive-individuals-in-uganda
#16
W Ssengooba, D Lukoye, C J Meehan, D P Kateete, M L Joloba, B C de Jong, F G Cobelens, F van Leth
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is considered to be less transmissible due to the fitness cost associated with drug resistance-conferring mutations in essential genes. OBJECTIVE: To test the hypothesis that TB drug resistance-conferring mutations with fitness cost are more frequent among human immunodeficiency virus (HIV) positive than among HIV-negative patients. DESIGN: We analysed all strains from the two TB drug resistance surveys conducted in Uganda between 2008 and 2011...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28398959/emergence-of-untreatable-multidrug-resistant-hiv-1-in-patients-failing-second-line-therapy-in-kenya
#17
Seth C Inzaule, Raph L Hamers, Irene Mukui, Kennedy Were, Prestone Owiti, Daniel Kwaro, Tobias F Rinke de Wit, Clement Zeh
: We performed a countrywide assessment of HIV drug resistance among 123 patients with virological failure on second-line antiretroviral therapy (ART) in Kenya. The percentage of patients harboring intermediate-to-high-level resistance was 27% for lopinavir-ritonavir, 24% for atazanavir-ritonavir and 7% for darunavir-ritonavir, and 25% had complete loss of activity to all available first- and second-line drugs. Overall, one in four patients failing second-line ART have completely exhausted available antiretrovirals in Kenya, highlighting the need for increased access to third-line drugs...
April 10, 2017: AIDS
https://www.readbyqxmd.com/read/28396546/structural-insights-into-hiv-reverse-transcriptase-mutations-q151m-and-q151m-complex-that-confer-multi-nucleoside-drug-resistance
#18
Kalyan Das, Sergio E Martinez, Eddy Arnold
HIV-1 reverse transcriptase (RT) is targeted by multiple drugs. RT mutations emerge that confer resistance to nucleoside RT inhibitors (NRTIs) in clinical use. Q151M, and four associated mutations A62V, V75I, F77L, and F116Y were detected in patients failing therapies to dideoxynucleosides (didanosine, ddI; zalcitabine, ddC) and/or zidovudine (AZT). The cluster of the five mutations is referred to as the Q151M complex (Q151Mc), and an RT or virus containing Q151Mc exhibits resistance to multiple NRTIs. To understand the structural basis for Q151M and Q151Mc resistance, we have systematically determined crystal structures of wild-type RT/dsDNA/dATP (I), wild-type RT/dsDNA/ddATP (II), Q151M RT/dsDNA/dATP (III), Q151Mc RT/dsDNA/dATP (IV), and Q151Mc RT/dsDNA/ddATP (V) ternary complexes...
April 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28394945/using-drug-exposure-for-predicting-drug-resistance-a-data-driven-genotypic-interpretation-tool
#19
Alejandro Pironti, Nico Pfeifer, Hauke Walter, Björn-Erik O Jensen, Maurizio Zazzi, Perpétua Gomes, Rolf Kaiser, Thomas Lengauer
Antiretroviral treatment history and past HIV-1 genotypes have been shown to be useful predictors for the success of antiretroviral therapy. However, this information may be unavailable or inaccurate, particularly for patients with multiple treatment lines often attending different clinics. We trained statistical models for predicting drug exposure from current HIV-1 genotype. These models were trained on 63,742 HIV-1 nucleotide sequences derived from patients with known therapeutic history, and on 6,836 genotype-phenotype pairs (GPPs)...
2017: PloS One
https://www.readbyqxmd.com/read/28387865/strengthening-hiv-therapy-and-care-in-rural-tanzania-affects-rates-of-viral-suppression
#20
Alex J Ntamatungiro, Lukas Muri, Tracy R Glass, Stefan Erb, Manuel Battegay, Hansjakob Furrer, Christoph Hatz, Marcel Tanner, Ingrid Felger, Thomas Klimkait, Emilio Letang
Objectives: To assess viral suppression rates, to assess prevalence of acquired HIV drug resistance and to characterize the spectrum of HIV-1 drug resistance mutations (HIV-DRM) in HIV-1-infected patients in a rural Tanzanian HIV cohort. Methods: This was a cross-sectional study nested within the Kilombero and Ulanga Antiretroviral Cohort. Virological failure was defined as HIV-1 RNA ≥50 copies/mL. Risk factors associated with virological failure and with the development of HIV-DRM were assessed using logistic regression...
April 6, 2017: Journal of Antimicrobial Chemotherapy
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