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coinfection guidelines

L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
March 1, 2018: HIV Medicine
M J Tong, C Q Pan, S-H B Han, D S-K Lu, S Raman, K-Q Hu, J K Lim, H W Hann, A D Min
BACKGROUND: Hepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide. AIM: To generate recommendations for the management of Asian Americans infected with HBV. METHODS: These guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans...
February 26, 2018: Alimentary Pharmacology & Therapeutics
Antonio Olveira, Lourdes Domínguez, Jesús Troya, Ana Arias, Federico Pulido, Pablo Ryan, Laura María Benítez, Juan González-García, María Luisa Montes
Guidelines recommend evaluating persistent alteration of liver tests in HCV-infected patients after sustained virological response (SVR) and its influence on liver disease progression. We studied the prevalence, aetiology, associated factors, and evolutionary implications of persistent alteration of liver tests in HCV patients after direct-acting antivirals (DAA) -induced SVR. This was a prospective study of HCV-infected patients and SVR after DAA. Those with another previously diagnosed liver disease were excluded...
February 24, 2018: Journal of Viral Hepatitis
Christophe Hézode
Direct-acting antivirals (DAAs) have transformed traditional treatment options for hepatitis C virus (HCV) infection. DAA combinations have been shown to be highly effective in reducing the burden of chronic HCV infection in clinical trials and have been recommended by the European Association for the Study of the Liver (EASL) treatment guidelines. This review examines the results of second-generation DAA combinations in real-life clinical practice in patients with genotypes 1-3 and in those co-infected with HIV (real-world data in genotypes 4-6 are rare)...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Sabra S Custer
In addition to chronic use of antiretrovirals to maintain suppression of human immunodeficiency virus (HIV), many persons living with HIV are coinfected with tuberculosis, hepatitis B, or hepatitis C. These coinfections can be successfully treated or managed alongside HIV infection. Clinicians should follow practice guidelines to appropriately screen patients with HIV for these coinfections and initiate treatment when necessary. The most significant concern when treating any of these coinfections is to avoid drug-drug interactions with the patient's antiretrovirals...
March 2018: Nursing Clinics of North America
Lars Peters, Amanda Mocroft, Daniel Grint, Santiago Moreno, Alexandra Calmy, Djordje Jevtovic, Helen Sambatakou, Karine Lacombe, Stephane De Wit, Jürgen Rockstroh, Jelena Smidt, Igor Karpov, Anna Grzeszczuk, Vesnadarjan Haziosmanovic, Magnus Gottfredsson, Roxana Radoi, Elena Kuzovatova, Chloe Orkin, Anna Lisa Ridolfo, Jose Zapirain, Jens Lundgren
BACKGROUND: According to guidelines all HIV/HBV co-infected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV/HBV patients in the EuroSIDA study. METHODS: All HBsAg+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events...
January 5, 2018: Antiviral Therapy
Benjamin Guiastrennec, Geetha Ramachandran, Mats O Karlsson, A K Hemanth Kumar, Perumal Kannabiran Bhavani, N Poorana Gangadevi, Soumya Swaminathan, Amita Gupta, Kelly E Dooley, Radojka M Savic
This work aimed to evaluate the once-daily anti-tuberculosis treatment as recommended by the new Indian pediatric guidelines. Isoniazid, rifampin and pyrazinamide concentration-time profiles and treatment outcome were obtained from 161 Indian children with drug-sensitive tuberculosis undergoing thrice-weekly dosing as per previous Indian pediatric guidelines. The exposure-response relationships were established using a population pharmacokinetic-pharmacodynamic approach. Rifampin exposure was identified as the unique predictor of treatment outcome...
December 16, 2017: Clinical Pharmacology and Therapeutics
More Mungati, Anna Machiha, Owen Mugurungi, Mufuta Tshimanga, Peter H Kilmarx, Justice Nyakura, Gerald Shambira, Vitalis Kupara, David A Lewis, Elizabeth Gonese, Beth A Tippett Barr, H Hunter Handsfield, Cornelis A Rietmeijer
BACKGROUND: In many countries, sexually transmitted infections (STIs) are treated syndromically. Thus, patients diagnosed as having genital ulcer disease (GUD) in Zimbabwe receive a combination of antimicrobials to treat syphilis, chancroid, lymphogranuloma venereum (LGV), and genital herpes. Periodic studies are necessary to assess the current etiology of GUD and assure the appropriateness of current treatment guidelines. MATERIALS AND METHODS: We selected 6 geographically diverse clinics in Zimbabwe serving high numbers of STI cases to enroll men and women with STI syndromes, including GUD...
January 2018: Sexually Transmitted Diseases
Cornelis A Rietmeijer, More Mungati, Anna Machiha, Owen Mugurungi, Vitalis Kupara, Luanne Rodgers, Peter H Kilmarx, Amy Herman Roloff, Elizabeth Gonese, Beth A Tippett-Barr, Gerald Shambira, David A Lewis, H Hunter Handsfield, Mufuta Tshimanga
INTRODUCTION: Sexually transmitted infections (STIs) are managed syndromically in most developing countries. In Zimbabwe, men presenting with urethral discharge are treated with a single intramuscular dose of kanamycin or ceftriaxone in combination with a week's course of oral doxycycline. This study was designed to assess the current etiology of urethral discharge and other STIs to inform current syndromic management regimens. METHODS: We conducted a study among 200 men with urethral discharge presenting at 6 regionally diverse STI clinics in Zimbabwe...
January 2018: Sexually Transmitted Diseases
J D Kowalska, K Aebi-Popp, M Loutfy, F A Post, M J Perez-Elias, M Johnson, F Mulcahy
OBJECTIVES: Gender-related factors can influence management decisions, treatment outcomes and the overall long-term wellbeing of people living with HIV (PLWH). The Women Against Viruses in Europe (WAVE) Working Group was established to promote the health and wellbeing of women living with HIV (WLWH). WAVE is part of the European AIDS Clinical Society (EACS) and organizes annual workshops to discuss different issues in the management of WLWH. METHODS: In 2016, 34 WAVE members including community representatives, HIV clinicians and researchers met to discuss standards of care for WLWH and to review current guidelines...
November 21, 2017: HIV Medicine
Christoph Boesecke, Patrick Ingiliz, Florian Berger, Thomas Lutz, Knud Schewe, Julian Schulze Zur Wiesch, Axel Baumgarten, Stefan Christensen, Jürgen K Rockstroh, Stefan Mauss
Current hepatitis C virus (HCV) treatment guidelines recommend treating HCV/human immunodeficiency virus (HIV)-coinfected individuals similar to HCV-monoinfected individuals. Recently inferior response rates to direct acting antiviral (DAA) therapy in HCV/HIV coinfection have been reported. Our German hepatitis C cohort (GECCO) cohort data show that coinfected patients with liver cirrhosis are less likely to achieve viral eradication.
2017: Open Forum Infectious Diseases
Jürgen K Rockstroh, Chloe Orkin, Rolando M Viani, David Wyles, Anne F Luetkemeyer, Adriano Lazzarin, Ruth Soto-Malave, Mark R Nelson, Sanjay R Bhagani, Hartwig H F Klinker, Giuliano Rizzardini, Pierre-Marie Girard, Cristina Tural, Nancy S Shulman, Niloufar Mobashery, Yiran B Hu, Linda M Fredrick, Tami Pilot-Matias, Roger Trinh, Edward Gane
BACKGROUND: Ombitasvir, paritaprevir with ritonavir, and dasabuvir (OBV/PTV/r ± DSV) ±ribavirin (RBV) are approved to treat hepatitis C virus (HCV) genotype 1 and 4 infection. Here, we investigate the safety and efficacy of OBV/PTV/r + DSV ±RBV for HCV genotype 1, and OBV/PTV/r + RBV for HCV genotype 4, in human immunodeficiency virus (HIV)-1 coinfected patients with or without compensated cirrhosis. METHODS: TURQUOISE-I, Part 2 is a phase 3 multicenter study...
2017: Open Forum Infectious Diseases
Theofilos Chrysanthidis, Georgia Loli, Simeon Metallidis, Georgios Germanidis
Although there is evidence that HCV progresses rapidly in HIV/HCV coinfected patients in comparison with HCV monoinfected, the HIV-, HCV- and host/genetic-related factors, as well as the exact mechanisms implicated in this process are not fully elucidated. Furthermore, cure of HCV in those coinfected seems possible with the new antiviral drugs, but high cost as well as insufficient identification, linkage with care and treatment hamper the achievement of this goal. Research on the subject, could reveal an important prognostic marker for the effectiveness of persuasion of patients with HIV/HCV coinfection with a predicted accelerated fibrosis course, in order to facilitate and prioritize, not in terms of guidelines but in the real life situation, their treatment with a medically just framework...
September 19, 2017: AIDS Reviews
Christina M Schumacher, Errol Fields, Aruna Chandran, Omeid Heidari, Yvonne Kingon, Patrick Chaulk, Jacky M Jennings
BACKGROUND: Syphilis incidence is increasing across the United States among men who have sex with men (MSM). Early latent (EL) versus primary and secondary (P&S) syphilis may be an indicator of delayed diagnosis and increased opportunity for transmission. To inform syphilis control strategies and identify potential gaps in case finding, we described recent syphilis trends among MSM and compared characteristics of syphilis cases by diagnosis stage. METHODS: We used public health surveillance data on P&S and EL syphilis diagnoses reported to the Baltimore City Health Department between 2009 and 2015...
August 28, 2017: Sexually Transmitted Diseases
Waldemar Halota, Robert Flisiak, Jacek Juszczyk, Piotr Małkowski, Małgorzata Pawłowska, Krzysztof Simon, Krzysztof Tomasiewicz
The goals of treatment is to eliminate HCV infection, stop or reverse histological changes, reduce the risk of hepatocellular carcinoma development and transmission of the infection to other individuals. According to the recommendation of the Polish Group of Experts for HCV in 2017 all patients with chronic HCV infection should receive treatment, but it is not recommended in patients at high risk of short overall survival. If access to therapy is restricted, priority should be given to patients whose HCV infection can lead to an unfavourable outcome of the disease within a short time frame, particular to individuals with liver cirrhosis, rapidly progressing liver fibrosis, extrahepatic manifestations of HCV infection, chronic kidney diseases, patients before and after organ transplantation...
June 2017: Clinical and experimental hepatology
Christoph Schweikardt, Geert Goderis, Steven Elli, Yves Coppieters
BACKGROUND: General practitioners (GPs) as a group have been identified as playing an important role in gonorrhoea management in Flanders. Belgian guidelines recommended ceftriaxone or alternatively spectinomycin from 2008 onwards and azithromycin combination therapy since 2012. OBJECTIVES: This study investigates to which extent contemporary gonorrhoea treatment guidelines were followed. METHODS: A retrospective cohort study (2009-2013) of antibiotic prescriptions for gonorrhoea cases registered in the Flemish Intego general practice database was carried out...
2017: Journal of Sexually Transmitted Diseases
Patrick G T Cudahy, Rodney Dawson, Brian W Allwood, Gary Maartens, Douglas Wilson
BACKGROUND: Evaluation of patients with suspected tuberculosis and negative sputum smears for acid-fast bacilli (AFB) is challenging, especially in high human immunodeficiency virus coinfection settings where sputum smears have lower sensitivity for detecting AFB. METHODS: We examined the utility of chest radiographs for detecting smear-negative pulmonary tuberculosis. Three hundred sixty sputum smear-negative patients who were referred from primary care clinics in the KwaZulu-Natal province of South Africa were evaluated...
2017: Open Forum Infectious Diseases
Josep Mallolas
Current antiretroviral therapy reaches and maintains viral suppression over the years in more than 90% of treated HIV-infected individuals. Although integrase inhibitors are the preferred third agent in antiretroviral therapy in the current guidelines, rilpivirine, a non-nucleoside reverse transcrip- tase inhibitor, and darunavir (DRV), a second-generation protease inhibitor, are the preferred third companion to be used along with a backbone of two nucleos(t)ide reverse transcriptase inhibitors as first-line triple HIV combination treatment...
April 2017: AIDS Reviews
Gibril Ndow, Mindy L Gore, Yusuke Shimakawa, Penda Suso, Abdoulie Jatta, Saydiba Tamba, Amina Sow, Coumba Touré-Kane, Fouzia Sadiq, Saihou Sabally, Ramou Njie, Mark R Thursz, Maud Lemoine
BACKGROUND: Compliance with WHO guidelines on HBV screening and treatment in HIV-coinfected patients is often challenging in resource limited countries and has been poorly assessed in sub-Saharan Africa. METHODS: Between 2015 and 2016, we assessed physician's compliance with WHO guidelines on HIV-HBV coinfection in the largest HIV clinic in The Gambia, and the hepatic outcomes in HIV-HBV coinfected patients as compared to randomly selected HIV-monoinfected controls...
2017: PloS One
Betty J Dong, Michelle R Williams, J Tyler Bingham, Jason Tokumoto, Jeffery D Allen
OBJECTIVES: To describe the collaboration and prospective outcome of challenging human immunodeficiency virus (HIV) cases presented by Board of Prisons (BOP) pharmacists in consultation with Clinician Consultation Center (CCC) clinical pharmacists and physicians to improve correctional patient care. SETTING: Federal correctional facilities. PRACTICE DESCRIPTION: Pharmacists improve care of incarcerated persons infected with HIV. PRACTICE INNOVATION: Pharmacists evaluate, implement, and provide successful oversight of HIV/hepatitis C virus (HCV) care...
June 10, 2017: Journal of the American Pharmacists Association: JAPhA
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