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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
Tomas Cihlar, Marshall Fordyce
Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades...
June 2016: Current Opinion in Virology
David A Margolis, Cynthia C Brinson, Graham H R Smith, Jerome de Vente, Debbie P Hagins, Joseph J Eron, Sandy K Griffith, Marty H St Clair, Marita C Stevens, Peter E Williams, Susan L Ford, Britt S Stancil, Melinda M Bomar, Krischan J Hudson, Kimberly Y Smith, William R Spreen
BACKGROUND: In phase 1 trials, the HIV-1 integrase strand transfer inhibitor cabotegravir (GSK1265744) was well tolerated, both alone, and in combination with the non-nucleoside reverse transcriptase inhibitor rilpivirine. We assessed cabotegravir plus rilpivirine, as a two-drug oral antiretroviral regimen, for the maintenance of viral suppression in antiretroviral-naive HIV-1-infected individuals. METHODS: In the phase 2b Long-Acting antireTroviral Treatment Enabling (LATTE) trial, a multicentre study done in Canada and the USA, antiretroviral-naive HIV-1-infected adults (aged ≥18 years) were randomly allocated in a 1:1:1:1 ratio to oral cabotegravir 10 mg once a day, 30 mg once a day, 60 mg once a day, or oral efavirenz 600 mg once a day with dual nucleoside reverse transcriptase inhibitors (NRTIs) for 24 weeks of induction...
October 2015: Lancet Infectious Diseases
Ignacio Pérez-Valero, Alicia González-Baeza, Miriam Estébanez, Susana Monge, María L Montes-Ramírez, Carmen Bayón, Federico Pulido, José I Bernardino, Francisco X Zamora, Juan J González-García, María Lagarde, Asunción Hernando, Francisco Arnalich, José R Arribas
BACKGROUND: The evolution of neurocognitive performance in aviremic human immunodeficiency virus (HIV)-positive patients treated with <3 antiretrovirals is unknown. METHODS: We prospectively included aviremic (≥1 year) HIV-positive patients, without concomitant major neurocognitive confounders, currently receiving boosted lopinavir or darunavir as monotherapy (n = 67) or triple antiretroviral therapy (ART) (n = 67) for ≥1 year. We evaluated neurocognitive function (7 domains) at baseline and after 1 year...
December 1, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Pedro Cahn, Jaime Andrade-Villanueva, José R Arribas, José M Gatell, Javier R Lama, Michael Norton, Patricia Patterson, Juan Sierra Madero, Omar Sued, Maria Inés Figueroa, Maria José Rolon
BACKGROUND: Daily oral triple therapy is effective at halting HIV disease progression, but can have toxic effects and is costly. We investigated whether dual therapy with lopinavir and ritonavir plus lamivudine is non-inferior to standard triple therapy. METHODS: The GARDEL study (Global AntiRetroviral Design Encompassing Lopinavir/r and Lamivudine vs LPV/r based standard therapy) is a 48 week, phase 3, randomised, controlled, open-label, non-inferiority trial in antiretroviral-therapy-naive adults (age ≥18 years) with documented HIV-1 RNA viral load of at least 1000 copies per mL...
July 2014: Lancet Infectious Diseases
Margaret T May, Suzanne M Ingle, Dominique Costagliola, Amy C Justice, Frank de Wolf, Matthias Cavassini, Antonella D'Arminio Monforte, Jordi Casabona, Robert S Hogg, Amanda Mocroft, Fiona C Lampe, François Dabis, Gerd Fätkenheuer, Timothy R Sterling, Julia del Amo, M John Gill, Heidi M Crane, Michael S Saag, Jodie Guest, Hans-Reinhard Brodt, Jonathan A C Sterne
The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection...
June 2014: International Journal of Epidemiology
(no author information available yet)
BACKGROUND: Combination antiretroviral therapy has led to significant increases in survival and quality of life, but at a population-level the effect on life expectancy is not well understood. Our objective was to compare changes in mortality and life expectancy among HIV-positive individuals on combination antiretroviral therapy. METHODS: The Antiretroviral Therapy Cohort Collaboration is a multinational collaboration of HIV cohort studies in Europe and North America...
July 26, 2008: Lancet
Graeme J Moyle, Edwin DeJesus, Pedro Cahn, Steve A Castillo, Henry Zhao, David N Gordon, Charles Craig, Trevor R Scott
The long intracellular half-life of abacavir (ABC) supports its once-daily use, and this would be expected to simplify treatment if ABC could be given as part of a complete once-daily regimen. A randomized double-blind clinical trial compared the efficacy and safety of 600 mg of ABC administered once daily (n = 384) versus 300 mg of ABC administered twice daily (n = 386) in combination with 300 mg of lamivudine (3TC) and 600 mg of efavirenz (EFV) administered once daily in antiretroviral-naive patients over 48 weeks...
April 1, 2005: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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