Publications by authors named "Hal Martin"

Article Synopsis
  • The BRAAVE study (NCT03631732) was a Phase 3b trial focusing on switching Black individuals with suppressed HIV to a new treatment (B/F/TAF) and showed positive results after 72 weeks.
  • Participants included those with various pre-existing drug resistance, yet had high rates of virologic suppression, with 99% achieving undetectable HIV-1 RNA levels.
  • Notably, despite some adherence challenges and occasional viral blips, no new drug resistance emerged, indicating B/F/TAF’s effectiveness even with resistant strains of HIV.
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Background: The capsular ligaments at the hip joint work in synchrony with the acetabulum and femoral head for articular stability. There is a lack of understanding about ischiofemoral ligament (ISFL) anatomy and function.

Purpose: To assess the insertion of the ISFL in non-arthritic adult hips.

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Article Synopsis
  • - The study assessed the safety and effectiveness of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) after 144 weeks of dolutegravir (DTG)-based therapy in HIV-1 patients.
  • - After 96 weeks on B/F/TAF, over 99% of participants maintained viral suppression and had stable CD4+ cell counts without emerging resistance, though some experienced mild side effects like diarrhea and weight gain.
  • - The findings support the switch to B/F/TAF as a safe and effective long-term treatment option for people previously on DTG-containing regimens.
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Background: For most adults with HIV-1 and hepatitis B virus (HBV) coinfection, initial recommended treatment is a tenofovir-containing antiretroviral regimen, but no randomised studies have compared tenofovir disoproxil fumarate with tenofovir alafenamide. We aimed to investigate whether bictegravir, emtricitabine, and tenofovir alafenamide is non-inferior to dolutegravir, emtricitabine, and tenofovir disoproxil fumarate for viral suppression in individuals with HIV-1 and HBV coinfection at 48 and 96 weeks.

Methods: We did this randomised, double-blind, active-controlled, phase 3, non-inferiority trial at 46 outpatient centres in China, Dominican Republic, Hong Kong, Japan, Malaysia, South Korea, Spain, Taiwan, Thailand, Turkey, and the USA.

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Background: Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a single-tablet regimen recommended for HIV-1 treatment. The safety and efficacy of B/F/TAF as initial therapy was established in two Phase 3 studies: 1489 (vs dolutegravir [DTG]/abacavir/lamivudine) and 1490 (vs DTG + F/TAF). After 144 weeks of randomized follow-up, an open-label extension evaluated B/F/TAF to 240 weeks.

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Partial resection of the lesser trochanter (LT plasty) has been increasingly recommended to treat ischiofemoral impingement. However, there is a lack of studies on the imaging findings following LT plasty. The purpose of this study was to assess magnetic resonance imaging (MRI) changes on the lesser trochanter and surrounding musculotendinous structures following LT plasty to treat ischiofemoral impingement.

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Objectives: Data on switching to bictegravir, emtricitabine, and tenofovir alafenamide (B/F/TAF) in virologically suppressed Asian people living with HIV are limited. We performed a pooled analysis of virologically suppressed Asian participants from three international phase III trials to evaluate the efficacy and safety of switching to B/F/TAF.

Methods: Virologically suppressed people living with HIV were randomized to switch to B/F/TAF or to stay on baseline regimens.

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Purpose: The purpose of this study was to determine the accuracy of electronic hip pain drawing to diagnose intra-articular source of pain in nonarthritic hips, defined by response to an intra-articular injection.

Methods: A retrospective assessment was performed in consecutive patients who had an intra-articular injection completed within a 1-year period. Patients were classified as responders or nonresponders to intra-articular hip injection.

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The association between hip and spine abnormalities is frequent, and limitation in hip extension has been linked with low back pain. The purpose of this study was to assess the radiographic osseous findings in nonarthritic hips of patients with hip pain, low back pain, and limited hip extension. Ninety patients (92 hips) were included in this study.

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Objectives: Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is an effective treatment for HIV-1 infection; however, clinical trial data in older people living with HIV (PLWH) are lacking. The primary 24-week and secondary 48-week analyses of study GS-US-380-4449 (NCT03405935), which assessed the efficacy and safety of switching to B/F/TAF in older PLWH, have been published. Here we report the results of the final 96-week analyses from the study.

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Objective: We investigated the prevalence of preexisting M184V/I and associated risk factors among clinical trial participants with suppressed HIV and evaluated the impact of M184V/I on virologic response after switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF).

Design: Participant data were pooled from six clinical trials investigating the safety and efficacy of switching to B/F/TAF in virologically suppressed people with HIV.

Methods: Preexisting drug resistance was assessed by historical genotypes and/or baseline proviral DNA genotyping.

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Article Synopsis
  • Preexisting drug resistance to HIV treatments can limit effectiveness, but the combination therapy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) has shown safety and effectiveness in some patients, even those with specific drug resistance mutations.
  • A study involving 1907 individuals revealed that only 20 participants (1%) had primary resistance to integrase strand transfer inhibitors (INSTI-R), mostly maintaining their viral load suppression over 48 weeks of B/F/TAF treatment without significant issues.
  • Overall, this small group of participants successfully managed their HIV with B/F/TAF, suggesting that this treatment could work for others with similar drug resistance if validated in future research.
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Background: With the highest rates of HIV/AIDS in the United States, Black Americans are still underrepresented in HIV medical research.

Setting: BRAAVE (NCT03631732) is a randomized, phase 3b, multicenter, open-label US study.

Methods: Adults identifying as Black or African American and virologically suppressed on 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus third agent were randomized (2:1) to switch to open-label bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) once daily or stay on baseline regimen (SBR) for 24 weeks, after which SBR had delayed switch to B/F/TAF.

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The 2019 International Society of Hip Preservation (ISHA) physiotherapy agreement on femoroacetabular impingement syndrome (FAIS) was intended to build an international physiotherapy consensus on the assessment, non-surgical physiotherapy treatment, pre-/post-operative management, and return to sport decisions for those patients with FAIS. The panel consisted of 11 physiotherapists and 8 orthopaedic surgeons. There is limited evidence regarding the use of physiotherapy in the overall management of those with FAIS.

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Background: Bictegravir is a potent integrase strand-transfer inhibitor (INSTI) with a high genetic barrier to resistance. Bictegravir, coformulated with emtricitabine and tenofovir alafenamide, is recommended by key European and US HIV treatment guidelines as the preferred single-tablet regimen for adults and adolescents. The aim of this study was to assess the pharmacokinetics, safety, and efficacy of switching to this regimen in virologically suppressed children and adolescents with HIV.

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Extra-articular impingement between the femur and ischium is increasingly recognized as a cause of hip pain. The purpose of this study was to assess the diagnostic parameters for greater trochanteric-ischial impingement (GTI) in magnetic resonance imaging (MRI) studies. Seven patients (seven hips) diagnosed with GTI were retrospectively identified.

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Purpose: To calculate the iliopsoas muscle/tendon ratio at 3 levels of arthroscopic iliopsoas tenotomy sites in fresh cadaveric specimens.

Methods: An anatomic study design was performed using 16 iliopsoas musculotendinous units from the level of the hip joint to their insertion on the lesser trochanter. All specimens came from 16 fresh cadaveric specimens (10 male, 6 female), with a median age of 41 years (range 31-55.

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Background: We sought to identify factors associated with weight gain in randomized clinical trials of antiretroviral therapy (ART) switch.

Methods: We explored the effects of demographic factors, clinical characteristics, and ART on weight gain in a pooled analysis of 12 prospective clinical trials, wherein virologically suppressed people living with human immunodeficiency virus (PWH) were randomized to switch or remain on a stable baseline regimen (SBR).

Results: Both PWH randomized to switch ART (n = 4166) and those remaining on SBR (n = 3150) gained weight.

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Ischiofemoral impingement (IFI) occurs due to the diminishing of space between the ischium and lesser trochanter. During a robotic hip study, one hip presented with indications of IFI, an opportunity to explore the pathophysiology and treatment strategies for this unusual condition. This specimen underwent kinematic tests in two states: (i) native lesser trochanter and (ii) resected lesser trochanter.

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Several post-operative pain control methods have been described for hip arthroscopy including systemic medications, intra-articular or peri-portal injection of local anesthetics and peripheral nerve blocks. The diversity of modalities used may reflect a lack of consensus regarding an optimal approach. The purpose of this investigation was to conduct an international survey to assess pain management patterns after hip arthroscopy.

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The term 'hip-spine syndrome' was introduced in recognition of the frequent occurrence of concomitant symptoms at the hip and lumbar spine. Limitations in hip range of motion can result in abnormal lumbopelvic mechanics. Ischiofemoral impingement, femoroacetabular impingement and abnormal femoral torsion are increasingly linked to abnormal hip and spinopelvic biomechanics.

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Article Synopsis
  • Two Phase 3 studies showed bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is as effective as other HIV treatments, with no resistance emerging over 144 weeks.
  • Analysis of resistance after 3 years revealed very low rates of pre-existing drug resistance among participants, which did not impact treatment outcomes.
  • Overall, treatment with B/F/TAF and other regimens led to high and sustained rates of HIV-1 viral suppression, even in individuals with some baseline resistance.
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Introduction: We report the 48-week results of an ongoing study to assess the efficacy and safety of switching older people with HIV to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF).

Methods: This was a 96-week, phase 3b, open-label, single-arm study (GS-US-380-4449; NCT03405935). Virologically suppressed individuals aged ≥ 65 years receiving elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide or a tenofovir disoproxil fumarate-based regimen were switched to B/F/TAF.

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