Publications by authors named "Hung Chin Tsai"

Article Synopsis
  • This study investigates the resistance profiles of integrase strand transfer inhibitors (INSTIs) in patients from southern Taiwan who experienced failure in antiretroviral therapy (ART), particularly focusing on those previously treated with highly active ART (HAART).
  • It analyzes data from patients who failed an INSTI-containing regimen between 2009 and 2022, with genotypic drug resistance tested against established guidelines, revealing insights into mutations associated with treatment failure.
  • Among 21 patients who failed INSTI therapy, 40% showed INSTI drug resistance, with specific mutations identified, highlighting the challenges in treating individuals with resistant strains in a treatment-experienced population.
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Angiostrongylus cantonensis is the major cause of eosinophilic meningitis worldwide. The imbalance of neurotoxic and neuroprotective metabolites in the kynurenine pathway (KP) have been suggested to contribute to the pathogenesis of central nervous system (CNS) infection. We hypothesized that KP may also be involved in parasitic eosinophilic meningitis.

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Background: Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan.

Methods: We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders.

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Article Synopsis
  • The study investigates the effects of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) on kidney function in patients who are coinfected with HIV and hepatitis C virus (HCV), focusing on changes in estimated glomerular filtration rate (eGFR) at various stages of treatment.
  • The research involved tracking eGFR values in 445 patients over multiple time points to identify any declines and the factors contributing to acute kidney disease (AKD), particularly in relation to different antiretroviral therapies (ART) and modes of HIV transmission.
  • The main finding indicates that aging is the only independent risk factor linked to a decline in kidney function among these patients during and after DAA treatment, particularly
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Data regarding the durability of tenofovir alafenamide (TAF)-containing antiretroviral therapy (ART) in maintaining hepatitis B virus (HBV) viral suppression among HIV/HBV-coinfected patients are limited. Between February and October 2018, 274 HIV/HBV-coinfected participants who had achieved HIV RNA of <50 copies/mL with tenofovir disoproxil fumarate (TDF)-containing ART and switched to elvitegravir/cobicistat/emtricitabine/TAF were prospectively enrolled. Serial plasma HIV and HBV viral loads, HBV and hepatitis D virus (HDV) serology, renal parameters, metabolic profiles, and bone mineral density (BMD) were assessed through 96 weeks.

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Introduction: International treatment guidelines recommend the rapid initiation of antiretroviral therapy (ART) with bictegravir (B)/emtricitabine (F)/tenofovir alafenamide (TAF) and dolutegravir (DTG)-based regimens for treatment-naïve persons living with HIV (PLWH) irrespective of their disease stage. However, we lack evidence of the virological efficacy, virological failure, and tolerability of coformulated B/F/TAF and DTG/ABC/3TC regimens in persons living with advanced HIV (PLWAH; defined as persons with a CD4 count of < 200 cells/μL or an AIDS-related opportunistic illness [AOI] at or before ART initiation) in the era of rapid ART.

Methods: This retrospective multicenter study enrolled treatment-naïve PLWAH initiating ART with coformulated DTG/ABC/3TC or B/F/TAF in 2019-2020.

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Persons who inject drugs (PWID) and their risk-related behaviors (e.g., unprotected sex and sharing needles/syringes/other injection equipment) have caused severe public health problems, especially in the rapid spread of HIV-1 and HCV.

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he first imported case of monkeypox in Taiwan was diagnosed in an Asian man with HIV-1 infection and asymptomatic COVID-19, returning from Germany. Atypical presentations included asynchronous skin lesions, anogenital lesions and prominent inguinal lymphadenopathy. Whole genomic sequence alignment indicate that the Taiwan strain clustered together with human monkeypox virus West African clade B.

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Background: The prevalence of transmitted drug resistance (TDR) after the universal implementation of STRs is unknown in Taiwan.

Objective: This study aimed to investigate the prevalence of TDR in patients with HIV-1 infection, clarify the risk factors for resistance, and compare differences in HIV drug resistance before and after the implementation of STRs in Taiwan.

Methods: Adult patients infected with HIV-1 were enrolled in this study from 2013 to 2021.

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Article Synopsis
  • This study explored how common resistance to a specific HIV treatment (NNRTI-based single-tablet regimen) is among Taiwanese patients and examined the implications of using doravirine in those who did not respond to this treatment.
  • A total of 107 patients were analyzed, revealing that a significant percentage developed resistance to NNRTIs and doravirine, with 62% of those who initially failed treatment and 64% of those who switched therapies showing doravirine resistance.
  • The results indicate a high prevalence of drug resistance, particularly among patients with certain mutations (like K65R), which raises concerns about the effectiveness of using doravirine as an alternative treatment.
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Background: Hepatitis C virus (HCV) genotype 6 (HCV-6) infection is prevalent predominantly in Southeast Asia, and the data on the virologic response of HCV-6 to direct-acting antivirals (DAAs) are sparse in people living with human immunodeficiency virus (HIV) (PLWH).

Aim: To assess the virologic response of HCV-6 to DAAs in PLWH.

Methods: From September 2016 to July 2019, PLWH coinfected with HCV-6 initiating DAAs were included.

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BackgroundThe Delta and Omicron variants of SARS-CoV-2 are currently responsible for breakthrough infections due to waning immunity. We report phase I/II trial results of UB-612, a multitope subunit vaccine containing S1-RBD-sFc protein and rationally designed promiscuous peptides representing sarbecovirus conserved helper T cell and cytotoxic T lymphocyte epitopes on the nucleocapsid (N), membrane (M), and spike (S2) proteins.MethodWe conducted a phase I primary 2-dose (28 days apart) trial of 10, 30, or 100 μg UB-612 in 60 healthy young adults 20 to 55 years old, and 50 of them were boosted with 100 μg of UB-612 approximately 7 to 9 months after the second dose.

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Background: A single-tablet regimen (STR) has been associated with better drug adherence. However, the durability of different STRs was unknown in the real-world settings. Our aim was to investigate the durability of different initial STR regimens in antiretroviral-naive patients starting STR in southern Taiwan.

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GEMINI-1 and GEMINI-2 (ClinicalTrials.gov, NCT02831673 and NCT02831764, respectively) are double-blind, multicenter, phase III studies that demonstrated the non-inferiority of once-daily dolutegravir + lamivudine to dolutegravir + tenofovir disoproxil fumarate/emtricitabine in achieving HIV-1 RNA <50 copies/mL at 48, 96, and 144 weeks in treatment-naive adults with HIV-1 infection. We present a post hoc analysis of the impact of treatment adherence on Week 48 virologic response.

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Background: The Jarisch-Herxheimer reaction (JHR) is an inflammatory reaction that can occur after treatment for syphilis. The mechanism of JHR is unknown. The level of C-reactive protein (CRP) increases during infection and inflammation.

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Purpose: This study evaluated the real-world tolerability and treatment effectiveness of BIC/FTC/TAF in treatment-experienced patients living with HIV-1 in Taiwan, especially in those with viremia at switch.

Patients And Methods: This was a retrospective cohort study of adult patients in Taiwan with HIV-1 who received BIC/FTC/TAF from between November 2019 and November 2020. The primary endpoint was the rate of viral suppression (plasma HIV RNA load <50 copies/mL) while on BIC/FTC/TAF.

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Introduction: While coformulated ledipasvir (90 mg)/sofosbuvir (400 mg) (LDV/SOF) is approved for the treatment of hepatitis C virus (HCV) genotype 2 (GT2) infection in Taiwan, Japan, and New Zealand, data regarding its use for HIV (Human Immunodeficiency Virus)-positive patients infected with HCV GT2 are sparse. We aimed to assess the effectiveness and tolerability of LDV/SOF for HIV-positive patients with HCV GT2 coinfection.

Methods: From January 2019 to July 2020, consecutive HIV-positive Taiwanese patients infected with HCV GT2 who received LDV/SOF were retrospectively included for analysis.

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Article Synopsis
  • Integrase strand transfer inhibitors (INSTIs) are a key treatment for HIV-1, and this study investigates their resistance in southern Taiwan, specifically using next-generation sequencing (NGS) to find low-level resistance mutations.
  • The research included 224 HIV-1 patients, revealing low prevalence rates for mutations against various drug classes, with 0.9% showing INSTI resistance, primarily the mutations G163K and E138A.
  • NGS identified additional INSTI resistance mutations not detected by conventional methods, suggesting that NGS could help clinicians better understand and manage drug resistance in patients starting INSTI therapy.
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Background: The efficacy and safety of switching from tenofovir disoproxil fumarate-based antiretroviral therapy to coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (E/C/F/TAF) has not been widely investigated in HIV/hepatitis B virus (HBV)-coinfected Asian population.

Methods: Between February and October 2018, HIV/HBV-coinfected patients who had achieved HIV viral suppression with tenofovir disoproxil fumarate-containing regimens were switched to E/C/F/TAF. Assessments of plasma HBV and HIV viral load, HBV serology, renal function, lipid profiles, and bone mineral density (BMD) were performed at weeks 24 and 48 after switch.

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Steroids have been shown to be beneficial in patients and mice with eosinophilic meningitis caused by Angiostrongylus cantonensis infection; however, the mechanism for this beneficial effect is unknown. We speculated that the effect of steroids in eosinophilic meningitis caused by A. cantonensis infection may be mediated by the downregulation of matrix metallopeptidase-9 (MMP-9) and oxidative stress pathways via glucocorticoid receptors (GRs).

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Objectives: Real-world experience regarding the effectiveness of co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/C/FTC/TAF) as a switch regimen is sparse among people living with HIV (PLWH) harbouring the M184V/I mutation with or without thymidine analogue-associated mutations (TAMs).

Methods: In this retrospective multicentre study, PLWH who were switched to EVG/C/FTC/TAF after having achieved viral suppression (plasma HIV RNA <200 copies/mL) for 6 months or longer were included. Patients with archived M184V/I mutation (case patients) were matched to controls without M184V/I mutation at a 1:4 ratio.

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Background: Pneumocystis pneumonia (PCP) is a common opportunistic infection with high mortality in individuals with decreased immunity. Pulmonary coinfections with PCP are associated with poor prognosis. The study aims to identify radiological predictors for pulmonary coinfections in patients with PCP and risk factors for mortality.

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