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Predicted environmental concentration (PEC), environmental risk assessment (ERA) and prioritization of antiretroviral drugs (ARVs) in seawater from Guarujá (Brazilian coastal zone).

Mar Environ Res

January 2025

Laboratório de Pesquisa em Produtos Naturais, Universidade Santa Cecília (UNISANTA), Rua Oswaldo Cruz, 266, C21, bloco C, Boqueirão, Santos, 11045-907, São Paulo, Brazil. Electronic address:

The antiretroviral therapy program's success in managing the human immunodeficiency virus (HIV) has inadvertently led to the release of antiretrovirals (ARVs) into worldwide aquatic ecosystems. However, few studies investigated the risks of ARV loadings that flow continuously to the marine waters of South America (such as Brazil). Against this backdrop, the aims of this study were: (i) to estimate the Predicted Environmental Concentration (PEC) of thirteen ARVs worldwide used in HIV treatment, and which are frequently disposed of in the marine aquatic ecosystems of Guarujá, São Paulo coastline, Brazil.

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Objectives: The increasing frequency of antibiotic-resistant bacterial infections is a major public health challenge, and new antibiotic drugs are urgently needed. A rapid solution to the problem is to repurpose clinically approved compounds with antibacterial properties, such as the nucleoside analogues zidovudine (azidothymidine) or 5-fluoro-2'-deoxyuridine. Here we report the in vitro and in vivo antibacterial properties of double and triple combinations of azidothymidine or 5-fluoro-2'-deoxyuridine with uridine and/or trimethoprim.

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Pronucleotides, after entering the cell, undergo chemical or enzymatic conversion into nucleotides with a free phosphate residue, and the released nucleoside 5'-monophosphate is then phosphorylated to the biologically active form, namely nucleoside 5'-triphosphate. The active form can inhibit HIV virus replication. For the most effective therapy, it is necessary to improve the transport of prodrugs into organelles.

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Despite decades of advancements in HIV treatment, the persistence of viral reservoirs necessitates lifelong therapy, complicating efforts to fully control the infection. Nucleoside reverse transcriptase inhibitors (NRTIs) remain a cornerstone of HIV treatment, but long-term use is associated with side effects, including lipid metabolism disruption and neurocognitive disorders. There is a gap in understanding the safety of antiretrovirals and their impact on lipid toxicity in the central nervous system.

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Background And Objective: Advances in antiretroviral therapy led to an increase in life expectancy among people living with human immunodeficiency virus (HIV). As aging is characterized by several physiological changes that can influence pharmacokinetics (PK), this systematic review aims to describe the impact of aging on the PK of antiretrovirals (ARV) approved by the Food and Drug Administration (FDA) before 2005.

Methods: Searches were performed in BVS, EMBASE, and PubMed databases for publications until June 2024.

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