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Cost-effectiveness of viral load testing for transitioning antiretroviral therapy-experienced children to dolutegravir in South Africa: a modelling analysis.
Lancet Glob Health
December 2024
Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, MA, USA; Harvard University Center for AIDS Research, Boston, MA, USA. Electronic address:
Background: For children with HIV on antiretroviral therapy (ART), transitioning to dolutegravir-containing regimens is recommended. The aim of this study was to assess whether introducing viral load testing to inform new nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) for children with HIV and viraemia alongside dolutegravir-based ART is beneficial and of good economic value.
Methods: We used the Cost-Effectiveness of Preventing AIDS Complications-Pediatric model to project clinical and cost implications of three strategies among a simulated cohort of South African children aged 8 years with HIV receiving abacavir-lamivudine-efavirenz: (1) continue current ART (no dolutegravir; abacavir-lamivudine-efavirenz); (2) transition all children with HIV to dolutegravir, keeping current NRTIs (dolutegravir; abacavir-lamivudine-dolutegravir); or (3) transition to dolutegravir based on viral load testing (viral load plus dolutegravir), keeping current NRTIs if virologically suppressed (abacavir-lamivudine-dolutegravir, 70% of cohort) or switching abacavir to zidovudine (zidovudine) if viraemic (zidovudine-lamivudine-dolutegravir, 30%).
Pre- and Post-Exposure Prophylaxis for HIV in Patients Taking Anti-Seizure Medications.
Epilepsy Curr
May 2024
Department of Neurology, University of Texas Southwestern, Dallas, TX, USA.
Article Synopsis
- Recent advancements in HIV prevention highlight the effectiveness of pre- and post-exposure prophylaxis (PrEP and PEP), particularly in the context of new anti-seizure medications (ASMs) that have emerged since 2012.
- The review discusses the potential drug interactions between PrEP/PEP and various ASMs, particularly focusing on enzyme-inducing ASMs that may lower the effectiveness of tenofovir-containing treatments, as well as the impact of ritonavir on lamotrigine levels.
- Clinicians are encouraged to be aware of these interactions and side effects, such as osteopenia and gastrointestinal issues, to provide better care for patients who might be at risk for both seizures and HIV infection.
Drug resistance and influencing factors in HIV-1-infected individuals under antiretroviral therapy in Guangxi, China.
J Antimicrob Chemother
May 2024
Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Key Laboratory of AIDS Prevention Control and Translation, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
Objectives: To assess the profiles and determinants of drug resistance in HIV-1-infected individuals undergoing ART in Guangxi.
Methods: Samples and data were collected from HIV-1-infected individuals experiencing virological failure post-ART from 14 cities in Guangxi. Sequencing of the HIV-1 pol gene was conducted, followed by analysis for drug resistance mutations using the Stanford University HIV Drug Resistance Database.
Risk Factors Associated with Unsuppressed Viral Load in People Living with HIV Receiving Antiretroviral Treatment in Jawa Barat, Indonesia.
HIV AIDS (Auckl)
January 2024
Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/ Hasan Sadikin General Hospital, Bandung, Indonesia.
Introduction: The success rate of antiretroviral therapy (ART) was sufficiently high globally that by 2030, Human Immunodeficiency Virus (HIV) infection would no longer become a significant health issue. The evaluation of the success rate of ART in Indonesia is still fairly low, with estimates that 6.1% of the total population living with HIV.
View Article and Find Full Text PDFA Phase-IV Non-interventional Study to Assess Virological Effectiveness, Safety, and Tolerability of DTG-based Antiretroviral Therapy in HIV-1 Infected Indian Persons Living with HIV.
Curr HIV Res
May 2024
Department of Medicine, Army College of Medical Sciences, New Delhi, 110010, India.
Background: Dolutegravir (DTG) is a novel yet preferential first- and -second-line treatment for persons living with HIV (PLH). Owing to its recent introduction, DTG-based regimens have not undergone a comprehensive, systematic evaluation regarding their real-world utilization and safety profile among a sizeable Indian population.
Objective: This study aimed to assess the 24 week immunovirological outcomes, anthropometric and metabolic changes, tolerability, and adverse events (AEs) of DTG-based antiretroviral (ART) regimens.
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