Current HIV Research最新文献

{"title":"Prevalence of Risk Factors Associated With Poor Quality of Sleep in People Living with HIV and the Correlation between Quality of Sleep and Cd4+ T Lymphocyte Reconstitution: A Cross-Sectional Study from Turkey.","authors":"Ozge Eren Korkmaz, Figen Kaptan Aydoğmuş","doi":"10.2174/011570162X300844240507095129","DOIUrl":"10.2174/011570162X300844240507095129","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of sleep disorders in people living with HIV (PLWH) is higher than in the general population. Even if viral suppression is achieved with Antiretroviral Therapy (ART), the chronic immune activation and increased inflammation due to immune reconstitution persist. The aim of our study was to determine the prevalence of poor quality of sleep (QoS) and associated risk factors in PLWH and to investigate the relationship between poor QoS and CD4 T lymphocyte count and CD4 reconstitution.</p><p><strong>Methods: </strong>PLWH ≥18 years old, attending for routine HIV monitoring were recruited. PLWH with conditions that may affect their QoS (pregnant, hospitalized, malignancy, substance-alcohol abuse, psychiatric disease or treatment, sleeping pill) were excluded. Pittsburgh Sleep Quality Index (PSQI, score ≥5 indicates poor QoS), Epworth Sleepiness Scale (ESS, score ≥11 indicates daytime sleepiness), and Beck Depression Scale (BDS, score ≥10 indicates clinical depression) were applied. CD4+ T lymphocyte reconstitution (current-baseline CD4+ count) and CD4+ T lymphocyte reconstitution rate [(current-baseline CD4+ count)/duration of HIV infection in years] were calculated for PLWH on ART. Student t-test and Pearson's chi-squared test were used for analysing the data, and p<0.05 was considered significant.</p><p><strong>Results: </strong>A total of 131 (15 newly diagnosed, 116 on ART for at least six months) PLWH were enrolled. Poor QoS was detected in 60.3% of PLWH. When compared, the ratio was higher in newly diagnosed PLWH (vs PLWH on ART, p>0,05). Daytime sleepiness in PLWH with poor Qos (p=0.04) was significantly increased (vs good QoS). Clinical depression (p=0.001) was significantly more common in PLWH with poor QoS (vs good QoS). Although statistically nonsignificant (p>0,05), younger age, female sex, being single, homosexüel sexual preference, high income and living with the family were associated with poor QoS. No association was found between the ART regime and QoS. PLWH with poor QoS had a higher CD4+ T lymphocyte count (p>0,05), a higher number of CD4+ T lymphocyte reconstitution (p<0.05), and a higher reconstitution rate than PLWH with good QoS (p<0.05).</p><p><strong>Conclusion: </strong>Prevalence of poor QoS was high in our cohort. Poor QoS was associated with CD4+ T lymphocyte reconstitution and reconstitution rate.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"202-211"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobronchial Tuberculosis in an HIV-positive Case.","authors":"Savaş Gegin, Burcu Özdemir, Özgür Günal, Şeyma Topal, Çiğdem Uzun, Levent Özdemir","doi":"10.2174/011570162X262663231214053029","DOIUrl":"10.2174/011570162X262663231214053029","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis is an opportunist infection that is fatal and most frequently seen in HIV-positive patients due to immunosuppression. Endobronchial lesions can portray symptoms in different ways. Endobronchial Tuberculosis is one of these lesions.</p><p><strong>Case report: </strong>An HIV-positive, untreated 26-year-old patient with fever, cough, and dyspnea consulted our clinic. In the chest X-ray taken, effusion on the right side and non-homogeneous density increase in the middle and upper lobes, bilaterally more prominent on the right side, were observed. Therefore, the patient underwent bronchoscopy because the CT (computerized tomography) showed mediastinal lymphadenopathy (LAP) and an endobronchial lesion in the left main bronchus. During bronchoscopy, a vegetative endobronchial lesion that causes obstruction in the left main bronchus was monitored. With the help of Pathology and PCR results, endobronchial tuberculosis was diagnosed.</p><p><strong>Conclusion: </strong>Even if Acid-alcohol-resistant Bacillus (ARB) is detected negative in patients who stop responding to antimicrobial treatment and are being monitored under radiological scanning, a distinctive diagnosis of endobronchial tuberculosis should be kept in mind while performing bronchoscopy.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Pregnancy Status in Patients with Acquired Immunodeficiency Syndrome and their Partners.","authors":"Mehmet Cabalak, Oya Soylu Karapınar, Cigdem El","doi":"10.2174/011570162X349194241125052104","DOIUrl":"10.2174/011570162X349194241125052104","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;HIV is a globally prevalent infection for which there is currently no cure or vaccine. As the number of individuals with HIV infection increases, so does the number of individuals wishing to have children despite being infected. This situation has highlighted issues related to couples where one partner is infected while the other is not (serodiscordant couples) and couples where both partners are positive. Major issues include pregnancy complications, transmission to the child, and potential side effects of the ART treatment on the health of the child. Women living with HIV who become pregnant or contract the virus during pregnancy are at risk for both maternal and perinatal morbidity and mortality, especially if the virus is not adequately controlled. Additionally, there is a risk of vertical transmission through breastfeeding during pregnancy and postpartum. To mitigate the consequences of HIV during pregnancy, it is ideal to start with prepregnancy counseling and plan pregnancies during periods of minimal viral load using appropriate methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objective: &lt;/strong&gt;There are limited studies and shared experiences regarding fertility status and issues of HIV/AIDS patients, especially in Turkey. Hence, this study aimed to investigate the fertility status of HIV/AIDS patients and their partners followed up in our clinic, shed light on the encountered issues, and share our experiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, observational, single-center cross-sectional study included HIV/AIDS patients and their partners followed at Hatay Mustafa Kemal University (MKÜ) Medical Faculty Hospital from January 2018 to December 2023. Demographic data of the patients, their sexual orientations, HIV/AIDS status of their partners and children, treatments received, CD4 cell counts, and viral load data were retrospectively obtained from the automation system of our hospital and patient files.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the couples, there were 21 pairs where both partners were HIV positive, 10 pairs where the woman was HIV positive and the man was seronegative (serodiscordant), and 5 pairs where the man was HIV positive and the woman was seronegative. In our study, eight couples with both partners HIV positive had nine children, and six couples with women who were HIV positive (serodiscordant) had ten children. The five couples with men who were HIV positive (serodiscordant) had six children. No vertical transmission was observed in our study, but three patients did not attend regular follow-ups. During the follow-up period, no seroconversion was detected in the partners of serodiscordant patients. The average gestational age was 38 weeks, and the average birth weight was 2873 ± 349 grams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study found no vertical transmission and no seroconversion in partners of serodiscordant couples. Issues related to pregnancy in HIV-positive couples can be man","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"402-408"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Immunodeficiency Virus-1 Drug Resistance Mutations in Iranian Treatment-experienced Individuals.","authors":"Farah Bokharaei-Salim, Khadijeh Khanaliha, Seyed Hamidreza Monavari, Seyed Jalal Kiani, Ahmad Tavakoli, Ensieh Jafari, Sara Chavoshpour, Mohammad Hossein Razizadeh, Saeed Kalantari","doi":"10.2174/011570162X273321240105081444","DOIUrl":"10.2174/011570162X273321240105081444","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus-1 infection still remains a global health threat. While antiretroviral therapy is the primary treatment option, concerns about the emergence of drug-resistance mutations and treatment failure in HIV-infected patients persist.</p><p><strong>Objective: </strong>In this study, we investigated the development of drug resistance in HIV-1-infected individuals receiving antiretroviral therapy for 6-10 years.</p><p><strong>Methods: </strong>In this cross-sectional study, we evaluated 144 people living with HIV-1 who had received antiretroviral therapy for at least 6 years. Plasma specimens were collected, and the HIV-1 viral load and drug-resistance mutations were assessed using molecular techniques.</p><p><strong>Results: </strong>The demographic and epidemiological characteristics of the participants were also analyzed: Twelve [8.3%) of the studied patients showed a viral load over 1000 copies per/mL, which indicates the suboptimal response to antiretroviral therapy. Significant correlations were found between viral load and CD4 count, as well as epidemiological factors, such as vertical transmission, history of imprisonment, and needle stick injuries. Drug resistance mutations were detected in 10 (83.3%) of patients who failed on antiretroviral therapy, with the most common mutations observed against nucleoside reverse transcriptase inhibitors (5 (41.7%)) and non-nucleoside reverse transcriptase inhibitors (9 (75%)). Phylogenetic analysis revealed that 12 patients who failed treatment were infected with CRF35_AD.</p><p><strong>Conclusion: </strong>Our study provides important insights into the characteristics and development of drug resistance in HIV-1-infected individuals receiving long-term antiretroviral therapy in Iran. The findings underline the need for regular viral load monitoring, individualized treatment selection, and targeted interventions to optimize treatment outcomes and prevent the further spread of drug-resistant strains.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"53-64"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal Abdominal Diameter as the Best Predictor of Metabolic Syndrome in HIV-Infected Men on Antiretroviral Therapy.","authors":"Zorka Drvendžija, Biljana Srdić Galić, Miloš Vujanović, Daniela Marić, Nina Brkić Jovanović, Snežana Brkić, Vesna Turkulov, Dalibor Ilić","doi":"10.2174/011570162X270929240125055222","DOIUrl":"10.2174/011570162X270929240125055222","url":null,"abstract":"<p><strong>Background: </strong>The interaction of human immunodeficiency virus (HIV), host and antiretroviral therapy (ART) causes a range of metabolic disorders that can be characterized as a metabolic syndrome (MetS) that increases the cardiovascular risk. MetS involves central obesity, which can be detected using different anthropometric parameters.</p><p><strong>Objective: </strong>To assess the abilities of different anthropometric parameters in the prediction of MetS in HIV-infected men on ART.</p><p><strong>Method: </strong>The study involved 92 male participants (mean age 44.46±10.38 years), divided into two groups: with and without MetS. All subjects underwent biochemical evaluation (triglycerides, HDL-cholesterol, fasting glucose), blood pressure measurement and anthropometric assessment: body mass, body height, body mass index (BMI), body fat mass, body circumferences (chest, upper arm, forearm, waist, hip, proximal and middle thigh and calf), sagittal abdominal diameter (SAD), skinfold thicknesses (subscapular, anterior and posterior upper arm, anterior and lateral forearm, abdominal, supraspinal, thigh and calf), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), sagittal abdominal diameter-to-body height ratio (SADH), body adiposity index (BAI) and conicity index. MetS was specified according to IDF criteria.</p><p><strong>Results: </strong>Subjects with MetS had statistically significant higher values of all anthropometric parameters except middle thigh circumference, calf skinfold and body height. According to ROC analysis and Binary Logistic Regression, SAD has been shown as the best predictor of MetS with a predictive value of 21.40 cm (AUC:0.91), followed by WHR with a predictive value of 0.93.</p><p><strong>Conclusion: </strong>Sagittal abdominal diameter is the strongest anthropometric indicator of MetS in HIV-infected patients on ART.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"91-99"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pill Burden: A Major Barrier to HAART Adherence and Fixed Dose Combinations (FDCS) as its Solution - A Mini-Review.","authors":"Mugisa Simon, Ssebaduka Derrick, Sreya Kosanam, Rajeshwari Pasupula","doi":"10.2174/011570162X307740240604115154","DOIUrl":"10.2174/011570162X307740240604115154","url":null,"abstract":"<p><p>HIV/ AIDS is a global pandemic, one of the most challenging; with no cure for the disease, various therapies available in the form of regimens as Highly Active Anti-Retroviral Therapy (HAART) or simply Anti-Retroviral Therapy (ART) are the only way to manage the disease. The Fixed Dose Combinations (FDCs) concept has been a well-recognised improvement in pharmacotherapy for the treatment of a variety of chronic maladies like hypertension, diabetes, HIV/AIDS, and several FDC products consisting of HIV drugs are approved. These single-tablet regimens have been essential in streamlining ART, lowering pill burden and increasing adherence. Adherence to HAART is the most vital factor to ensure medication success and virologic suppression. However, adherence is faced with several barriers including adverse effects of drugs, the complexity of ART, social-cultural factors, and pill burden among others. This writing reviews the concept of adherence to ART, and its barriers while stressing pill burden as a significant one which we suggest would be solved by using Fixed Dose Combinations (FDCs).</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"143-152"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection Of CCR5 Delta-32 Mutation Using High-Resolution Melting Curve Analysis: Challenges and Facts.","authors":"Seyed Jalal Kiani, Tahereh Donyavi, Farah Bokharaei-Salim","doi":"10.2174/011570162X326491240906064322","DOIUrl":"10.2174/011570162X326491240906064322","url":null,"abstract":"<p><strong>Introduction: </strong>The C-C chemokine receptor type 5 (CCR5) is a major co-receptor for human immunodeficiency virus (HIV). Some individuals carry the CCR5 delta-32 genetic polymorphism. People with homozygous CCR5 delta-32 gene are nearly completely resistant to HIV-1 infection. High-resolution melting curve (HRM) analysis is a post-PCR technique utilized for identifying genetic variations in a quick, affordable, and closed-tube assay. The objective of this study was to develop an HRM assay for easy detection of delta-32 mutations.</p><p><strong>Materials and methods: </strong>DNA was extracted from peripheral blood mononuclear cells. HRM was performed to detect delta-32 mutation. The study investigated the impact of various factors, including annealing temperature, template concentration, touchdown PCR, additives, amplicon size, and program settings, on HRM Tm differentiation.</p><p><strong>Results: </strong>It was expected that there would be a 4°C Tm difference between amplicons with and without delta-32 mutation, but the test showed a difference of only 2.3°C. In attempts to identify heterozygote delta-32 variants, a Tm difference of only 0.4°C could be achieved. Various modifications were applied, such as adjusting the template concentration, using touchdown PCR, and adding DMSO and glycerol. However, none of these changes helped to differentiate the Tm effectively, especially in delta-32 heterozygote samples.</p><p><strong>Conclusion: </strong>The HRM test identified four samples with heterozygote mutations in each HIV-infected (8.89%) and control (5.72%) groups. More importantly, this study showed that identifying the delta-32 mutation of the CCR5 gene using HRM assay is not as straightforward as previously suggested in some literature, and it requires special setup conditions.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"368-373"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterologous DNA Prime/Protein Boost Immunization Targeting Nef-Tat Fusion Antigen Induces Potent T-cell Activity and <i>in vitro</i> Anti-SCR HIV-1 Effects.","authors":"Leila Sadeghi, Azam Bolhassani, Elham Mohit, Kazem Baesi, Mohammad Reza Aghasadeghi","doi":"10.2174/011570162X297602240430142231","DOIUrl":"10.2174/011570162X297602240430142231","url":null,"abstract":"<p><strong>Background: </strong>Heterologous combinations in vaccine design are an effective approach to promote T cell activity and antiviral effects. The goal of this study was to compare the homologous and heterologous regimens targeting the Nef-Tat fusion antigen to develop a human immunodeficiency virus-1 (HIV-1) therapeutic vaccine candidate.</p><p><strong>Methods: </strong>At first, the DNA and protein constructs harboring HIV-1 Nef and the first exon of Tat as linked form (pcDNA-<i>nef-tat</i> and Nef-Tat protein) were prepared in large scale and high purity. The generation of the Nef-Tat protein was performed in the <i>E. coli</i> expression system using an IPTG inducer. Then, we evaluated and compared immune responses of homologous DNA prime/ DNA boost, homologous protein prime/ protein boost, and heterologous DNA prime/protein boost regimens in BALB/c mice. Finally, the ability of mice splenocytes to secret cytokines after exposure to single-cycle replicable (SCR) HIV-1 was compared between immunized and control groups <i>in vitro</i>.</p><p><strong>Results: </strong>The nef-tat gene was successfully subcloned in eukaryotic pcDNA3.1 (-) and prokaryotic pET-24a (+) expression vectors. The recombinant Nef-Tat protein was generated in the <i>E. coli Rosetta</i> strain under optimized conditions as a clear band of ~ 35 kDa detected on SDS-PAGE. Moreover, transfection of pcDNA-<i>nef-tat</i> into HEK-293T cells was successfully performed using Lipofectamine 2000, as confirmed by western blotting. The immunization studies showed that heterologous DNA prime/protein boost regimen could significantly elicit the highest levels of Ig- G2a, IFN-γ, and Granzyme B in mice as compared to homologous DNA/DNA and protein/protein regimens. Moreover, the secretion of IFN-γ was higher in DNA/protein regimens than in DNA/DNA and protein/protein regimens after exposure of mice splenocytes to SCR HIV-1 <i>in vitro</i>.</p><p><strong>Conclusion: </strong>The chimeric HIV-1 Nef-Tat antigen was highly immunogenic, especially when applied in a heterologous prime/ boost regimen. This regimen could direct immune response toward cellular immunity (Th1 and CTL activity) and increase IFN-γ secretion after virus exposure.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"109-119"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance of Aqueous/Plasma HIV Replication on ART.","authors":"Xin Che, Luoziyi Wang, Weimei Ma, Rui Wang, Zhiliang Wang","doi":"10.2174/011570162X268730231212112119","DOIUrl":"10.2174/011570162X268730231212112119","url":null,"abstract":"<p><strong>Background: </strong>The study was conducted to analyze HIV dynamics across blood-retinal barrier (BRB) and the relevant risk factors for HIV-associated ocular complications.</p><p><strong>Methods: </strong>This study included a case series of 40 HIV-positive patients with ocular lesions, which were studied retrospectively. Clinical and laboratory examinations included plasma and intraocular viral load (VL).</p><p><strong>Results: </strong>HIV VL on paired aqueous/plasma samples was available for 40 patients. Aqueous VL was negatively associated with antiretroviral treatment (ART) duration (p = 0.02 and p < 0.05), and plasma VL was independent of ART duration (p = 0.53). An aqueous/plasma discordance was found in 19/40 (47.5%) patients, eight of whom (20%) had detectable aqueous VL despite a suppressed plasma VL (escape). There were significant differences in CD4+ T-lymphocyte levels (p = 0.011 and p < 0.05) and ART duration (p = 0.007 and p < 0.05) between the patients with HIV-associated ocular complications and the patients without.</p><p><strong>Conclusion: </strong>This study provides a rationale for initiating ART early in the course of infection to reduce HIV VL in the aqueous humor, and raises the possibility of the ocular sanctuary where HIV replicates. Meanwhile, early and standard ART would be an optimal option to protect against ocular opportunistic infection.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"27-30"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 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.","authors":"Kuldeep K Ashta, Sumit Arora, Rajesh Khanna, Nishant Raman, Anirudh Anilkumar, Charu Mohan","doi":"10.2174/011570162X264021231108010324","DOIUrl":"10.2174/011570162X264021231108010324","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>A single-centre phase-IV non-interventional observational study involving 322 ART naïve and treatment-experienced PLH initiating DTG-based-regimens until October 2022 were followed up for outcomes at 24 weeks.</p><p><strong>Results: </strong>At 24 weeks, all PLH (n = 113) in the naïve group, all PLH (n = 67) in the first-line substitution group, 93.9% PLH (n = 46) in the first-line failure group, and 95.7% PLH (n = 89) in the second-line substitution group were virologically suppressed to plasma HIV-RNA <1000 copies/mL. Virological suppression rates to plasma HIV-RNA <200 copies/mL and <50 copies/mL were consistent among PLH who received DTG as first- or second-line ART. The mean-unadjusted weight gain observed was 3.5 kg (SE: 0.330), and it was significantly higher in PLH with poorer health at baseline (either HIV-RNA ≥ 1000 copies/ml or CD4 cell count <350 cells/μL). Overall, 27.3% PLH (n = 88) gained ≥10% of their baseline body weight, corresponding to 3.7% incidence (n = 12) of treatment-emergent clinical obesity. DTG had an overall lipid-neutral effect, with an advantageous effect being observed in PLH switching from non-nucleoside analogue reverse-transcriptase inhibitors (NNRTI) or ritonavir-boosted protease inhibitors (b/PI), especially in dyslipidemic pre-treated PLH (median change in total cholesterol: 28.5 mg/dL and triglycerides: 51 mg/dL), possibly emanating from the withdrawal of the offending ART. The incidence of DTG-specific AEs, including CNS AEs, was low. Two PLH developed proximal myopathy and one developed transaminitis, warranting DTG discontinuation. Asymptomatic serum-CPK elevation and drug-induced transaminitis were seen in 25.2% (n = 27) and 3.2% (n = 10) PLH, respectively. No apparent negative effects on renal function were detected.</p><p><strong>Conclusion: </strong>Our results from a large Indian cohort indicate a favourable virological and metabolic response, with good tolerance of DTG-based ART at 24 weeks.</p>","PeriodicalId":10911,"journal":{"name":"Current HIV Research","volume":" ","pages":"31-46"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}