Current Opinion in HIV and AIDS最新文献_第9页

Lenacapavir: a first-in-class HIV-1 capsid inhibitor. Lenacapavir:一流的HIV-1衣壳抑制剂。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2022-01-01 DOI: 10.1097/COH.0000000000000713

Hadas Dvory-Sobol, Naveed Shaik, Christian Callebaut, Martin S Rhee

引用次数: 34

Fostemsavir: a first-in-class HIV-1 attachment inhibitor. Fostemsavir:一种一流的HIV-1附着抑制剂。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2022-01-01 DOI: 10.1097/COH.0000000000000712

Philip M Grant, Michael J Kozal

引用次数: 4

Editorial: New drugs for HIV: quo vadis? 社论:艾滋病新药:现状如何?

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2022-01-01 DOI: 10.1097/COH.0000000000000710

Charles W Flexner, Angela Kashuba

引用次数: 0

A new paradigm for antiretroviral delivery: long-acting cabotegravir and rilpivirine for the treatment and prevention of HIV. 抗逆转录病毒递送的新范例:长效卡博特韦和利匹韦林用于治疗和预防艾滋病毒。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2022-01-01 DOI: 10.1097/COH.0000000000000708

Sara H Bares, Kimberly K Scarsi

{"title":"A new paradigm for antiretroviral delivery: long-acting cabotegravir and rilpivirine for the treatment and prevention of HIV.","authors":"Sara H Bares, Kimberly K Scarsi","doi":"10.1097/COH.0000000000000708","DOIUrl":"https://doi.org/10.1097/COH.0000000000000708","url":null,"abstract":"Purpose of review: Cabotegravir (CAB) and rilpivirine (RPV) is the first long-acting injectable antiretroviral therapy (ART) option approved for virologically suppressed adults with HIV-1. In addition, long-acting CAB is a promising agent for HIV preexposure prophylaxis (PrEP). This review focuses on phase 3 clinical trial results and implementation considerations for these long-acting ART and PrEP strategies.Recent findings: Long-acting CAB and RPV administered every 4 weeks demonstrated noninferiority to oral ART through week 96 in both the ATLAS and FLAIR studies, whereas ATLAS-2M found similar efficacy through 96 weeks when the long-acting injectable ART was administered every 8 weeks instead of every 4 weeks. For prevention, two phase 3 trials were stopped early due to fewer incident HIV infections in participants receiving long-acting CAB every 8 weeks compared with daily oral tenofovir disoproxil fumarate-emtricitabine for PrEP. The long-acting therapies were well tolerated across all clinical trials.Summary: Clinical trial results support the use of long-acting CAB for HIV PrEP and long-acting CAB and RPV as a switch strategy for adults with HIV-1 who are first virologically suppressed with oral ART. Implementation challenges persist, and data are urgently needed in populations who may benefit most from long-acting therapy, including adolescents, pregnant individuals, and those with barriers to medication adherence.","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"17 1","pages":"22-31"},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/25/cohiv-17-22.PMC8694245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Cardiovascular toxicity of contemporary antiretroviral therapy. 当代抗逆转录病毒治疗的心血管毒性。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-11-01 DOI: 10.1097/COH.0000000000000702

Alinda G Vos, W D F Venter

{"title":"Cardiovascular toxicity of contemporary antiretroviral therapy.","authors":"Alinda G Vos, W D F Venter","doi":"10.1097/COH.0000000000000702","DOIUrl":"https://doi.org/10.1097/COH.0000000000000702","url":null,"abstract":"Purpose of review: HIV treatment has evolved since the introduction of antiretroviral therapy (ART) in the 1990s. Earlier treatment strategies, and the introduction of integrase inhibitors in preferred first-line ART have fundamentally changed cardiovascular side effects due to HIV infection and ART. This review provides an update on cardiovascular toxicity of contemporary ART.Recent findings: Cardiovascular disease (CVD) risk, including heart failure, is still increased in people living with HIV (PLWH). Exposure to older antiretrovirals, including stavudine and zidovudine, still impact on CVD risk through persistent changes in body fat distribution years after discontinuation. Protease inhibitors (PI) and efavirenz have associated metabolic disturbances and increased risk of CVD, although use is decreasing worldwide. Integrase inhibitors and CCR5 antagonists seem to have negligible immediate CVD toxicity. Weight gain on newer antiretrovirals including integrase inhibitors is a reason for concern.Summary: CVD risk should be monitored carefully in PLWH who were exposed to first generation ART, efavirenz or to PIs. Registries should capture ART use and CVD events to stay informed on actual clinical risk in the current era of rapid initiation on integrase inhibitor-based ART.","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"16 6","pages":"286-291"},"PeriodicalIF":4.1,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

The intersection of drug interactions and adverse reactions in contemporary antiretroviral therapy. 当代抗逆转录病毒治疗中药物相互作用和不良反应的交叉。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-11-01 DOI: 10.1097/COH.0000000000000701

Salin Nhean, Alice Tseng, David Back

{"title":"The intersection of drug interactions and adverse reactions in contemporary antiretroviral therapy.","authors":"Salin Nhean, Alice Tseng, David Back","doi":"10.1097/COH.0000000000000701","DOIUrl":"https://doi.org/10.1097/COH.0000000000000701","url":null,"abstract":"Purpose of review: Advances in antiretroviral therapy (ART) have transformed HIV infection into a chronic and manageable condition. The introduction of potent and more tolerable antiretrovirals (ARVs) with favorable pharmacokinetic profiles has changed the prevalence and nature of drug-drug interactions (DDIs). Here, we review the relevance of DDIs in the era of contemporary ART.Recent findings: Management of DDIs remains an important challenge with modern ART, primarily due to increased polypharmacy in older persons living with HIV. Significant DDIs exist between boosted ARVs or older nonnucleoside reverse transcriptase inhibitors and comedications for chronic comorbidities (e.g., anticoagulants, antiplatelets, statins) or complex conditions (e.g., anticancer agents, immunosuppressants). Newer ARVs such as unboosted integrase inhibitors, doravirine, and fostemsavir have reduced DDI potential, but there are clinically relevant DDIs that warrant consideration. Potential consequences of DDIs include increased toxicity and/or reduced efficacy of ARVs and/or comedications. Management approaches include switching to an ARV with less DDI potential, changing comedications, or altering medication dosage or dosing frequency. Deprescribing strategies can reduce DDIs and polypharmacy, improve adherence, minimize unnecessary adverse effects, and prevent medication-related errors.Summary: Management of DDIs requires close interdisciplinary collaboration from multiple healthcare disciplines (medicine, nursing, pharmacy) across a spectrum of care (community, outpatient, inpatient).","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"16 6","pages":"292-302"},"PeriodicalIF":4.1,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Hepatotoxicity of contemporary antiretroviral drugs. 当代抗逆转录病毒药物的肝毒性。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-11-01 DOI: 10.1097/COH.0000000000000706

Christina G Rivera, Ashley O Otto, John D Zeuli, Zelalem Temesgen

{"title":"Hepatotoxicity of contemporary antiretroviral drugs.","authors":"Christina G Rivera, Ashley O Otto, John D Zeuli, Zelalem Temesgen","doi":"10.1097/COH.0000000000000706","DOIUrl":"https://doi.org/10.1097/COH.0000000000000706","url":null,"abstract":"Purpose of review: To date, more than 30 antiretroviral drugs have been approved by the Food and Drug Administration for the treatment of HIV infection. As new drugs with better efficacy and safety profile become available for clinical practice, older drugs are either withdrawn from the market or become no longer actively prescribed. We review hepatotoxicity associated with contemporary antiretroviral drugs, with emphasis on data from the past 3 years.Recent findings: Although less robust data exists for side effects of contemporary antiretroviral medications recently approved for the management of HIV (i.e., doravirine, ibalizumab, fostemsavir, cabotegravir), the risks of substantial hepatotoxicity appears to be minimal with these agents.Summary: Although newer antiretroviral drugs are better tolerated than their earlier counterparts, they are not completely devoid of adverse drug reactions, including hepatotoxicity. Monitoring patients on antiretroviral therapy for treatment-emergent liver injury should continue to be part of routine clinical care.","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"16 6","pages":"279-285"},"PeriodicalIF":4.1,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Renal adverse drug reactions. 肾脏药物不良反应。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-11-01 DOI: 10.1097/COH.0000000000000703

Christine Hughes

{"title":"Renal adverse drug reactions.","authors":"Christine Hughes","doi":"10.1097/COH.0000000000000703","DOIUrl":"https://doi.org/10.1097/COH.0000000000000703","url":null,"abstract":"Purpose of review: Chronic kidney disease (CKD) is common in people living with HIV (PLWH) and is related to a multitude of factors. The aim of this review is to provide an overview of the most recent evidence of renal adverse effects of antiretroviral drugs, predictors of CKD risk and areas for future research.Recent findings: Advancing age, cardiometabolic risk factors and adverse effects of antiretroviral drugs contribute to the higher prevalence of CKD in PLWH. Genetic factors and baseline clinical CKD risk are strongly correlated to risk of incident CKD, although it is unclear to what extent gene polymorphisms explain renal adverse effects related to tenofovir disoproxil fumarate (TDF). Switching from TDF to tenofovir alafenamide (TAF) in people with baseline renal dysfunction improves renal parameters; however, the long-term safety and benefit of TAF in individuals at low risk of CKD is an area of ongoing research.Summary: Several factors contribute to estimated glomerular function decline and CKD in PLWH. Clinical risk scores for CKD may be useful to inform selection of ART in an ageing population. In people with baseline renal dysfunction, potentially nephrotoxic antiretroviral drugs should be avoided.","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"16 6","pages":"303-308"},"PeriodicalIF":4.1,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

An update on neuropsychiatric adverse effects with second-generation integrase inhibitors and nonnucleoside reverse transcriptase inhibitors. 第二代整合酶抑制剂和非核苷类逆转录酶抑制剂的神经精神不良反应的最新进展。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-11-01 DOI: 10.1097/COH.0000000000000705

Tessa Senneker, Alice Tseng

{"title":"An update on neuropsychiatric adverse effects with second-generation integrase inhibitors and nonnucleoside reverse transcriptase inhibitors.","authors":"Tessa Senneker, Alice Tseng","doi":"10.1097/COH.0000000000000705","DOIUrl":"https://doi.org/10.1097/COH.0000000000000705","url":null,"abstract":"Purpose of review: Neuropsychiatric adverse effects (NPAE) associated with integrase strand transfer inhibitors (INSTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) are a growing concern, with higher rates in the real-world compared to phase III trials. This paper reviews the incidence, risk factors, and management of NPAE with second-generation INSTIs, INSTI/rilpivirine dual therapy, and doravirine.Recent findings: Recent cohort data confirm up to 8% NPAE-associated discontinuations for dolutegravir; NPAE with dolutegravir/rilpivirine therapy are higher than with dolutegravir alone, whereas bictegravir appears similar to dolutegravir. In contrast, NPAE with cabotegravir alone or with rilpivirine appears to be low. Doravirine has NPAE rates similar to rilpivirine and lower than efavirenz. Risk factors for NPAE include female gender, concurrent abacavir use, Sub-Saharan African descent, and age, whereas underlying psychiatric conditions do not appear to increase risk. Strategies to manage NPAE include changing administration time, therapeutic drug monitoring, or regimen modification including within-class INSTI changes. People experiencing NPAE with dolutegravir may tolerate bictegravir.Summary: Overall, mild to moderate NPAE are associated with INSTIs and newer NNRTIs. Rarely, more severe symptoms may occur and lead to treatment discontinuation. Clinicians should be aware of NPAE to identify and manage drug-related adverse effects.","PeriodicalId":10949,"journal":{"name":"Current Opinion in HIV and AIDS","volume":"16 6","pages":"309-320"},"PeriodicalIF":4.1,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Editorial: Immune-mediated control of HIV. 编辑:免疫介导的HIV控制。

IF 4.1 3区医学

Current Opinion in HIV and AIDS Pub Date : 2021-09-01 DOI: 10.1097/COH.0000000000000698

Katharine J Bar, Ole S Søgaard

引用次数: 0