HIV Clinical Trials最新文献

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PRO 140, a monoclonal antibody targeting CCR5, as a long-acting, single-agent maintenance therapy for HIV-1 infection. pro140,一种靶向CCR5的单克隆抗体,作为HIV-1感染的长效单药维持疗法。
HIV Clinical Trials Pub Date : 2018-06-01 Epub Date: 2018-04-20 DOI: 10.1080/15284336.2018.1452842
Kush Dhody, Nader Pourhassan, Kazem Kazempour, Derry Green, Shide Badri, Hana Mekonnen, Denis Burger, Paul J Maddon
{"title":"PRO 140, a monoclonal antibody targeting CCR5, as a long-acting, single-agent maintenance therapy for HIV-1 infection.","authors":"Kush Dhody,&nbsp;Nader Pourhassan,&nbsp;Kazem Kazempour,&nbsp;Derry Green,&nbsp;Shide Badri,&nbsp;Hana Mekonnen,&nbsp;Denis Burger,&nbsp;Paul J Maddon","doi":"10.1080/15284336.2018.1452842","DOIUrl":"https://doi.org/10.1080/15284336.2018.1452842","url":null,"abstract":"<p><p>Background PRO 140 is a humanized monoclonal antibody targeting CCR5 with potent antiviral activity in patients with CCR5-tropic HIV-1 infection. In phase 2b studies, we evaluated the long-term efficacy, safety, and tolerability of PRO 140 monotherapy in maintaining viral suppression for over 24 months in patients who were stable on combination antiretroviral therapy on entry into the trials. Methods and Results Forty-one adult patients, infected exclusively with CCR5-tropic HIV-1 with viral loads <50 copies/mL, were switched from daily oral combination ART regimens to weekly PRO 140 monotherapy for 12 weeks. Participants who completed 12 weeks of treatment without experiencing virologic rebound were allowed to self-administer PRO 140 as a 350 mg subcutaneous injection weekly, for up to an additional 160 weeks. Participants were monitored bi-weekly for one year, and every four weeks thereafter for virologic rebound. PRO 140 provided virologic suppression in 23/41 (56.1%) participants for 12 weeks and was well tolerated. Ten (10) participants are currently ongoing, of which nine participants have completed more than two years of monotherapy treatment (47-129 weeks). Participants experiencing virologic rebound achieved full viral suppression upon re-initiation of oral combination ART regimen. Anti-PRO 140 antibodies were not detected in any patient, and no drug-related major adverse events or treatment discontinuations were reported. Conclusions PRO 140 has a potential to address an unmet need for a long-acting, single-agent, maintenance regimen for HIV infection in selected patients. Studies are underway to determine host and/or virologic factors that may predict treatment success on PRO 140 monotherapy. Moreover, it has sufficient potency for a prolonged period of monotherapy that it would be an excellent component of a multi long-acting drug combination.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1452842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36026713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 30
The effect of switching protease inhibitors to raltegravir on endothelial function, in HIV-infected patients. 在hiv感染患者中将蛋白酶抑制剂转换为雷替格拉韦对内皮功能的影响。
HIV Clinical Trials Pub Date : 2018-04-01 DOI: 10.1080/15284336.2018.1455366
Maaike Krikke, Kiki Tesselaar, Guido E L van den Berk, Sigrid A Otto, Laura H Freriks, Steven F L van Lelyveld, Frank J L Visseren, Andy I M Hoepelman, Joop E Arends
{"title":"The effect of switching protease inhibitors to raltegravir on endothelial function, in HIV-infected patients.","authors":"Maaike Krikke,&nbsp;Kiki Tesselaar,&nbsp;Guido E L van den Berk,&nbsp;Sigrid A Otto,&nbsp;Laura H Freriks,&nbsp;Steven F L van Lelyveld,&nbsp;Frank J L Visseren,&nbsp;Andy I M Hoepelman,&nbsp;Joop E Arends","doi":"10.1080/15284336.2018.1455366","DOIUrl":"https://doi.org/10.1080/15284336.2018.1455366","url":null,"abstract":"<p><p>Objective Lipid management is one of the cornerstones of cardiovascular risk reduction. Treatment of HIV infection with protease inhibitors (PIs) may cause dyslipidaemia, whilst the integrase inhibitor raltegravir (RAL) has a relatively favorable effect on plasma lipids. We examined the effect of switching from PIs to RAL on endothelial function, and its effect on immunological and inflammatory parameters. Methods We performed a 16-week open-label prospective crossover study: 8 weeks intervention (switch PIs to RAL) and 8 weeks control (unchanged cART regimen). Flow-mediated dilatation (FMD), inflammatory plasma, and cellular markers of immune activation were measured at weeks 0, 8, and 16. Results Study participants (n = 22) with a median age of 50 years (IQR 42-60) and known HIV infection of 6.5 years (IQR 5.0-17.3) were on stable cART with undetectable HIV viral loads. After 8 weeks of RAL therapy, a reduction in FMD of -0.81% was seen, compared to +0.54% control (pairwise, p = 0.051), while fasting total cholesterol (-17% versus +10%; p < 0.001), LDL cholesterol (-21% versus -3%; p = 0.026), and triglycerides (-41% versus +18%; p = 0.001) significantly decreased during RAL therapy compared to the control. Furthermore, a relation between the change in percentage of B-1 cells and the change in FMD was found (β 0.40, 95%CI 0.16; 0.64, p = 0.005) during treatment with RAL. Finally, during RAL therapy, 27% of the patients experienced an increased ALT rise. Conclusions We present an overall negative study, where switching from PIs to RAL slightly reduced the endothelial function while decreasing plasma lipids, thus possibly decreasing the CVD risk in the long term. A transient elevation of ALT was seen upon switch to RAL.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1455366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Durability and tolerability of first-line regimens including two nucleoside reverse transcriptase inhibitors and raltegravir or ritonavir boosted-atazanavir or -darunavir: data from the ICONA Cohort. 包括两种核苷类逆转录酶抑制剂和雷替格拉韦或利托那韦增强型阿扎那韦或达那韦在内的一线治疗方案的耐受性和耐受性:来自ICONA队列的数据
HIV Clinical Trials Pub Date : 2018-04-01 Epub Date: 2018-03-01 DOI: 10.1080/15284336.2018.1440691
Antonella d'Arminio Monforte, Patrizia Lorenzini, Alessandro Cozzi-Lepri, Cristina Mussini, Antonella Castagna, Franco Baldelli, Massimo Puoti, Francesca Vichi, Adelaide Maddaloni, Sergio Lo Caputo, Nicola Gianotti, Andrea Antinori
{"title":"Durability and tolerability of first-line regimens including two nucleoside reverse transcriptase inhibitors and raltegravir or ritonavir boosted-atazanavir or -darunavir: data from the ICONA Cohort<sup/>.","authors":"Antonella d'Arminio Monforte,&nbsp;Patrizia Lorenzini,&nbsp;Alessandro Cozzi-Lepri,&nbsp;Cristina Mussini,&nbsp;Antonella Castagna,&nbsp;Franco Baldelli,&nbsp;Massimo Puoti,&nbsp;Francesca Vichi,&nbsp;Adelaide Maddaloni,&nbsp;Sergio Lo Caputo,&nbsp;Nicola Gianotti,&nbsp;Andrea Antinori","doi":"10.1080/15284336.2018.1440691","DOIUrl":"https://doi.org/10.1080/15284336.2018.1440691","url":null,"abstract":"<p><p>Background We aimed to mimic the ACTG 5257 trial, comparing raltegravir (RAL), ritonavir-boosted atazavavir (ATV/r) and ritonavir-boosted darunavir (DRV/r) in the observational setting. Methods All the ICONA patients starting a first cART with 2NRTI + ATV/r, DRV/r or RAL were included. Primary end-point was treatment failure, i.e. virological failure (confirmed HIV-RNA > 200copies/mL > 6 months therapy) or discontinuation for any reason of the third drug. Secondary end-points: virological failure50 (50 copies/mL threshold), and discontinuation of the third drug due to intolerance/toxicity. Cox regression analyses were run to compare the risk of outcomes between the three regimens. Results 2249 patients were included, 985 (44%) initiated ATV/r, 1023 (45%) DRV/r and 241 (11%) RAL; median follow-up of 3.6 years (IQR: 2.3-5.2). After controlling for baseline confounding factors, patients given ATV/r showed a 26% higher risk of treatment failure (TF) vs. DRV/r (AHR 1.26, 95%CI 1.11-1.43); patients on RAL had a lower risk of TF vs. ATV/r (AHR 0.81, 95%CI 0.66-0.99). The probability of virological failure50 was significantly lower for people initiating RAL vs. DRV/r (AHR 0.46, 95%CI 0.24-0.87) or ATV/r (AHR 0.52, 95%CI 0.27-0.99). In addition, RAL was associated to a lower risk of discontinuation for toxicity vs. both DRV/r (AHR: 0.37, 95%CI: 0.19-0.72) and ATV/r (AHR: 0.18, 95%CI: 0.09-0.34). ATV/r was associated with a higher risk of discontinuing due to toxicity (AHR 2.09, 95%CI 1.63-2.67) vs. DRV/r. Conclusions In our observational study, we confirmed higher risk of treatment failure and lower tolerability of ATV/r-based regimens as compared to those including DRV/r or RAL.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1440691","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35873520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey. 对土耳其144例艾滋病毒/艾滋病病例的流行病学、临床和实验室特征及死亡率进行评估。
HIV Clinical Trials Pub Date : 2018-04-01 Epub Date: 2018-03-22 DOI: 10.1080/15284336.2018.1453990
Burcu Ozdemir, Meltem A Yetkin, Aliye Bastug, Ayşe But, Halide Aslaner, Esragul Akinci, Hurrem Bodur
{"title":"Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey.","authors":"Burcu Ozdemir,&nbsp;Meltem A Yetkin,&nbsp;Aliye Bastug,&nbsp;Ayşe But,&nbsp;Halide Aslaner,&nbsp;Esragul Akinci,&nbsp;Hurrem Bodur","doi":"10.1080/15284336.2018.1453990","DOIUrl":"https://doi.org/10.1080/15284336.2018.1453990","url":null,"abstract":"<p><p>Background The number of HIV/AIDS cases in Turkey is increasing rapidly, as is the number of cases worldwide. The aim of this study is to evaluate the characteristics of the clinical and laboratory findings and epidemiological features of HIV/AIDS patients to obtain useful data on the epidemic type and transmission routes associated with Turkey and to identify risk factors for mortality. Methods The patient records of 144 HIV-infected patients who were admitted to our clinic between 2000 and 2015 were analyzed retrospectively. Results Most of the cases (55%) were diagnosed due to the detection of anti-HIV-positive individuals without clinical symptoms. The mean CD4 + lymphocyte count on first admission was 108 cells/μL for those admitted before 2009 and 265 cells/μL for those admitted after 2009 (p = 0.003). When the pre- and post-2009 groups were compared for the status of the disease, 55.6 and 44.4% of patients were in the AIDS stage, respectively (p = 0.04). The most noted opportunistic infection was mycobacterial, and throughout the follow-up, 31.2% of the cases were fatal. Conclusions Early diagnosis of HIV infection can have a direct impact on prognosis and survival. Therefore, screening laboratory investigations should be extended, particularly in high-risk groups.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1453990","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35938158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Use of next-generation sequencing in the CHAT study (acute HCV in HIV): effect of baseline resistance-associated NS3 variants on treatment failure. 在CHAT研究(HIV中的急性HCV)中使用新一代测序:基线耐药相关NS3变异对治疗失败的影响
HIV Clinical Trials Pub Date : 2018-04-01 Epub Date: 2018-03-01 DOI: 10.1080/15284336.2018.1439714
Gurmit Kaur Jagjit Singh, Steve Kaye, James C Abbott, Christoph Boesecke, Juergen Rockstroh, Myra O McClure, Mark Nelson
{"title":"Use of next-generation sequencing in the CHAT study (acute HCV in HIV): effect of baseline resistance-associated NS3 variants on treatment failure.","authors":"Gurmit Kaur Jagjit Singh,&nbsp;Steve Kaye,&nbsp;James C Abbott,&nbsp;Christoph Boesecke,&nbsp;Juergen Rockstroh,&nbsp;Myra O McClure,&nbsp;Mark Nelson","doi":"10.1080/15284336.2018.1439714","DOIUrl":"https://doi.org/10.1080/15284336.2018.1439714","url":null,"abstract":"<p><p>Background The epidemic of acute HCV infection among HIV-infected men who have sex with men (MSM) is ongoing. Transmission of drug-resistant variants (DRVs) after HCV treatment failure could pose a major threat to the effectiveness of future therapies. We determined the baseline prevalence of pre-existing DRVs in the HCV NS3 protease gene and their effects on the addition of telaprevir (TVR) to standard pegylated interferon and ribavirin (PEG-IFN/RBV) for acute HCV infection in individuals enrolled in a multicentre randomized controlled trial (2013 and 2014). Methods The HCV NS3 viral protease was analyzed using Sanger and next-generation sequencing (NGS) for DRVs at baseline (n = 31), and at viral breakthrough following TVR-based treatment (n = 3) or PEG-IFN/RBV alone (n = 2). Results Sequence analysis indicated that all individuals were infected with HCV genotype 1a. Complete (100%) concordance was seen between Sanger and NGS for high levels of mutant viral populations. The simeprevir-associated Q80K variant was present at high frequency in the German samples (7/11-64%) and infrequently in the UK samples (1/20-5%). In the three TVR-based treatment failures, V36M/l and R155K/T emerged, but not R155G which was detectable at low levels in two individuals at baseline. Failure rate at week 24 was 26.7% (with baseline DRVs) vs. 6.3% (without baseline DRVs), p = 0.17). Comparison of sequences pre- and post-therapy in 5 who failed therapy revealed the emergence of not previously described variants V193G, E176K, P189S (on TVR), and V181S in one instance each. Conclusion The presence of baseline DRVs for the NS3 protease gene of HCV genotype 1a did not appear to predict treatment failure in our patient cohort. Where detected, Q80K was present at high levels (>98%), but had no effect on outcomes and remained high after failure.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1439714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35873700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
CD16-expressing monocytes correlate with arterial stiffness in HIV-infected ART-naïve men. 表达cd16的单核细胞与hiv感染ART-naïve男性动脉僵硬相关
HIV Clinical Trials Pub Date : 2018-04-01 DOI: 10.1080/15284336.2018.1437863
Ling Luo, Yang Han, Xiaojing Song, Ting Zhu, Yong Zeng, Taisheng Li
{"title":"CD16-expressing monocytes correlate with arterial stiffness in HIV-infected ART-naïve men.","authors":"Ling Luo,&nbsp;Yang Han,&nbsp;Xiaojing Song,&nbsp;Ting Zhu,&nbsp;Yong Zeng,&nbsp;Taisheng Li","doi":"10.1080/15284336.2018.1437863","DOIUrl":"https://doi.org/10.1080/15284336.2018.1437863","url":null,"abstract":"<p><p>Objectives To determine the association of the markers of monocyte activation and arterial stiffness among HIV-infected antiretroviral therapy (ART)-naïve men. Methods Sixty HIV-infected ART-naïve men and 20 HIV-uninfected male controls without symptoms or history of cardiovascular disease were recruited. Pulse wave velocity (PWV) were used as the marker of arterial stiffness and determined using a pulse pressure analyzer. The percentage of CD16-expressing monocytes was used as a marker of monocyte activation. Plasma neopterin concentration, one of the monocyte/macrophage activation markers and plasma tissue factor (TF), the coagulation marker in response to inflammatory stimuli, were also analyzed. Multivariate analyses were used to explore the association of the percentage of CD16-expressing monocytes with arterial stiffness in HIV-infected men. Results HIV-infected ART-naïve men demonstrated significantly higher PWV (1252.8 ± 161.6 vs.1159.2 ± 108.3 cm/s, p = 0.018). The percentage of CD16-expressing monocytes was significantly higher in HIV-infected men comparing male controls (23.4 ± 6.0% vs. 19.6 ± 4.6%, p = 0.012). Plasma concentrations of neopterin (0.91 vs. 0.64 ng/ml), p < 0.001) and TF (5.29 vs. 4.43 pg/ml, p = 0.04) were higher in HIV-infected men comparing controls. In the multivariate model for PWV among HIV-infected men, the percentage of CD16-expressing monocytes (p = 0.023) and age (p = 0.017) were significantly associated with PWV. HIV viral load, CD4 count, percentage of CD8+CD38+T cells and percentage of CD8+HLA-DR+ T cells were not associated with PWV. Discussion Higher level of monocyte activation marker is associated with higher level of arterial stiffness in ART naïve HIV-infected men. HIV viral load, CD4 count, and the markers of CD8 T cell activation were unrelated to PWV.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1437863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36107362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
New design, development, and optimization of an in-house quantitative TaqMan Real-time PCR assay for HIV-1 viral load measurement. 新设计,开发和优化内部定量TaqMan实时PCR检测HIV-1病毒载量测量。
HIV Clinical Trials Pub Date : 2018-04-01 Epub Date: 2018-02-23 DOI: 10.1080/15284336.2018.1440991
Hassan Noorbazargan, Seyed Alireza Nadji, Siamak Mirab Samiee, Mahdi Paryan, Samira Mohammadi-Yeganeh
{"title":"New design, development, and optimization of an in-house quantitative TaqMan Real-time PCR assay for HIV-1 viral load measurement.","authors":"Hassan Noorbazargan,&nbsp;Seyed Alireza Nadji,&nbsp;Siamak Mirab Samiee,&nbsp;Mahdi Paryan,&nbsp;Samira Mohammadi-Yeganeh","doi":"10.1080/15284336.2018.1440991","DOIUrl":"https://doi.org/10.1080/15284336.2018.1440991","url":null,"abstract":"<p><p>Background Viral load measurement is commonly applicable to monitor HIV infection in patients to determine the number of HIV-RNA in serum samples of individuals. The aim of the present study was to set up a highly specific, sensitive, and reproducible home-brewed Real-time PCR assay based on TaqMan chemistry to quantify HIV-1 RNA genome. Methods In this study, three sets of primer pairs and a TaqMan probe were designed for HIV subtypes conserved sequences. An internal control was included in this assay to evaluate the presence of inhibition. Standard curve and threshold cycle values were determined using in vitro transcribed RNA from int region of HIV-1. A serial dilution of RNA standards was generated by in vitro transcription, from 10 to 10<sup>9</sup> copies/ml to find the sensitivity and the limit of detection (LOD) of the assay and to evaluate its performance in a quantitative RT-PCR assay. Results The assay has a low LOD equivalent to 33.13 copies/ml of HIV-1 RNA and a linear range of detection from 10 to 10<sup>9</sup> copies/ml. The coefficient of variation (CV) for Inter and Intra-assay precision of this in-house HIV Real-time RT-PCR ranged from 0.28 to 2.49% and 0.72 to 4.47%, respectively. The analytical and clinical specificity was 100%. Conclusions The results indicate that the developed method has a suitable specificity and sensitivity and is highly reproducible and cost-benefit. Therefore, it will be useful to monitor HIV infection in plasma samples of individuals.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2018.1440991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35857403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
False-positive HIV diagnoses: lessons from Ugandan and Russian research cohorts. 艾滋病毒诊断假阳性:乌干达和俄罗斯研究队列的经验教训。
HIV Clinical Trials Pub Date : 2018-02-01 Epub Date: 2018-01-31 DOI: 10.1080/15284336.2018.1429846
Sharon M Coleman, Natalia Gnatienko, Christine A Lloyd-Travaglini, Michael R Winter, Carly Bridden, Elena Blokhina, Dmitry Lioznov, Julian Adong, Jeffrey H Samet, Teri Liegler, Judith A Hahn
{"title":"False-positive HIV diagnoses: lessons from Ugandan and Russian research cohorts.","authors":"Sharon M Coleman, Natalia Gnatienko, Christine A Lloyd-Travaglini, Michael R Winter, Carly Bridden, Elena Blokhina, Dmitry Lioznov, Julian Adong, Jeffrey H Samet, Teri Liegler, Judith A Hahn","doi":"10.1080/15284336.2018.1429846","DOIUrl":"10.1080/15284336.2018.1429846","url":null,"abstract":"<p><strong>Background: </strong>Research studies rely on accurate assessment of entry criteria in order to maintain study integrity and participant safety, however, challenges can exist with HIV studies in international settings.</p><p><strong>Objective: </strong>Examine the unexpectedly high proportion of study participants with an undetectable HIV viral load found in Ugandan and Russian research cohorts meeting antiretroviral therapy (ART)-naïve entry criteria.</p><p><strong>Methods: </strong>Russian participants with documented HIV and ART-naïve status were recruited between 2012 and 2015 from clinical and non-clinical sites in St. Petersburg. Participants in Uganda were recruited from Mbarara Regional Referral Hospital from 2011 to 2014 with documented HIV infection via rapid diagnostic testing and recorded ART-naïve in the clinic database. HIV viral load testing of baseline samples was performed; the lower limit of detection was 500 copies/mL in Russia and 40 in Uganda. Due to an unexpectedly high proportion of participants with undetectable viremia, additional tests were performed: enzyme-linked immunosorbent assay HIV testing and testing for ART.</p><p><strong>Results: </strong>In Russia, 16% (58/360) had undetectable viremia; 3% (9/360) re-tested HIV-seronegative and 4% (13/360) tested positive for ART. In Uganda 11% (55/482) had undetectable viremia; 5% (26/482) re-tested HIV-seronegative, while <1% (4/482) tested positive for ART.</p><p><strong>Conclusions: </strong>In both Russia & Uganda, undetectable viremia was much higher than would be expected for an HIV-infected ART-naïve cohort. Misclassification of study participants was due to misdiagnosis of HIV with rapid diagnostic testing and inaccurate accounting of ART use. Confirmatory HIV testing could improve accuracy of participants meeting entry criteria for HIV infection as might increased scrutiny of medication use in an ART-naïve cohort.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949866/pdf/nihms958843.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35779533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of a prospective pregnancy registry for antiretroviral based HIV prevention trials. 实施基于抗逆转录病毒的艾滋病毒预防试验的前瞻性妊娠登记。
HIV Clinical Trials Pub Date : 2018-02-01 Epub Date: 2017-12-21 DOI: 10.1080/15284336.2017.1411419
Felix G Mhlanga, Lisa Noguchi, Jennifer E Balkus, Samuel Kabwigu, Rachel Scheckter, Jeanna Piper, Heather Watts, Colin O'Rourke, Kristine Torjesen, Elizabeth R Brown, Sharon L Hillier, Richard Beigi
{"title":"Implementation of a prospective pregnancy registry for antiretroviral based HIV prevention trials.","authors":"Felix G Mhlanga,&nbsp;Lisa Noguchi,&nbsp;Jennifer E Balkus,&nbsp;Samuel Kabwigu,&nbsp;Rachel Scheckter,&nbsp;Jeanna Piper,&nbsp;Heather Watts,&nbsp;Colin O'Rourke,&nbsp;Kristine Torjesen,&nbsp;Elizabeth R Brown,&nbsp;Sharon L Hillier,&nbsp;Richard Beigi","doi":"10.1080/15284336.2017.1411419","DOIUrl":"https://doi.org/10.1080/15284336.2017.1411419","url":null,"abstract":"<p><strong>Background: </strong>Safety data on pregnancy and fetal outcomes among women in HIV prevention trials are urgently needed to inform use of effective antiretroviral agents for HIV prevention. We describe an effective, efficient, and novel method to prospectively collect perinatal safety data concurrent with on-going parent clinical trials.</p><p><strong>Methods: </strong>The Microbicide Trials Network (MTN)-016 study is a multinational prospective pregnancy exposure registry designed to capture pregnancy and neonatal outcomes. Studies currently contributing data to this registry included phase I and II safety trials with planned exposures to candidate HIV prevention agents, as well as phase IIB and III efficacy trials capturing data on pregnancy and infant outcomes following inadvertent fetal exposure during study participation.</p><p><strong>Results: </strong>To date, participants from two phase I studies and two effectiveness trials have participated in MTN-016, resulting in 420 pregnant women and 381 infants enrolled. Infant retention has been high, with 329 of 381 (86%) infants completing the 12-month follow-up visit.</p><p><strong>Conclusion: </strong>In a research setting context, it is feasible to establish and implement a prospective, multinational HIV chemoprophylaxis pregnancy registry that will generate pregnancy exposure data in a robust fashion.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2017.1411419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35680172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Pharmacokinetics and pharmacodynamics of the nucleoside sparing dual regimen containing rilpivirine plus darunavir/ritonavir in treatment-naïve HIV-1-infected individuals. 含有利匹韦林加达那韦/利托那韦的核苷保留双重方案在treatment-naïve hiv -1感染者中的药代动力学和药效学
HIV Clinical Trials Pub Date : 2018-02-01 Epub Date: 2017-11-30 DOI: 10.1080/15284336.2017.1408928
Akil Jackson, Laura Else, Christopher Higgs, Zeenat Karolia, Saye Khoo, David Back, Emma Devitt, Anton Pozniak, Marta Boffito
{"title":"Pharmacokinetics and pharmacodynamics of the nucleoside sparing dual regimen containing rilpivirine plus darunavir/ritonavir in treatment-naïve HIV-1-infected individuals.","authors":"Akil Jackson,&nbsp;Laura Else,&nbsp;Christopher Higgs,&nbsp;Zeenat Karolia,&nbsp;Saye Khoo,&nbsp;David Back,&nbsp;Emma Devitt,&nbsp;Anton Pozniak,&nbsp;Marta Boffito","doi":"10.1080/15284336.2017.1408928","DOIUrl":"https://doi.org/10.1080/15284336.2017.1408928","url":null,"abstract":"<p><strong>Background: </strong>We aimed at investigating the antiviral activity and the pharmacokinetics of the dual antiretroviral (ARV) combination of rilpivirine plus darunavir/ritonavir 25/800/100 mg once-daily in naïve HIV-1-infected individuals (NHII) with different baseline viral loads.</p><p><strong>Settings: </strong>Pharmacokinetic/pharmacodynamics study in ARV-naïve HIV-infected individuals.</p><p><strong>Methods: </strong>The primary endpoint was the number of NHII with HIV-RNA < 40 copies/mL at week 48. Secondary endpoints included rilpivirine/darunavir/ritonavir pharmacokinetics, HIV-RNA decay, and changes in ECG QT interval.</p><p><strong>Results: </strong>Thirty-six individuals were enrolled, 18 with a baseline viral load < 100,000 copies/mL (group A) and 18 with a baseline viral load > 100,000 copies/mL (group B). All but 1 (HIV-RNA = 63 copies/mL) subjects achieved viral load < 50 copies/mL by week 36, and all at week 48. Median (range) HIV-RNA reduction (Log10 copies/mL) was 1.3 (0.6-1.9) over the first week, with no differences between groups A and B. Geometric mean and 95%CI rilpivirine C<sub>max</sub>, C<sub>trough</sub>, AUC were 183 (165-239), 114 (104-109) ng/mL, 2966 (2704-3820) ng h/mL. No QTcF interval changes were recorded.</p><p><strong>Conclusions: </strong>rilpivirine/darunavir/ritonavir could be efficacious, with limited short-term toxicity in ARV-naïve patients. Although rilpivirine was co-administered with ritonavir, its exposure was within ranges measured during phase III trials.</p>","PeriodicalId":13216,"journal":{"name":"HIV Clinical Trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15284336.2017.1408928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35207315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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