Antiviral Therapy最新文献

{"title":"Magnolol inhibits viral replication and enhances antiviral immune responses against porcine reproductive and respiratory syndrome virus (PRRSV) in Marc-145 cells.","authors":"Shun Li, Mingzhan Zhu, Jingfei Deng, Yajuan Li, Yunfei Huang, Bikash R Giri, Quan Liu, Qiang Fu","doi":"10.1177/13596535251345953","DOIUrl":"https://doi.org/10.1177/13596535251345953","url":null,"abstract":"<p><p>BackgroundPorcine reproductive and respiratory syndrome virus (PRRSV) is a pathogen that affects swine and causes substantial economic losses in the global pig industry. Despite the availability of vaccines, it remains crucial to explore innovative therapeutic strategies to control PRRSV infections. Magnolol, a bioactive compound extracted from the root and bark of <i>Magnolia officinalis</i>, has demonstrated broad-spectrum antiviral activity in previous studies.MethodsThe cytotoxicity of magnolol was determined by the CCK-8 method. RT-qPCR, western blot, and immunofluorescence were used to study the inhibitory effect of magnolol on PRRSV N gene and protein expression through antiviral assay and viral attachment, internalization, replication and release assays. The effect of magnolol on immune-related gene expression was analysed by RT-qPCR.ResultsWe found magnolol hinders multiple facets of the PRRSV lifecycle, encompassing the stages of viral attachment and replication. Furthermore, magnolol enhances the expression of pivotal cytokines, including interleukin-6 (IL-6), interleukin-8 (IL-8), and tumour necrosis factor-α (TNF-α), during PRRSV infection, thereby reinforcing the host cells' capacity to mount an effective antiviral defence. Additionally, it exerts inhibitory effects on PRRSV replication by upregulating the expression of a disintegrin and metalloprotease 17 (ADAM17) at both the protein and mRNA levels.ConclusionsIn this study, we provide evidence demonstrating the potent efficacy of magnolol in inhibiting PRRSV replication within Marc-145 cells. Our findings underscore the potential of magnolol as a novel antiviral agent for the PRRSV control.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 3","pages":"13596535251345953"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156051","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":"Pediatric darunavir/cobicistat fixed-dose combination tablet for dispersion: Bioequivalence versus separate agents in healthy participants and acceptability in children living with human immunodeficiency virus-1.","authors":"Sandy Van Hemelryck, Erika Van Landuyt, Sofie Deleu, Lorant Leopold, Jay Ariyawansa, Martyn Palmer, Maria Labourdette","doi":"10.1177/13596535251349336","DOIUrl":"https://doi.org/10.1177/13596535251349336","url":null,"abstract":"<p><p>ObjectiveThe bioequivalence of the simplified protease-inhibitor-based HIV-1 antiretroviral regimen darunavir/cobicistat (DRV/COBI) 600/90-mg fixed-dose combination (FDC) tablet dispersed in water was evaluated in healthy adults and swallowability in children living with HIV aged >3 years and weighing ≥15 to <25 kg, respectively.MethodsIn the bioequivalence study 32 healthy adult participants received either a single oral dose of the DRV/COBI-600/90-mg FDC tablet dispersed in water (test) or the separate formulations (DRV 100-mg/mL at a dose of 600-mg and COBI 90-mg tablet: reference) separated by ≥ 7 days of washout. In a separate acceptability study children living with HIV-1, aged ≥3 years and weighing ≥15 to <25 kg, received a single oral dose of the dispersed DRV/COBI-600/90-mg FDC tablet. Acceptability questionnaires were completed by observers, participants and caregivers.ResultsThe bioequivalence study indicated that the geometric mean ratios for DRV maximum plasma concentration and area under the concentration-time curve of the dispersed DRV/COBI-600/90-mg FDC tablet versus the separate formulations fell within the 80-125% bioequivalence limits. In the acceptability study in children, per independent observers 83% (10/12) of the children were able to swallow the dispersion completely and rated the dispersed FDC tablet as \"ok\" to \"very easy\" to swallow.ConclusionThe DRV/COBI 600/90-mg FDC tablet dispersed in water was bioequivalent to coadministration of the separate formulations and was acceptable for long-term daily use in the intended pediatric population.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 3","pages":"13596535251349336"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301110","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":"Cost-effectiveness of tenofovir alafenamide fumarate for treatment of chronic hepatitis B: Evidence from a tertiary hospital in Vietnam.","authors":"Tran Dieu Thuy, Nguyen Thu Ha, Do Duy Cuong, Le Van Long, Nguyen Quynh Anh","doi":"10.1177/13596535251349054","DOIUrl":"https://doi.org/10.1177/13596535251349054","url":null,"abstract":"<p><p>BackgroundThis study aims to evaluate the cost-effectiveness of tenofovir alafenamide fumarate (TAF) versus tenofovir disoproxil fumarate (TDF) for chronic hepatitis B treatment from a payer's perspective in a limited-income context like Vietnam.MethodsA Markov model was developed to estimate the lifetime cost and effectiveness (measured in quality-adjusted life year, QALY) of TAF compared to TDF in the HbeAg+ patient population. Efficacy data came from clinical trials, and costs were based on 2023 data from an exit survey of 94 inpatients and 464 outpatients in Bach Mai hospital. Other clinical data were also sourced from CHB patients at Bach Mai hospital. Along with deterministic analysis, two-way sensitivity analysis, probabilistic sensitivity analysis, threshold, and budget impact analysis were performed.ResultsCompared to TDF, TAF yielded an additional cost of USD 3,983 and an additional QALY gained of 0.14, resulting in the incremental cost-effectiveness ratio (ICER) of USD 32,090 per QALY gained. The ICER exceeds the cost-effective threshold of three-time gross domestic product (GDP) per capita, that is, USD 11,348, by 2.8 times. According to one-way sensitivity analysis, ICERs were driven mainly by transition probabilities and TDF/ TAF prices. TAF would be cost-effective compared to TDF at the three-time GDP per capital threshold if TAF price were reduced by 33.4%.ConclusionsTAF is not cost-effective compared to TDF for treating chronic hepatitis B in HBeAg+ patients. The study offers relevant evidence for policymakers to consider including TAF in the social health insurance package, with a focus on price negotiation. Future updates are needed as new evidence on the effectiveness and costs of treating chronic hepatitis B emerges.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 3","pages":"13596535251349054"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246206","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":"The diagnostic significance of the C-reactive protein (CRP) in HIV/TB coinfection: A systematic review and meta-analysis.","authors":"Ying Gao, Wenjuan Ji, Qiuyan Chen","doi":"10.1177/13596535251345870","DOIUrl":"https://doi.org/10.1177/13596535251345870","url":null,"abstract":"<p><p>BackgroundDrug-resistant Mycobacterium tuberculosis strains have challenged efforts to combat tuberculosis (TB), a major global killer. C-reactive protein (CRP) shows promise as a biomarker for TB screening, particularly in HIV-positive cases, with demonstrated sensitivity and specificity in meta-analyses.MethodsWe performed a meta-analysis to assess the accuracy of CRP for screening HIV-associated PTB in outpatients, combining the sensitivities and specificities of diagnostic tests. PubMed, Web of Science, and SCOPUS were searched for articles that were published until April 2024. Quality assessment was done using the QUADAS-2 scale, and analysis was conducted using the random-effect model in STATA 17.ResultsEighteen studies, primarily from Africa (2013-2023), were analysed from an initial pool of 1186. These studies included 5625 HIV patients, 1248 of whom had PTB coinfection. Using a CRP threshold of 10 mg/L, 17 studies (5109 patients) showed 84% sensitivity (95% CI: 72%-91%) and 67% specificity (95% CI: 52%-79%) with I² = 84.91%. At 8 mg/L, nine studies (3631 patients) reported 77% sensitivity (95% CI: 65%-86%) and 81% specificity (95% CI: 69%-89%) with I² = 86.75%.ConclusionsOur study showed that CRP may aid in screening for PTB in PLHIV but requires clinical assessment and additional tests. Its high sensitivity can rule out PTB, but low specificity necessitates further investigation.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 3","pages":"13596535251345870"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207437","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":"Functional foods and immune system: A sustainable inhibitory approach against SARS-COV-2.","authors":"Hubza Ruatt Khan, Rabia Sultan, Mehvish Javeed, Humaira Yasmeen, Iqra Arooj, Sara Janiad","doi":"10.1177/13596535251322297","DOIUrl":"10.1177/13596535251322297","url":null,"abstract":"<p><p><b>Background:</b> COVID-19 has become the center of attention since its outbreak in December 2019. Despite the discovery of its preventive vaccine, role of healthy immune system is undebatable. Functional foods are continuously hunted as a promising option for a safe natural therapeutic treatment.<b>Purpose:</b> This review demonstrates how functional foods can boost host immune system, promote antiviral operation, and synthesize biologically effective molecules against SARS-COV-2.<b>Research Methodology:</b> For current review, online search was conducted for nature-based functional immune boosters against SARS-COV-2.<b>Conclusion:</b> Functional foods, alongside a healthy lifestyle, fortifies the human immune system and could all help to dramatically lower the cost burden of COVID-19, the suffering of the patients, and the mortality rates worldwide.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 2","pages":"13596535251322297"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727487","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":"Durability of multi-drug antiretroviral therapy (mega-ART) in treatment-experienced people with HIV in the ARCA database.","authors":"Laura Labate, Barbara Rossetti, Chiara Russo, Chiara Cassol, Martina Bottanelli, Rebecka Papaioannu Borjesson, Laura Rancan, Fiorenza Bracchitta, Lucia Graziani, Marta Tilli, Costanza Malcontenti, Sara Mora, Antonia Bezenchek, Adrian Shallvari, Maurizio Zazzi, Antonio Di Biagio","doi":"10.1177/13596535251317054","DOIUrl":"https://doi.org/10.1177/13596535251317054","url":null,"abstract":"<p><p>ObjectiveTo explore the durability of multi-drug antiretroviral regimens in treatment-experienced PWH.DesignThis retrospective observational study including PWH who started mega-ART regimens between 1 January 2009 and 31 December 2019, selected from the ARCA cohort.MethodsTime-dependent events were analysed by Kaplan-Meier methods, while Cox regression models were used to define the predictors of mega-ART discontinuation.ResultsA total of 1,514 ART-experienced PWH were included. Over a median follow-up of 47 weeks (IQR 15-127), 1,299 (83%) mega-ART were interrupted, with an incidence of 85.62 per 100 person-years of follow-up. In the multivariable analysis, predictors of higher risk of mega-ART discontinuation were a higher number of antiretroviral drugs included in baseline regimens (aHR 1.206, CI 95% 1.016-1.431, <i>p</i> = .032) and a higher baseline HIV RNA log₁₀ (aHR 1.113, CI 95% 1.048-1.181, <i>p</i> < .001); otherwise, shorter duration of previous ART was associated with a lower risk of discontinuation (aHR 0.982, CI 95% 0.965-0.999, <i>p</i> = .037). When mega-ART was stopped, 299 PWH (23%) had HIV RNA levels above 50 copies/ml, 16/299 (1%) had HIV RNA levels >50 copies/ml but less than 200 copies/ml, 792 PWH (61%) had HIV RNA levels below 50 copies/ml, and 208 PWH (16%) had an undetermined HIV RNA load.ConclusionsMega-ART was characterized by limited durability and poor virological success.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 2","pages":"13596535251317054"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967837","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 review of photodynamic therapy for the treatment of viral skin diseases.","authors":"Joanna Bartosińska, Dorota Kowalczuk, Paulina Szczepanik-Kułak, Mirosław Kwaśny, Dorota Krasowska","doi":"10.1177/13596535251331728","DOIUrl":"https://doi.org/10.1177/13596535251331728","url":null,"abstract":"<p><p><b>Introduction:</b> Photodynamic therapy (PDT) is a two-stage treatment method making use of light energy and a photosensitizer in the presence of oxygen. PDT has already proved to bring good anti-inflammatory and anti-proliferative effects in the treatment of actinic keratosis, squamous cell carcinoma in situ as well as in superficial and nodular basal cell carcinoma. In PDT-treated lesions, infected or cancerous keratinocytes are effectively destroyed due to selective apoptosis and necrosis induced by a release of reactive oxygen species. PDT is distinguished by several features, most notably its non-invasiveness, selectivity for the target tissue, which causes fewer side effects and brings excellent cosmetic results. PDT is an effective option for treating viral diseases using a photosensitizer capable of selective accumulation in virus-infected cells not only within visible lesions, but also in subclinical disease areas where the virus is in latent form. <b>Objectives and methods:</b> This literature review presents recent reports on PDT for the treatment of viral skin infections, with a particular focus on the efficacy of this method. <b>Results:</b> The viruses that most commonly cause skin diseases include the human papilloma virus (HPV), herpes simplex virus (HSV), varicella-zoster virus (VZV), molluscum contagiosum virus (MCV). PDT inhibits the proliferation of virus-infected cells, induces apoptosis, damages lesional blood vessels, regulates local immunity and controls viral loads. An additional advantage of PDT is the short healing period and little damage to the treated tissue. Furthermore, wider use of PDT may contribute to reducing the risk of developing drug resistance. <b>Conclusion:</b> The safety of PDT makes this method an effective way to treat viral skin diseases in difficult locations, as well as in children and immunocompromised patients.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 2","pages":"13596535251331728"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963162","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":"Seroprevalence, seroconversion, and mother-to-child transmission of dual and triplex infections of HIV, HBV, and HCV among Nigerian obstetric population: A national multicentre prospective cohort study.","authors":"George Uchenna Eleje, Hadiza Abdullahi Usman, Chinyere Ukamaka Onubogu, Preye Owen Fiebai, Godwin Otuodichinma Akaba, Ayyuba Rabiu, Ikechukwu Innocent Mbachu, Osita Samuel Umeononihu, Rebecca Chinyelu Chukwuanukwu, Chukwuanugo Nkemakonam Ogbuagu, Ngozi Nneka Joe-Ikechebelu, Emeka Philip Igbodike, Richard Obinwanne Egeonu, Ijeoma Chioma Oppah, Uchenna Chukwunonso Ogwaluonye, Chike Henry Nwankwo, Stephen Okoroafor Kalu, Chisom God'swill Chigbo, Moriam Taiwo Chibuzor, Shirley Nneka Chukwurah, Chinwe Elizabeth Uzochukwu, Aishat Ahmed, Samuel Oluwagbenga Inuyomi, Bukola Abimbola Adesoji, Ubong Inyang Anyang, Ekene Agatha Emeka, Odion Emmanuel Igue, Ogbonna Dennis Okoro, Prince Ogbonnia Aja, Chiamaka Perpetua Chidozie, Hadiza Sani Ibrahim, Fatima Ele Aliyu, Harrison Chiro Ugwuoroko, Aisha Ismaila Numan, Solace Amechi Omoruyi, Chukwuemeka Chukwubuikem Okoro, Ifeanyi Kingsley Nwaeju, Arinze Anthony Onwuegbuna, Lydia Ijeoma Eleje, David Chibuike Ikwuka, Eric Okechukwu Umeh, Sussan Ifeyinwa Nweje, Ifeoma Clara Ajuba, Angela Ogechukwu Ugwu, Uzoamaka Rufina Ebubedike, Divinefavour Echezona Malachy, Chiamaka Henrietta Jibuaku, Chigozie Geoffrey Okafor, Nnaedozie Paul Obiegbu, Obinna Kenneth Nnabuchi, Chukwuemeka Okwudili Ezeama, Kingsley Chidiebere Nwaogu, Rashida Khalid Yakubu, Ifunanya Anita Ezeamama, Amaka Elizabeth Agbata, Maryrose Onyinyechukwu Ikem, Kingsley Chukwuebuka Agu, Ekenedilichukwu Anselem Odiegwu, Chinedu Charles Nwankwo, Emmanuel Onyebuchi Ugwu, Ibrahim Adamu Yakasai, Olabisi Morebise Loto, Oliver Chukwujekwu Ezechi, Joseph Ifeanyichukwu Ikechebelu","doi":"10.1177/13596535251333259","DOIUrl":"https://doi.org/10.1177/13596535251333259","url":null,"abstract":"<p><p>ObjectivesTo determine seroprevalence, seroconversion, and mother-to-child transmission (MTCT) rates for dual and triplex infections of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among pregnant women.MethodsA multicentre prospective cohort study was conducted in six randomly selected tertiary hospitals from six geopolitical zones of Nigeria. Consenting participants were tested at recruitment for triplex infections and followed-up till delivery. Retests were performed at delivery for those who tested negative for all three infections/positive for only one. Polymerase chain reaction was used for validation while rapid test kits were employed for initial screening.ResultsOf the 2775 participants recruited, 13 (0.47%; 95% CI: 0.25%-0.80%) and 4 (0.14%; 95% CI: 0.04%-0.37%) were seropositive for dual and triplex infections, respectively. Dual infections revealed seroprevalences of 0.22% for HIV-HBV (6/2775; 95% CI: 0.08%-0.47%), 0.14% for HIV-HCV (4/2775; 95% CI: 0.04%-0.37%), and 0.11% for HBV-HCV (3/2775; 95% CI: 0.02%-0.32%). Multivariable analysis highlighted significant associations between HIV/HBV co-infection and religion (adjusted odds ratio (aOR): 0.068, 95% CI: 0.006-0.757) and house ownership (aOR): 1.65 × 10^-9, 95% CI: 1.60 × 10^-9-1.70 × 10^-9). Continuing our follow-up until delivery for 2403 initial participants, 2386 did not have dual or triplex infections at the start. Upon retesting at delivery, three of these women were seropositive for a dual infection of HIV and HBV, giving a seroconversion rate of 0.12% (95% CI: 0.03% to 0.37%). MTCT rate stood at 0% at 6-week post-delivery.ConclusionWe observed a relatively low seroprevalence and seroconversion rates for dual and triplex infections of HIV, HBV, and HCV among pregnant women in Nigeria and no MTCT.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 2","pages":"13596535251333259"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957856","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":"Sustained viral suppression with once daily dolutegravir-containing regimen in presence of the strong inducer carbamazepine.","authors":"Micol Pallanza, Paul Thoueille, Myriam Briki, Susana Alves Saldanha, Matthias Cavassini, Catia Marzolini","doi":"10.1177/13596535251335080","DOIUrl":"https://doi.org/10.1177/13596535251335080","url":null,"abstract":"<p><p>Dolutegravir 50 mg twice daily (BID) dosing is currently recommended in presence of strong inducers of drug metabolism. However, this dosing has been challenged by studies showing similar rates of viral suppression with dolutegravir once daily (QD) compared to BID dosing in presence of the strong inducer rifampicin. We report the case of a 41-year-old man with sustained virological suppression and documented therapeutic dolutegravir concentration on once daily dosing while treated with the strong inducer carbamazepine. Therapeutic drug monitoring can guide the need for twice daily dosing dolutegravir in presence of strong inducers.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 2","pages":"13596535251335080"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952659","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":"Increased insulin resistance following switch from efavirenz to cobicistat-boosted elvitegravir.","authors":"Richard Taylor Pickering, Archana Asundi, Alex Olson, Katie Soden, Daniel R Kuritzkes, Nina H Lin","doi":"10.1177/13596535251314571","DOIUrl":"10.1177/13596535251314571","url":null,"abstract":"<p><strong>Background: </strong>Integrase strand transfer inhibitors (INSTIs) have been associated with excess weight gain in people living with HIV compared to other antiretroviral agents. The mechanisms that underlie these effects are not well defined. Thus, we aimed to examine the effects of switching to INSTI-containing regimens on clinical metabolic parameters.</p><p><strong>Setting: </strong>A secondary analysis of a prospective cohort study in which people living with HIV on a stable efavirenz-based regimen were switched to a cobicistat-boosted elvitegravir or raltegravir-containing regimen. Participants remained on the NRTI backbone of tenofovir disoproxil fumarate and emtricitabine.</p><p><strong>Methods: </strong>Frozen plasma samples from 19 participants were used to determine concentrations of leptin, adiponectin, insulin and lactate at baseline and 8 weeks post-switch. Fasting lipids and blood glucose not reported in the initial study were obtained to examine metabolic changes. Anthropometric data including height and weight were abstracted from the medical record.</p><p><strong>Results: </strong>Participants switched from efavirenz to cobicistat-boosted elvitegravir without change in tenofovir disoproxil fumarate/emtricitabine backbone showed a 20% increase in HOMA-IR after 8 weeks (1.84 vs 2.24, <i>p</i> < .05), due mostly to increases in fasting insulin. This increase occurred independent of weight gain in the cohort as whole (83.4 vs 85.9 kg, pre vs post, <i>p</i> = .04), but was linked to increases in circulating lactate.</p><p><strong>Conclusions: </strong>Participants switched to an INSTI-based regimen tended to gain weight, and those switched to cobicistat-boosted elvitegravir had increases in markers of insulin resistance and elevation in plasma lactic acid compared to raltegravir, suggesting that elvitegravir may promote metabolic perturbations in people living with HIV.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"30 1","pages":"13596535251314571"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424718","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}