Antiviral Therapy最新文献

{"title":"DAA-based treatment for HIV-HCV-coinfected patients: analysis of factors of sustained virological response in a real-life study.","authors":"Loredana Alessio,&nbsp;Lorenzo Onorato,&nbsp;Vincenzo Sangiovanni,&nbsp;Francesco Borrelli,&nbsp;Elio Manzillo,&nbsp;Vincenzo Esposito,&nbsp;Filomena Simeone,&nbsp;Salvatore Martini,&nbsp;Nicolina Capoluongo,&nbsp;Sebastiano Leone,&nbsp;Giovanni Di Filippo,&nbsp;Maurizio D'Abbraccio,&nbsp;Lucia Aprea,&nbsp;Angelo Salomone Megna,&nbsp;Eugenio Milano,&nbsp;Viviana Rizzo,&nbsp;Annalisa Saracino,&nbsp;Nicola Coppola","doi":"10.3851/IMP3353","DOIUrl":"https://doi.org/10.3851/IMP3353","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present study was to evaluate in HIV-infected patients treated with a direct-acting antiviral agent (DAA)-based regimen the variables associated with sustained virological response (SVR) and the trend in biochemical parameters and clinical events during and after DAA regimen.</p><p><strong>Methods: </strong>We performed a multicentre retrospective cohort study, enrolling all 243 HIV-HCV-coinfected adult patients treated with DAAs between January 2015 and December 2018 in one of the nine participating Infectious Disease Centers in southern Italy, eight in Campania and one in Apulia.</p><p><strong>Results: </strong>Of the 243 patients enrolled, 233 (95.9%) obtained an SVR at 12 weeks (SVR12). Of the 10 patients with non-SVR, 7 were tested for NS3, NS5A and NS5B resistance-associated substitutions (RASs) by sequencing analysis and 6 showed at least 1 major RAS in 1 HCV region (all in NS5A, 2 in NS5B and 1 in NS3). Comparing the 233 patients achieving SVR and the 10 non-achievers, no variable was independently associated with non-SVR. During and after DAA regimen, no modification in the biochemical parameters and clinical events was observed; however, the serum cholesterol and low-density lipoprotein (LDL) levels showed an increase (from 159 ±41.3 mg/dl at baseline to 174 ±44.5 mg/dl at week 12 after stopping treatment, P<0.001, and from 92 ±34.6 mg/dl to 109.4 ±73.7 mg/dl, P=0.002, respectively).</p><p><strong>Conclusions: </strong>The treatment with DAAs led to a high SVR12 rate in HIV-HCV-coinfected subjects, irrespective of epidemiological, clinical or virological characteristics. However, the DAA regimen was associated with an increase in total- and LDL-cholesterol, to be taken into account in the management of HIV infection.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 4","pages":"193-201"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37856296","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":"Statin effect on coronary calcium distribution, mass and volume scores and associations with immune activation among HIV+ persons on antiretroviral therapy.","authors":"Jerry Lipinski, Seunghee Margevicius, Mark D Schluchter, David L Wilson, Grace A McComsey, Chris T Longenecker","doi":"10.3851/IMP3389","DOIUrl":"10.3851/IMP3389","url":null,"abstract":"<p><strong>Background: </strong>Inflammation has been associated with whole heart coronary artery calcification (CAC) among people with HIV (PWH) on antiretroviral therapy (ART); however, prior studies have not evaluated the distribution of calcium or separated mass versus volume scores, which are differentially associated with clinical events in the general population. Statins may also have a greater effect on CAC mass compared with volume.</p><p><strong>Methods: </strong>147 PWH were randomized 1:1 to rosuvastatin 10 mg or placebo and followed for 96 weeks. We re-analysed coronary calcium scans from 0, 48 and 96 weeks to determine mass and volume scores and measures of CAC diffusivity. Mixed effects models and generalized estimating equations were used to examine longitudinal associations of CAC with treatment and biomarkers.</p><p><strong>Results: </strong>Median age at study entry was 46 years; 78% were male and 68% African American. Median CD4+ was 613 and half were on protease inhibitors. Randomization to statin therapy was not associated with a change in mass score, volume score, number of involved vessels or diffusivity index (all P>0.1). Soluble CD14 was associated with the presence of CAC (P=0.05) and borderline associated with number of involved vessels (P=0.07) across all three time points.</p><p><strong>Conclusions: </strong>In PWH on ART, moderate intensity rosuvastatin does not appear to have a significant effect on volume, mass or regional distribution of CAC over 96 weeks. We extend previous cross-sectional observations to show that soluble CD14 is associated with whole heart CAC over time and independently of age and systolic blood pressure.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 8","pages":"419-427"},"PeriodicalIF":1.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38910174","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":"Treatment modification after second-line failure among people living with HIV in the Asia-Pacific.","authors":"Awachana Jiamsakul,&nbsp;Iskandar Azwa,&nbsp;Fujie Zhang,&nbsp;Evy Yunihastuti,&nbsp;Rossana Ditangco,&nbsp;Nagalingeswaran Kumarasamy,&nbsp;Oon Tek Ng,&nbsp;Yu-Jiun Chan,&nbsp;Penh Sun Ly,&nbsp;Jun Yong Choi,&nbsp;Man-Po Lee,&nbsp;Sanjay Pujari,&nbsp;Sasisopin Kiertiburanakul,&nbsp;Romanee Chaiwarith,&nbsp;Tuti Parwati Merati,&nbsp;Shashikala Sangle,&nbsp;Suwimon Khusuwan,&nbsp;Benedict Lh Sim,&nbsp;Anchalee Avihingsanon,&nbsp;Cuong Duy,&nbsp;Junko Tanuma,&nbsp;Jeremy Ross,&nbsp;Matthew Law,&nbsp;Treat Asia Hiv Observational Database Of IeDEA Asia-Pacific","doi":"10.3851/IMP3388","DOIUrl":"https://doi.org/10.3851/IMP3388","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends continuation with the failing second-line regimen if third-line option is not available. We investigated treatment outcomes among people living with HIV in Asia who continued with failing second-line regimens compared with those who had treatment modifications after failure.</p><p><strong>Methods: </strong>Treatment modification was defined as a change of two antiretrovirals, a drug class change or treatment interruption (TI), all for >14 days. We assessed factors associated with CD4 changes and undetectable viral load (UVL <1,000 copies/ml) at 1 year after second-line failure using linear and logistic regression, respectively. Survival time was analysed using competing risk regression.</p><p><strong>Results: </strong>Of the 328 patients who failed second-line ART in our cohorts, 208 (63%) had a subsequent treatment modification. Compared with those who continued the failing regimen, the average CD4 cell increase was higher in patients who had a modification without TI (difference =77.5, 95% CI 35.3, 119.7) while no difference was observed among those with TI (difference =-5.3, 95% CI -67.3, 56.8). Compared with those who continued the failing regimen, the odds of achieving UVL was lower in patients with TI (OR=0.18, 95% CI 0.06, 0.60) and similar among those who had a modification without TI (OR=1.97, 95% CI 0.95, 4.10), with proportions of UVL 60%, 22% and 75%, respectively. Survival time was not affected by treatment modifications.</p><p><strong>Conclusions: </strong>CD4 cell improvements were observed in those who had treatment modification without TI compared with those on the failing regimen. When no other options are available, maintaining the same failing ART combination provided better VL control than interrupting treatment.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 7","pages":"377-387"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275121/pdf/nihms-1717472.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25599374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment HIV drug resistance and treatment failure in non-Italian HIV-1-infected patients enrolled in ARCA.","authors":"Davide Fiore Bavaro,&nbsp;Domenico Di Carlo,&nbsp;Barbara Rossetti,&nbsp;Bianca Bruzzone,&nbsp;Ilaria Vicenti,&nbsp;Emanuele Pontali,&nbsp;Alessia Zoncada,&nbsp;Francesca Lombardi,&nbsp;Simona Di Giambenedetto,&nbsp;Vanni Borghi,&nbsp;Monica Pecorari,&nbsp;Paola Milini,&nbsp;Paola Meraviglia,&nbsp;Laura Monno,&nbsp;Annalisa Saracino","doi":"10.3851/IMP3349","DOIUrl":"https://doi.org/10.3851/IMP3349","url":null,"abstract":"<p><strong>Background: </strong>An increase in pretreatment drug resistance (PDR) to first-line antiretroviral therapy (ART) in low-income countries has been recently described. Herein we analyse the prevalence of PDR and risk of virological failure (VF) over time among migrants to Italy enrolled in ARCA.</p><p><strong>Methods: </strong>HIV-1 sequences from ART-naive patients of non-Italian nationality were retrieved from ARCA database from 1998 to 2017. PDR was defined by at least one mutation from the reference 2009 WHO surveillance list.</p><p><strong>Results: </strong>Protease/reverse transcriptase sequences from 1,155 patients, mainly migrants from sub-Saharan Africa (SSA; 42%), followed by Latin America (LA; 25%) and Western countries (WE; 21%), were included. PDR was detected in 8.6% of sequences (13.1% versus 5.8% for B and non-B strains, respectively; P<0.001). 2.1% of patients carried a PDR for protease inhibitors (PIs; 2.1% versus 2.3%; P=0.893), 3.9% for nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs; 6.8% versus 2.1%; P<0.001) and 4.3% for non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs; 6.3% versus 3.1%; P=0.013). Overall, prevalence of PDR over the years remained stable, while it decreased for PIs in LA (P=0.021) and for NRTIs (P=0.020) among migrants from WE. Having more than one class of PDR (P=0.015 versus absence of PDR), higher viral load at diagnosis (P=0.008) and being migrants from SSA (P=0.001 versus WE) were predictive of VF, while a recent calendar year of diagnosis (P<0.001) was protective for VF.</p><p><strong>Conclusions: </strong>PDR appeared to be stable over the years in migrants to Italy enrolled in ARCA; however, it still remains an important cause of VF together with viral load at diagnosis.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 2","pages":"61-71"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37694991","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":"HBV flare associated with immunosuppressive treatments: it is still dangerous in the third-generation antivirals era.","authors":"Bilal Toka,&nbsp;Aydin Seref Koksal,&nbsp;Gülşen İskender,&nbsp;Erol Çakmak,&nbsp;Oğuz Üsküdar,&nbsp;Mesut Sezikli,&nbsp;Göktuğ Şirin,&nbsp;Abdullah Emre Yildirim,&nbsp;Sami Fidan,&nbsp;Şencan Acar,&nbsp;Ahmet Tarik Eminler,&nbsp;Mustafa Ihsan Uslan,&nbsp;Sadettin Hülagü","doi":"10.3851/IMP3356","DOIUrl":"https://doi.org/10.3851/IMP3356","url":null,"abstract":"<p><strong>Background: </strong>There are limited data about the mortality and morbidity of patients with HBV flare related to immunosuppressive treatments (IST) in the third-generation antivirals era. Herein, we performed a multi-centric study in patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF) and evaluated their clinical course.</p><p><strong>Methods: </strong>The study group included patients who were referred to gastroenterology or infectious disease specialists at eight different hospitals in Turkey. HBV flare was defined as at least a threefold elevation in alanine aminotransferase (ALT) levels above the upper limit of normal range. The demographic data, IST protocol, virological markers, liver tests, international normalized ratio (INR), HBV DNA, reactivation risk profile according to AGA guideline, MELD and MELD-Na scores were retrospectively evaluated. The primary aim of the study was to determine the liver-related mortality, including transplantation, at 12 weeks and factors predicting it. Secondary aims were to compare ETV and TDF with respect to mortality and time to ALT, bilirubin normalization and HBV DNA undetectability.</p><p><strong>Results: </strong>The study group included 40 patients (29 males, mean age: 57 ±12 years). Twenty-five patients (62.5%) had a high risk of reactivation. Twenty-six patients received TDF and 14 patients received ETV treatment. Eight (20%) patients developed acute liver failure and one patient (2.5%) underwent living donor liver transplantation. Seven patients died due to liver-related complications, revealing a mortality rate of 17.5%. In multivariate analysis, total bilirubin levels at the onset, ALT levels and delta-MELD score at the first week were the independent risk factors for liver related mortality (HR: 1.222, 1.003, 1.253 and 95% CI: 1.096, 1.362; 1.001, 1.004 and 1.065, 1.470, respectively). There was no significant difference between the TDF and ETV groups with respect to time to normalize ALT and bilirubin levels, HBV DNA undetectability and mortality rates (16% and 21.4%, respectively).</p><p><strong>Conclusions: </strong>HBV flare associated with IST has a high mortality in the third-generation antivirals era. High total bilirubin at the onset and high ALT and delta-MELD score at the first week predict poor prognosis.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 3","pages":"121-129"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37898254","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":"Evaluation of drugs for potential repurposing against COVID-19 using a tier-based scoring system.","authors":"Michael A Jarvis, Frederick A Hansen, Kyle Rosenke, Elaine Haddock, Christopher Rollinson, Simon Rule, Graham Sewell, Andrew Hughes, Heinz Feldmann","doi":"10.3851/IMP3368","DOIUrl":"10.3851/IMP3368","url":null,"abstract":"<p><strong>Background: </strong>As the coronavirus disease 2019 (COVID-19) pandemic grows daily, we remain with no prophylactic and only minimal therapeutic interventions to prevent or ameliorate severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Prior to SARS-CoV-2 emergence, high throughput screens utilizing clinically developed drugs identified compounds with in vitro inhibitory effect on human coronaviruses that may have potential for repurposing as treatment options for COVID-19. However, caution should be applied to repurposing of these drugs when they are taken out of context of human pharmacokinetic parameters associated with normal therapeutic use.</p><p><strong>Methods: </strong>Our aim was to provide a tier-based scoring system to interrogate this data set and match each drug with its human pharmacokinetic criteria, such as route of administration, therapeutic plasma levels and half-life, tissue distribution and safety.</p><p><strong>Results: </strong>Our analysis excluded most previously identified drugs but identified members of four drug classes (antimalarial amino-quinolones, selective estrogen receptor modulators [SERMs], low potency tricyclic antipsychotics and tricyclic antidepressants) as potential drug candidates for COVID-19. Two of them, the tricyclic antipsychotics and tricyclic antidepressants were further excluded based on a high adverse event profile.</p><p><strong>Conclusions: </strong>In summary, our findings using a new pharmacokinetic-based scoring system supports efficacy testing of only a minority of candidates against SARS-CoV-2 infection.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 4","pages":"223-231"},"PeriodicalIF":1.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38219752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of veno-arterial extracorporeal oxygenation and nasogastric tube administration on the pharmacokinetic profile of abacavir, lamivudine and dolutegravir: a case report.","authors":"Alison L Blackman,&nbsp;Emily L Heil,&nbsp;Aaron S Devanathan,&nbsp;Neha Sheth Pandit","doi":"10.3851/IMP3355","DOIUrl":"https://doi.org/10.3851/IMP3355","url":null,"abstract":"<p><strong>Background: </strong>Pharmacokinetic (PK) changes can affect antiretroviral (ARV) systemic exposure for critically ill patients living with HIV (CI-PLWH). Studies to guide ARV adjustments in this population are limited.</p><p><strong>Methods: </strong>A PK analysis was conducted in a 44-year-old CI-PLWH who presented for a heart and lung transplant on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Home ARV therapy (ART) of co-formulated abacavir/lamivudine/dolutegravir (ABC/3TC/DTG) was continued. ARV serum concentrations were obtained during and after VA ECMO. Two blood levels were drawn at 1 h, for maximum serum concentration (C_max) and a serum trough (C_t). ARVs were given as a single tablet crushed via nasogastric tube.</p><p><strong>Results: </strong>Area under the concentration-time curve (AUC_0-t) was calculated using non-compartmental analysis. C_max and AUC_0-t were higher during VA ECMO compared with post-decannulation. The C_max of ABC was >2.5-fold higher than the mean in the reference. C_max and C_t post VA ECMO were within range of referenced literature for all ARVs. C_max and AUC_0-t of DTG post VA ECMO was approximately four- to fivefold lower than referenced literature. HIV virological suppression was maintained throughout the hospitalization.</p><p><strong>Conclusions: </strong>ART adjustments would not be required for this patient. Additional studies are needed to assess effects of VA ECMO and crushed tube administration of ARVs in CI-PLWH.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 2","pages":"115-119"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351529/pdf/nihms-1728414.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37877540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of HIV-specific CD8⁺ T-cells from HIV+ donors by vesatolimod.","authors":"Renee R Ram,&nbsp;Paul Duatschek,&nbsp;Nicolas Margot,&nbsp;Michael Abram,&nbsp;Romas Geleziunas,&nbsp;Joseph Hesselgesser,&nbsp;Christian Callebaut","doi":"10.3851/IMP3359","DOIUrl":"https://doi.org/10.3851/IMP3359","url":null,"abstract":"<p><strong>Background: </strong>Vesatolimod (VES; GS-9620) is a Toll-like receptor 7 (TLR7) agonist that directly activates human plasmacytoid dendritic cells (pDCs) and B lymphocytes resulting in direct and indirect production of cytokines and immune activation. VES is being evaluated in HIV-1-infected people as part of an HIV remission strategy. Here we investigated the potential of VES to trigger indirect activation of HIV-specific CD8⁺ T-cells using immune cell cultures derived from HIV+ donors.</p><p><strong>Methods: </strong>Peripheral blood mononuclear cell (PBMC) cultures derived from HIV+ donors virologically suppressed on stable antiretroviral therapy (n=31) were isolated and treated with VES or vehicle for 24 h. Cells were stained with surface and intracellular fluorescent conjugated antibodies and HIV-specific pentamers, and analysed by flow cytometry.</p><p><strong>Results: </strong>Treatment of PBMCs with VES resulted in all 31 donors demonstrating a concentration dependent increase in CD8⁺ T-cell activation (CD69⁺) of up to 88%. Of these donors, 20 of 31 donors displayed a concentration-dependent increase in HIV-specific CD8⁺ T-cell activation due to VES with a maximum of 20.8%. Intracellular staining was performed in a subset of donors (n=14), 5 of which displayed VES-induced activation of functional HIV-specific CD8⁺ T-cells as assessed by CD107a and/or tumour necrosis factor (TNF)-α upregulation.</p><p><strong>Conclusions: </strong>This study demonstrates that VES treatment can induce the activation of functional HIV-specific CD8⁺ T-cells in donor derived PBMCs. These data support the potential use of VES to activate functional HIV-specific CD8⁺ T-cells as part of an HIV remission strategy.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 3","pages":"163-169"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37945851","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":"Correcting eGFR for the effects of ART on tubular creatinine secretion: does one size fit all?","authors":"Frank A Post,&nbsp;Lisa Hamzah","doi":"10.3851/IMP3378","DOIUrl":"https://doi.org/10.3851/IMP3378","url":null,"abstract":"<p><p>Several antiretrovirals including dolutegravir, rilpivirine and cobicistat inhibit tubular creatinine secretion, leading to benign increases in serum creatinine and reductions in estimated glomerular filtration rate (eGFR). This commentary discusses the magnitude and pattern of eGFR decline, whether this can be overcome by applying a standardized correction factor (as reported by Brunet et al. in Antiviral Therapy), the value of serial eGFR measures to detect rapid eGFR decline and the potential utility of cystatin C as an alternative biomarker of kidney function.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 5","pages":"241-243"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834192","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":"Weight gain during pregnancy in women with HIV receiving different antiretroviral regimens.","authors":"Marco Floridia,&nbsp;Giulia Masuelli,&nbsp;Beatrice Tassis,&nbsp;Laura Franceschetti,&nbsp;Valeria Maria Savasi,&nbsp;Arsenio Spinillo,&nbsp;Enrica Tamburrini,&nbsp;Giovanni Guaraldi,&nbsp;Serena Dalzero,&nbsp;Matilde Sansone,&nbsp;Antonella Chiodo,&nbsp;Anna Maria Degli Antoni,&nbsp;Carmela Pinnetti,&nbsp;Giuseppina Liuzzi,&nbsp;Marina Ravizza","doi":"10.3851/IMP3376","DOIUrl":"https://doi.org/10.3851/IMP3376","url":null,"abstract":"<p><strong>Background: </strong>No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes.</p><p><strong>Methods: </strong>Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses.</p><p><strong>Results: </strong>Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4⁺ T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65).</p><p><strong>Conclusions: </strong>No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":"25 6","pages":"315-325"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38834193","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}