Neuroactive Antiretroviral Drugs Do Not Influence Neurocognitive Performance in Less Advanced HIV-Infected Patients Responding to Highly Active Antiretroviral Therapy

2006 ◽  
Vol 41 (3) ◽  
pp. 332-337 ◽  
Author(s):  
Maria Letizia Giancola ◽  
Patrizia Lorenzini ◽  
Pietro Balestra ◽  
Dora Larussa ◽  
Francesco Baldini ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Antiretroviral Drugs ◽  
Neurocognitive Performance ◽  
Highly Active

scholarly journals Persistence of Genital Tract T Cell Responses in HIV-Infected Women on Highly Active Antiretroviral Therapy

2010 ◽  
Vol 84 (20) ◽  
pp. 10765-10772 ◽  
Author(s):  
Nonhlanhla N. Mkhize ◽  
Pamela P. Gumbi ◽  
Lenine J. Liebenberg ◽  
Yuan Ren ◽  
Peter Smith ◽  
...  
Keyword(s):  
T Cell ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Genital Tract ◽  
T Cell Responses ◽  
Antiretroviral Drugs ◽  
Cd4 T Cell ◽  
Cell Responses ◽  
Highly Active ◽  
Cell Counts

ABSTRACT Initiation of highly active antiretroviral therapy (HAART) for HIV-infected individuals is associated with control of viremia, improved CD4 counts, and declining systemic HIV-specific immune responses. While HAART effectively reduces plasma viremia, it remains unclear how effectively antiretroviral drugs reach mucosal surfaces, such as those of the genital tract. The aim of this study was to determine the effect of HAART on genital tract CD4 T cell reconstitution, HIV shedding, and HIV-specific T cell responses. Cervical cytobrush and blood specimens were obtained from 35 HIV-infected, HAART-naïve women and 27 women on HAART in order to investigate HIV Gag-specific T cell responses by intracellular gamma interferon (IFN-γ) staining. Interleukin 1β (IL-1β), IL-6, and IL-8 concentrations were measured by enzyme-linked immunosorbent assays (ELISA). We show that for HIV-infected women, HAART is associated with significantly improved CD4 T cell counts both in blood and at the cervix. While HAART effectively suppressed both blood and cervical viremia, HIV-specific CD8 T cell responses in blood were lost, while those at the cervix were preserved.

Highly Active Antiretroviral Therapy Does Not Affect Mitochondrial β-Oxidation of Fatty Acids: An in Vitro Study in Fibroblasts

2008 ◽  
Vol 11 (1) ◽  
pp. 35-38
Author(s):  
Yasmeen M. Butt ◽  
Samira A. Kamrudin ◽  
Dinesh Rakheja
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Culture Media ◽  
Antiretroviral Drugs ◽  
Acid Oxidation ◽  
Highly Active

Preeclampsia is a multifactorial pregnancy-specific disease. In some cases, severe preeclampsia and related disorders of acute fatty liver of pregnancy and hemolysis, elevated liver enzymes, low platelets syndrome are associated with inherited defects in mitochondrial β-oxidation of fatty acids, especially a deficiency of long-chain 3-hydroxyacyl coenzyme A dehydrogenase (LCHAD). Recently, an unexplained increase in the incidence of preeclampsia has been documented in human immunodeficiency virus (HIV)–infected pregnant women on treatment with highly active antiretroviral therapy (HAART). We performed this study to determine if antiretroviral drugs affect mitochondrial β-oxidation fatty acids in vitro. Two normal and 1 heterozygous LCHAD-deficient cell lines were exposed to up to 5 times the therapeutic concentrations of the following antiretroviral drugs: nevirapine, didanosine, lamivudine, and a combination of nelfinavir, zidovudine, and lamivudine. One homozygous LCHAD-deficient cell line served as the positive control. After exposure of the fibroblasts to these drugs for periods ranging from 2 to 10 days, accumulations of even-chain 3-hydroxy fatty acids (3-OH-C6 to 3-OH-C18) in the culture media were measured by stable-isotope dilution gas chromatography/mass spectrometry. Compared to the respective unexposed fibroblasts, there was no significant build-up of 3-hydroxy fatty acids in the culture media of normal or heterozygous LCHAD-deficient fibroblasts exposed to antiretroviral drugs. Our results show that the commonly used antiretroviral drugs do not adversely affect fatty acid oxidation in fibroblasts. Therefore, an altered fatty acid oxidation may not be the mechanism for the reported increased risk of preeclampsia in HIV-infected pregnant women on HAART.

scholarly journals Insulin Resistance and Glucose Dysregulation in Hiv Treated Patients

2018 ◽  
Vol 6 (03) ◽  
Author(s):  
Prof. Xu Yancheng ◽  
Salama A. ALI ◽  
Ass. Prof Chen Xiaoqi
Keyword(s):  
Insulin Resistance ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Current Knowledge ◽  
Antiretroviral Drugs ◽  
Fat Accumulation ◽  
Highly Active ◽  
Age Related ◽  
Glucose Dysregulation

The emergence of a new HIV infected elderly population as a result of chronic use of highly active antiretroviral therapy (HAART) has attributed to the increase of metabolic disorders particularly insulin resistance(IR) and diabetes, dyslipidemia and lipodystrophy.The pathogenesis of these metabolic derangements is complex and multifactorial and could be a consequence of an interplay between traditional age-related risk factors, HIV infection, antiretroviral therapy effects, the inflammatory effect and immune activation in this population. IR in HIV infection has numerous causes which include not only the direct effects of antiretroviral drugs but also factors such as aging and restoration to health accompanied by fat accumulation. Studies have shown that insulin levels increase over time with antiretroviral therapy, likely the result of improved health, fat accumulation, and aging, and that increases in visceral fat and upper trunk fat are associated with a higher risk of IR in HIV infected and uninfected individuals. Since metabolic and cardiovascular disease (CVD) increase with aging, knowledge of the optimal management of these conditions is essential for practitioners caring for HIV infected patients including endocrine subspecialists. This review aims to synthesize the current knowledge on insulin resistance and dysregulation of glucose on treated HIV population

scholarly journals Nephrotoxicity of HAART

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Robert Kalyesubula ◽  
Mark A. Perazella
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Kidney Disease ◽  
Highly Active Antiretroviral Therapy ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Antiretroviral Drugs ◽  
Systematic Screening ◽  
Highly Active ◽  
Preexposure Prophylaxis

Highly active antiretroviral therapy (HAART) and other medical therapies for HIV-related infections have been associated with toxicities. Antiretroviral therapy can contribute to renal dysfunction directly by inducing acute tubular necrosis, acute interstitial nephritis, crystal nephropathy, and renal tubular disorders or indirectly via drug interactions. With the increase in HAART use, clinicians must screen patients for the development of kidney disease especially if the regimen employed increases risk of kidney injury. It is also important that patients with chronic kidney disease (CKD) are not denied the best combinations, especially since most drugs can be adjusted based on the estimated GFR. Early detection of risk factors, systematic screening for chronic causes of CKD, and appropriate referrals for kidney disease management should be advocated for improved patient care. The interaction between immunosuppressive therapy and HAART in patients with kidney transplants and the recent endorsement of tenofovir/emtricitabine by the Centers for Disease Control (CDC) for preexposure prophylaxis bring a new dimension for nephrotoxicity vigilance. This paper summarizes the common antiretroviral drugs associated with nephrotoxicity with particular emphasis on tenofovir and protease inhibitors, their risk factors, and management as well as prevention strategies.

scholarly journals Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Marianne Harris ◽  
Bohdan Nosyk ◽  
Richard Harrigan ◽  
Viviane Dias Lima ◽  
Calvin Cohen ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Treatment Options ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Antiretroviral Drugs ◽  
Early Years ◽  
New Drugs ◽  
Multiple Drug ◽  
Highly Active

In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.

scholarly journals Clinical and immunological responses of zidovudine lamivudine-nevirapine versus tenofovir lamivudine-efavirenz antiretroviral treatment among HIV-1 infected adults: Gandhi Hospital, Telangana, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2177
Author(s):  
Deepak Pandharpurkar ◽  
Gudikandula Krishna ◽  
P. Mallikarjun
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Tertiary Care ◽  
Antiretroviral Drugs ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Cross Sectional ◽  
Highly Active

Background: HAART (Highly active antiretroviral therapy) is the cornerstone of management of patients with HIV infection. Antiretroviral therapy was started in the year 1986 with the first drug Zidovudine (ZDV). Later on, other antiretroviral drugs (NRTIs, NNRTIs and Pls) were introduced. Dual and mono therapies were used initially but the problem of resistance emerged. Currently, 3 or more ARV drugs are recommended globally for the treatment of people with HIV infection.Methods: A cross-sectional descriptive study conducted at a tertiary care Hospital over 200 patients, two commonly used medications are ZLN (Zidovudine+Lamivudine+Nevirapine) and TLE (Tenofovir+Lamivudine+Efavirenz ). The factors considered to affect the clinical and immunologic outcomes in both groups were assessed using baseline CD4 count, WHO clinical staging, presence of chronic diarrhea, anemia, and baseline weight, occurrence of TB, and switching of ART regimen.Results: A total of 200 patients were included in the study. ART documents of 100 patients are on Zidovudine+Lamivudine+Nevirapine) and 100 patients are on TLE (Tenofovir+Lamivudine+Efavirenz) regimen. Out of 200 patients, 97 were males and 103 were females. Maximum number of subjects were in the age of 15-45 years (82.5%) followed by 45 and above (17.5%). Mean age was 34.5±2.5 (years) with range 15 to 65 years. The baseline CD4 count of the patients, 94 were <350 and 6 were ≥350 on ZLN, in case of TLE 82 were <350 and 18 were ≥350. CD4 count after 6 months in 200 patients as follows, 60 were <350 and 40 were ≥350 in case of TLE 53 were <350 and 47 were ≥350.Conclusions: This research finding concluded that there is no critical difference between the two medications in regards to serious adverse events but did find that TDF is superior to AZT in terms of immunologic response and adherence and more frequent emergence of resistance.

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