Impact of efavirenz mid-dose plasma concentration on long-term weight change among virologically suppressed people living with HIV

Abstract Background Recently, an association between CYP2B6 516 G > T polymorphism and weight change was observed among African people living with HIV (PLWH) who were started on efavirenz(EFV)-based antiretroviral therapy (ART). We aimed to investigate the effect of EFV mid-dose plasma concentration on weight change among Taiwanese PLWH. Methods The medical records of adult PLWH who were taking EFV-containing ART and had been enrolled in a EFV therapeutic drug monitoring study between Oct 2009 and May 2014 were accessed. EFV mid-dose plasma concentration (C12) was determined in the previous study and those with serial weight measurements within 48 weeks around the time of EFV C12 measurement were included in the present study. The weight change in the 48 weeks and its associations with mid-dose EFV concentrations and CYP2B6 516 G > T polymorphism were examined by general estimating equations (GEE) after adjusting for age, baseline HIV viremia, baseline weight, and the companion backbone antiretroviral agents. Results One-hundred and fifteen predominantly male (94.8%) PLWH were included in this study (Table 1). The mean CD4 lymphocyte count was 542 cells/μL at the beginning of the observation and 94.8% achieved HIV viral suppression. Forty-four (38.3%) patients had non-wildtype CYP2B6 516 G > T polymorphism. On average, the included PLWH gained 0.8 kilogram at 48 weeks and the weight change did not differ among those with wildtype and non-wildtype CYP2B6 516 G > T(Figure 1). In the GEE models, CYP2B6 516 G > T polymorphism was not associated with weight change (p=0.81), instead, higher EFV C12 was found to be independently associated with less weight gain (p=0.045). Table 1. Baseline characteristics. Figure 1. The absolute weight (A) and weight change from baseline (B) among patients with wildtype and non-wildtype CYP2B6 516G>T polymorphism. Conclusion Our findings support that increased EFV exposure may have a negative effect on weight gain. Disclosures Chien-Ching Hung, MD,PHD, Abbvie (Advisor or Review Panel member, Speaker’s Bureau)Bristol-Myers Squibb (Speaker’s Bureau)Gilead Sciences (Advisor or Review Panel member, Speaker’s Bureau)Janssen (Grant/Research Support, Advisor or Review Panel member)Merck (Grant/Research Support)ViiV (Grant/Research Support, Advisor or Review Panel member, Speaker’s Bureau)

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Correction to: Inflammation and microbial translocation measured prior to combination antiretroviral therapy (cART) and long-term probability of clinical progression in people living with HIV

BMC Infectious Diseases ◽

10.1186/s12879-021-06330-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Esther Merlini ◽

Alessandro Cozzi-lepri ◽

Antonella Castagna ◽

Andrea Costantini ◽

Sergio Lo Caputo ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Microbial Translocation ◽

People Living With Hiv ◽

Combination Antiretroviral Therapy ◽

Clinical Progression ◽

Living With Hiv

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Substance use, Unlike Dolutegravir, is Associated with Mood Symptoms in People Living with HIV

AIDS and Behavior ◽

10.1007/s10461-021-03272-2 ◽

2021 ◽

Author(s):

Lisa Van de Wijer ◽

Wouter van der Heijden ◽

Mike van Verseveld ◽

Mihai Netea ◽

Quirijn de Mast ◽

...

Keyword(s):

Substance Use ◽

Term Treatment ◽

Assessment Tools ◽

Self Report ◽

People Living With Hiv ◽

Antiretroviral Drug ◽

Long Term Treatment ◽

Living With Hiv ◽

Neuropsychiatric Side Effects

AbstractContradictory data have been reported concerning neuropsychiatric side effects of the first-line antiretroviral drug dolutegravir, which may be partly due to lack of control groups or psychiatric assessment tools. Using validated self-report questionnaires, we compared mood and anxiety (DASS-42), impulsivity (BIS-11), and substance use (MATE-Q) between dolutegravir-treated and dolutegravir-naive people living with HIV (PLHIV). We analyzed 194, mostly male, PLHIV on long-term treatment of whom 82/194 (42.3%) used dolutegravir for a median (IQR) of 280 (258) days. Overall, 51/194 (26.3%) participants reported DASS-42 scores above the normal cut-off, 27/194 (13.5%) were classified as highly impulsive, and 58/194 (29.9%) regularly used recreational drugs. Regular substance use was positively associated with depression (p = 0.012) and stress scores (p = 0.045). We observed no differences between dolutegravir-treated and dolutegravir-naive PLHIV. Our data show that depressed and anxious moods and impulsivity are common in PLHIV and associate with substance use and not with dolutegravir use.

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Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

Journal of Aging and Health ◽

10.1177/0898264317724549 ◽

2017 ◽

Vol 31 (1) ◽

pp. 109-138 ◽

Cited By ~ 10

Author(s):

Mark J. Siedner

Keyword(s):

Quality Of Life ◽

Conceptual Framework ◽

Care Delivery ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

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Trans cohort metabolic reprogramming towards glutaminolysis in long-term successfully treated HIV-infection

Communications Biology ◽

10.1038/s42003-021-02985-3 ◽

2022 ◽

Vol 5 (1) ◽

Author(s):

Flora Mikaeloff ◽

Sara Svensson Akusjärvi ◽

George Mondinde Ikomey ◽

Shuba Krishnan ◽

Maike Sperk ◽

...

Keyword(s):

Hiv Infection ◽

Cell Model ◽

Antiretroviral Drugs ◽

Metabolic Reprogramming ◽

System Level ◽

People Living With Hiv ◽

Low Grade ◽

Middle Income ◽

Living With Hiv

AbstractDespite successful combination antiretroviral therapy (cART), persistent low-grade immune activation together with inflammation and toxic antiretroviral drugs can lead to long-lasting metabolic flexibility and adaptation in people living with HIV (PLWH). Our study investigated alterations in the plasma metabolic profiles by comparing PLWH on long-term cART(>5 years) and matched HIV-negative controls (HC) in two cohorts from low- and middle-income countries (LMIC), Cameroon, and India, respectively, to understand the system-level dysregulation in HIV-infection. Using untargeted and targeted LC-MS/MS-based metabolic profiling and applying advanced system biology methods, an altered amino acid metabolism, more specifically to glutaminolysis in PLWH than HC were reported. A significantly lower level of neurosteroids was observed in both cohorts and could potentiate neurological impairments in PLWH. Further, modulation of cellular glutaminolysis promoted increased cell death and latency reversal in pre-monocytic HIV-1 latent cell model U1, which may be essential for the clearance of the inducible reservoir in HIV-integrated cells.

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STUDI RETROSPEKTIF KETAHANAN HIDUP ORANG DENGAN INFEKSI HIV/AIDS (ODHA) DI RSUD DR. ACHMAD MOCHTAR BUKITTINGGI

Human Care Journal ◽

10.32883/hcj.v3i3.89 ◽

2019 ◽

Vol 3 (3) ◽

pp. 175

Author(s):

Sukarsi Rusti

Keyword(s):

Opportunistic Infection ◽

Opportunistic Infections ◽

Analysis Data ◽

P Value ◽

People Living With Hiv ◽

Chi Square ◽

The People ◽

Living With Hiv ◽

Hiv Aids

HIV/AIDS disease is a health problem in indonesia. The problem cause of the number of morbility and mortality that still hight. It is cause of long term infection, adherance consuming the drungs and opportunistic that can deastroy the imun system of People Living With HIV/AIDS (PLHIV). The purpose of this research is to identify the factors related to the people living with PLHIV in Achmad Muchtar Hospital Bukittinggi2016.This research was conducted by a retrospective cohort design approach, doing research of the death of people who living with HIV by observing the patient’s medical record from 2014-2015. The research of study were 215 patient’s who is criteria inclusion. Analysis data using test chi-square. who became the independent variable is long infection, adherance comsuming the Anti Retroviral (ARV) , and opportunistic infection and dependent variable that survive the HIV people life.The research showed that among 215 patients with the number of deaths 39 people ( 18,% ), stages 3 and 4 (>5 th) is 89 people ( 41.4% ), not adherence is 77 people ( 35.8% ), and who suffered an opportunistic infection were 61 people (28.4% ). The statistical test relationships survival of people living with HIV with long-term infection obtained p value = 0,000 and RR = 0,019 ( confidence interfal 95 % with alpha = 0.05 ), adherance comsuming the ARV obtained p value = 0,000 and RR = 0,494 ( confidence interfal 95 % with alpha = 0.05 ), infection opportunistic obtained p value = 0,000 and RR = 0,361 ( confidence interfal 95 % with αlpha = 0.05 ).From these findings, it can be concluded that the long-term infection, adherence ARV and opportunistic infections associated with survival of people living with HIV. Of the three variables obtained interrelated and value the highest association is long-term infection.

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Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART

Viruses ◽

10.3390/v11030200 ◽

2019 ◽

Vol 11 (3) ◽

pp. 200 ◽

Cited By ~ 47

Author(s):

Sonia Zicari ◽

Libera Sessa ◽

Nicola Cotugno ◽

Alessandra Ruggiero ◽

Elena Morrocchi ◽

...

Keyword(s):

Immune Activation ◽

People Living With Hiv ◽

Residual Viremia ◽

Immune Exhaustion ◽

Full Control ◽

Increased Risk ◽

Persistent Antigen ◽

Gut Mucosa ◽

Living With Hiv

Despite effective antiretroviral therapy (ART), people living with HIV (PLWH) still present persistent chronic immune activation and inflammation. This condition is the result of several factors including thymic dysfunction, persistent antigen stimulation due to low residual viremia, microbial translocation and dysbiosis, caused by the disruption of the gut mucosa, co-infections, and cumulative ART toxicity. All of these factors can create a vicious cycle that does not allow the full control of immune activation and inflammation, leading to an increased risk of developing non-AIDS co-morbidities such as metabolic syndrome and cardiovascular diseases. This review aims to provide an overview of the most recent data about HIV-associated inflammation and chronic immune exhaustion in PLWH under effective ART. Furthermore, we discuss new therapy approaches that are currently being tested to reduce the risk of developing inflammation, ART toxicity, and non-AIDS co-morbidities.

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Transitioning From Medicaid Disability Coverage to Long-Term Medicare Coverage: The Case of People Living With HIV/AIDS in California

AIDS Education and Prevention ◽

10.1521/aeap.2017.29.1.49 ◽

2017 ◽

Vol 29 (1) ◽

pp. 49-61 ◽

Cited By ~ 2

Author(s):

Warren S. Comulada ◽

Katherine A. Desmond ◽

Jennifer L. Gildner ◽

Arleen A. Leibowitz

Keyword(s):

People Living With Hiv ◽

Medicare Coverage ◽

Living With Hiv ◽

Hiv Aids

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Facing new challenges to promote long-term health for people living with HIV

Current Opinion in Infectious Diseases ◽

10.1097/qco.0000000000000338 ◽

2017 ◽

Vol 30 (1) ◽

pp. 1-3

Author(s):

David H. Dockrell

Keyword(s):

People Living With Hiv ◽

New Challenges ◽

Living With Hiv

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An observational study of the prevalence of metabolic syndrome in treatment-experienced people living with HIV in Singapore

PLoS ONE ◽

10.1371/journal.pone.0252320 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252320

Author(s):

Li Wei Ang ◽

Oon Tek Ng ◽

Irving Charles Boudville ◽

Yee Sin Leo ◽

Chen Seong Wong

Keyword(s):

Metabolic Syndrome ◽

Protease Inhibitors ◽

Drug Effects ◽

People Living With Hiv ◽

Strand Transfer ◽

Metabolic Complications ◽

Obesity And Diabetes ◽

Living With Hiv

Background While the use of combination antiretroviral therapy (cART) has conferred significant reduction in morbidity and mortality, there are growing concerns about the metabolic complications of antiretroviral regimens in HIV-infected patients. The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) among people living with HIV (PLHIV) in Singapore. Methods We conducted a retrospective study using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. Treatment-experienced PLHIV on follow-up during 2015–2017 were included. MetS was defined as having three or more of the following five abnormalities: hypertriglyceridemia, HDL hypocholesterolemia, hypertension, obesity, and diabetes. Results A total of 2,231 PLHIV were included in this study. 93.9% were men, and the median age at latest follow-up was 48 years. The median duration of HIV infection and duration of exposure to cART was 6.8 years and 5.7 years, respectively. All had been exposed to nucleoside reverse transcriptase inhibitors (NRTIs) as the first line of treatment, 93.9% to non-NRTIs, 28.6% to protease inhibitors (PIs) and 12.8% to integrase strand transfer inhibitors. The most common metabolic abnormality among PLHIV was HDL hypocholesterolemia (60.2%) followed by hypertriglyceridemia (45.5%). Of all the 2,231 individuals, 68.8% had at least one component of MetS. The overall prevalence of MetS was 23.6% (95% confidence interval 21.9%–25.4%). Of the 526 with MetS, the most common combination was HDL hypocholesterolemia, hypertriglyceridemia and hypertension (51.0%), followed by HDL hypocholesterolemia, hypertriglyceridemia, hypertension and diabetes (25.1%). Compared with PLHIV without MetS, a significantly higher proportion of those with MetS were ever on protease inhibitors (33.5% vs. 27.1%). Conclusion MetS is common in PLHIV. In view of the progressive aging of HIV-infected population and long-term use of cART, regular monitoring for metabolic abnormalities, surveillance of drug effects and behavioural interventions are needed to optimize management and prevention of metabolic disorders in PLHIV.

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