scholarly journals Effect of HSV-2 Suppressive Therapy on Genital Tract HIV-1 RNA Shedding among Women on HAART: A Pilot Randomized Controlled Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
A. E. Nijhawan ◽  
A. K. DeLong ◽  
S. Chapman ◽  
A. Rana ◽  
J. Kurpewski ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Genital Tract ◽  
Controlled Trial ◽  
Sexual Transmission ◽  
Suppressive Therapy ◽  
Control Group ◽  
Highly Active ◽  
One Year ◽  
Hiv 1

Background. The role of suppressive HSV therapy in women coinfected with HSV-2 and HIV-1 taking highly active antiretroviral therapy (HAART) is unclear.Methods. 60 women with HIV-1/HSV-2 coinfection on HAART with plasma HIV-1 viral load (PVL) ≤75 copies/mL were randomized to receive acyclovir (N=30) or no acyclovir (N=30). PVL, genital tract (GT) HIV-1, and GT HSV were measured every 4 weeks for one year.Results. Detection of GT HIV-1 was not significantly different in the two arms (OR 1.23,P=0.67), although this pilot study was underpowered to detect this difference. When PVL was undetectable, the odds of detecting GT HIV were 0.4 times smaller in the acyclovir arm than in the control arm, though this was not statistically significant (P=0.07). The odds of detecting GT HSV DNA in women receiving acyclovir were significantly lower than in women in the control group, OR 0.38,P<0.05.Conclusions. Chronic suppressive therapy with acyclovir in HIV-1/HSV-2-positive women on HAART significantly reduces asymptomatic GT HSV shedding, though not GT HIV shedding or PVL. PVL was strongly associated with GT HIV shedding, reinforcing the importance of HAART in decreasing HIV sexual transmission.

Proviral HIV-1 DNA in subjects followed since primary HIV-1 infection who suppress plasma viral load after one year of highly active antiretroviral therapy

AIDS ◽  
2001 ◽  
Vol 15 (6) ◽  
pp. 665-673 ◽  
Author(s):  
Nicole Ngo-Giang-Huong ◽  
Christiane Deveau ◽  
Isabelle Da Silva ◽  
Isabelle Pellegrin ◽  
Alain Venet ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Plasma Viral Load ◽  
Highly Active ◽  
One Year ◽  
Hiv 1

scholarly journals Mycobacteriosis treatment challenges in patients with HIV-infection

2020 ◽  
Vol 12 (3) ◽  
pp. 35-45
Author(s):  
M. A. Savchenko ◽  
A. M. Panteleev
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
The United States ◽  
Steady Increase ◽  
The Past ◽  
Highly Active ◽  
History Of ◽  
One Year

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

scholarly journals Exploiting the Anti-HIV-1 Activity of Acyclovir: Suppression of Primary and Drug-Resistant HIV Isolates and Potentiation of the Activity by Ribavirin

2012 ◽  
Vol 56 (5) ◽  
pp. 2604-2611 ◽  
Author(s):  
Christophe Vanpouille ◽  
Andrea Lisco ◽  
Andrea Introini ◽  
Jean-Charles Grivel ◽  
Arshi Munawwar ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Ex Vivo ◽  
Suppressive Therapy ◽  
Highly Active ◽  
Clinical Investigations ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2 ◽  
Anti Hiv ◽  
Hiv 1 ◽  
Viral Isolates

ABSTRACTMultiple clinical trials have demonstrated that herpes simplex virus 2 (HSV-2) suppressive therapy using acyclovir (ACV) or valacyclovir in HIV-1/HSV-2-infected persons increased the patient's survival and decreased the HIV-1 load. It has been shown that the incorporation of ACV-monophosphate into the nascent DNA chain instead of dGMP results in the termination of viral DNA elongation and directly inhibits laboratory strains of HIV-1. We evaluated here the anti-HIV activity of ACV against primary HIV-1 isolates of different clades and coreceptor specificity and against viral isolates resistant to currently used drugs, including zidovudine, lamivudine, nevirapine, a combination of nucleoside reverse transcriptase inhibitors (NRTIs), a fusion inhibitor, and two protease inhibitors. We found that, at clinically relevant concentrations, ACV inhibits the replication of these isolates in human tissues infectedex vivo. Moreover, addition of ribavirin, an antiviral capable of depleting the pool of intracellular dGTP, potentiated the ACV-mediated HIV-1 suppression. These data warrant further clinical investigations of the benefits of using inexpensive and safe ACV alone or in combination with other drugs against HIV-1, especially to complement or delay highly active antiretroviral therapy (HAART) initiation in low-resource settings.

scholarly journals Blood Cell Membrane Fluidity and Intracellular Ca2+Changes in Antiretroviral-Naïve and -Treated HIV-1–Infected Patients

2010 ◽  
Vol 10 ◽  
pp. 350-355
Author(s):  
Nuno C. Santos ◽  
J. Martins e Silva ◽  
Teresa Freitas ◽  
M. Doroana ◽  
N. Duarte ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Membrane Fluidity ◽  
Highly Active Antiretroviral Therapy ◽  
Calcium Concentration ◽  
Infectious Virus ◽  
Control Group ◽  
Cell Infection ◽  
Highly Active ◽  
Cell Membrane Fluidity ◽  
Hiv 1

We previously showed that lymphocytes and erythrocytes of HIV-1–infected patients, prior to antiretroviral therapy, presented significant changes in intracellular calcium concentration ([Ca2+]int) and membrane fluidity. The present study evaluates the same parameters after response to highly active antiretroviral therapy (HAART). Blood samples were collected from patients prior to and after antiretroviral therapy, and from control subjects. Membrane fluidity and [Ca2+]intwere assessed by fluorescence spectroscopy measurements, using three different probes: TMA-DPH and DPH for membrane fluidity, and fura-2 for Ca2+. When compared with the control group, both untreated and treated patients presented increased lymphocyte [Ca2+]intand decreased lymphocyte membrane fluidity, without significant differences between the two groups of patients. On the contrary, the therapy reversed the membrane fluidity variations observed in erythrocytes. The decreased erythrocyte [Ca2+]intof untreated patients was not reversed by HAART. AIDS patients present changes in lymphocyte (mostly noninfected) and erythrocyte properties, partially reversed by HAART, consistent with a process of facilitated propagation of the infection to new cells, stimulation of virion production, and maintenance of a reservoir of erythrocyte-bound infectious virus. These observations can be related with the action of the HIV Nef protein in the cell's proteins and lipid composition, as well as with the recently observed cell infection by HIV-1 via endocytosis.

HIV-Related Hodgkin Lymphoma in the Era of Highly Active Antiretroviral Therapy: Incidence and Survival in a Prospective European Multi-Cohort Study On Behalf of the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) Study Group.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 895-895
Author(s):  
Julia Bohlius ◽  
Francois Boue
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Incidence Rates ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Kaplan Meier ◽  
One Year ◽  
Cd4 Cell ◽  
Hiv 1

Abstract Abstract 895 Introduction: HIV-infected patients are at increased risk to develop Hodgkin Lymphoma (HL). We examined the incidence and risk factors for HL, and the prognosis of patients with HIV-related HL in the era of highly active antiretroviral therapy (HAART) in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). Patients and Methods: 40,168 adult HIV-1 infected patients who started HAART in one of 16 prospective cohort studies in Europe were included in the present analysis. Incidence rates per 100,000 person-years, Kaplan-Meier estimates of cumulative incidence and survival, and adjusted hazard ratios (HRs) from Weibull random-effects models, with 95% confidence intervals (CIs), were calculated. Results: During 159,133 person-years of follow-up, 78 patients were diagnosed with HL. The crude incidence rate of HL was 50.4 per 100,000 person-years for patients who developed HL before starting HAART (17 cases) and 48.7 per 100,000 person-years in patients who were already on HAART (61 cases). Age, gender, CDC clinical stage, CD4 cell counts and HIV-1 RNA viral load at baseline (start of observation) were not significantly associated with the risk of HL. At HL diagnosis median age was 38.9 years (inter quartile range (IQR) 35.3 - 45.9 years) and the median CD4 cell count was 158 cells/μL (IQR 54 – 281 cells/μL). During a median follow-up of 18 months (IQR 4.8 - 34.8 months) 12 of 78 patients with HL died (15%), six of them during the first 6 months after diagnosis. Survival was 88% (95% CI 77% - 94%) at one year and 81% (95% CI 68% - 89%) at two years. Restricting the analysis to patients aged 16-44 years, one year survival in our population (86%, 95% CI 73% - 93%) was less compared to a European population of male Hodgkin patients of similar age (97.7%) [1]. The figure shows Kaplan-Meier plots of cumulative incidence (upper panel) and survival (lower panel). Conclusions: HL incidence rates were similar in HAART treated and untreated patients. In contrast to HIV-related Non-Hodgkin's Lymphoma no clear association with baseline CD4 cell count was observed. Disclosures: No relevant conflicts of interest to declare.

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