scholarly journals Psychiatric Disorders after Switching to Dolutegravir: A Case Report of a 59-Year-Old Virosuppressed HIV-1 Positive Woman

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Daniele Mengato ◽  
Raffaella Binazzi ◽  
Ivan Unterholzner ◽  
Elke M. Erne ◽  
Alicia Tavella
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Beta Blockers ◽  
Integrase Inhibitor ◽  
Cardiovascular Disorders ◽  
Positive Woman ◽  
Tenofovir Alafenamide ◽  
Hiv 1

We report a case of a woman who experienced psychiatric disorders after switching her antiretroviral therapy (c-ART) to dolutegravir (DTG). She is a 59-year-old HIV-1 positive woman with a recent story of cardiovascular disorders treated with beta-blockers, clopidogrel, and rosuvastatin. She underwent a c-ART switch from darunavir/cobicistat and maraviroc to emtricitabine/tenofovir alafenamide fumarate in association with dolutegravir due to drug-drug interactions. One week later, she started to show psychiatric symptoms that required admission to the psychiatric unit. These disorders resolved within a couple of days after DTG discontinuation to allow a regular discharge. With this case-report, we would like to analyse the possible correlation between integrase inhibitor and severe psychiatric disorders in order to confirm the evidences already published in literature.

Simplification of ART in a patient living with multidrug resistant HIV-1: A case report using twice daily cobicistat and darunavir

2019 ◽  
Vol 30 (13) ◽  
pp. 1333-1336
Author(s):  
Marisa B Brizzi ◽  
Richard M Novak ◽  
Thomas D Chiampas
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Multidrug Resistant ◽  
Virologic Suppression ◽  
Pill Burden ◽  
Tenofovir Alafenamide ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Potential Option ◽  
Hiv Aids

Multidrug-resistant (MDR) HIV can be complicated to manage. Patients are often on a high pill burden regimen, taking antiretrovirals twice daily, and often have other comorbidities. This study is a case report of a patient living with MDR HIV, and considerations are taken into account when simplifying the patient from a ten-pill regimen to a unique and unconventional six-pill regimen. The patient was living with HIV/AIDS with an MDR virus on a five-tablet, twice-daily (ten total pill burden) regimen who was simplified to a unique and novel regimen of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide + darunavir 600 mg twice daily + cobicistat + maraviroc twice daily. This unique regimen, which decreased the patient’s HIV pill burden from ten to six, has maintained virologic suppression 1 year after his antiretroviral therapy transition. When consolidating therapy in patients with MDR HIV, one regimen will not fit each individual patient. Our case demonstrates unique and unconventional dosing of darunavir 600 mg along with cobicistat as twice-daily pharmacokinetic enhancing which assisted in consolidating our patient’s regimen by a 40% decrease in pill burden. This change most importantly maintained virologic suppression and provides evidence for a potential option for similar patients with MDR HIV.

scholarly journals Effects of integrase inhibitor-based antiretroviral therapy on brain outcomes according to time since acquisition of HIV-1 infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Prats ◽  
Ignacio Martínez-Zalacaín ◽  
Beatriz Mothe ◽  
Eugènia Negredo ◽  
Núria Pérez-Álvarez ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Integrase Inhibitor ◽  
Strand Transfer ◽  
Cognitive Differences ◽  
Integrase Strand Transfer Inhibitors ◽  
Initiation Of Therapy ◽  
Main Component ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv 1

AbstractIntegrase strand transfer inhibitors (INSTI) are a main component of the current antiretroviral regimens recommended for treatment of HIV infection. However, little is known about the impact of INSTI on neurocognition and neuroimaging. We developed a prospective observational trial to evaluate the effects of INSTI-based antiretroviral therapy on comprehensive brain outcomes (cognitive, functional, and imaging) according to the time since HIV-1 acquisition. We recruited men living with HIV who initiated antiretroviral therapy with INSTI < 3 months since the estimated date of HIV-1 acquisition (n = 12) and > 6 months since estimated date of HIV-1 acquisition (n = 15). We also recruited a group of matched seronegative individuals (n = 15). Assessments were performed at baseline (before initiation of therapy in HIV arms) and at weeks 4 and 48. Baseline cognitive functioning was comparable between the arms. At week 48, we did not find cognitive differences between starting therapy with INSTI earlier than 3 months or later than 6 months after acquisition of HIV-1 infection. Functional status was poorer in individuals diagnosed earlier. This effect recovered 48 weeks after initiation of therapy. Regarding brain imaging, we found that men living with HIV initiating antiretroviral therapy later experienced a greater decrease in medial orbitofrontal cortex over time, with expected negative repercussions for decision-making tasks.

Transmission of integrase strand-transfer inhibitor multidrug-resistant HIV-1: case report and response to raltegravir-containing antiretroviral therapy

2011 ◽  
Vol 16 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Benjamin Young ◽  
Signe Fransen ◽  
Kenneth S Greenberg ◽  
Amy Thomas ◽  
Sharon Martens ◽  
...  
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Multidrug Resistant ◽  
Strand Transfer ◽  
Transfer Inhibitor ◽  
Integrase Strand Transfer Inhibitor ◽  
Hiv 1

scholarly journals Absence of Integrase Inhibitor-Associated Resistance Among Antiretroviral Therapy-Naïve HIV-1-Infected Adults in Guangdong Province, China, in 2018

2020 ◽  
Vol Volume 13 ◽  
pp. 4389-4394
Author(s):  
Yun Lan ◽  
Linghua Li ◽  
Weilie Chen ◽  
Xizi Deng ◽  
Junbin Li ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Guangdong Province ◽  
Integrase Inhibitor ◽  
Hiv 1

scholarly journals Comparison of the Antiviral Activity of Bictegravir against HIV-1 and HIV-2 Isolates and Integrase Inhibitor-Resistant HIV-2 Mutants

2019 ◽  
Vol 63 (5) ◽  
Author(s):  
Robert A. Smith ◽  
Dana N. Raugi ◽  
Vincent H. Wu ◽  
Christopher G. Zavala ◽  
Jennifer Song ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Antiviral Activity ◽  
Integrase Inhibitor ◽  
Single Cycle ◽  
Hiv 1

ABSTRACTWe compared the activity of the integrase inhibitor bictegravir against HIV-1 and HIV-2 using a culture-based, single-cycle assay. Values of 50% effective concentrations ranged from 1.2 to 2.5 nM for 9 HIV-1 isolates and 1.4 to 5.6 nM for 15 HIV-2 isolates. HIV-2 integrase mutants G140S/Q148R and G140S/Q148H were 34- and 110-fold resistant to bictegravir, respectively; other resistance-associated mutations conferred ≤5-fold changes in bictegravir susceptibility. Our findings indicate that bictegravir-based antiretroviral therapy should be evaluated in HIV-2-infected individuals.

scholarly journals Acute hydrocephalus secondary to meningioma with psychiatric symptoms as initial manifestation

2018 ◽  
Vol 5 (3) ◽  
pp. 32
Author(s):  
Marta Valentim ◽  
Iván Cadena Velez ◽  
Catarina Teles Neto ◽  
Sónia Almeida ◽  
Ana Gameiro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Psychiatric Disorders ◽  
Neurological Disorders ◽  
Psychiatric Symptoms ◽  
Correct Diagnosis ◽  
Medical Emergency ◽  
Psychiatric Symptomatology ◽  
Initial Manifestation ◽  
Acute Hydrocephalus

Background: Psychiatric disorders are often difficult to evaluate and sometimes have negative connotations associated. That could be a reason to ignore the correct diagnosis of underlying neurological diseases.Case report: We present a case report of a patient with psychiatric symptomatology, where during the study in the Emergency Department an acute hydrocephalus secondary to a massive meningioma was evidenced.Conclusions: This case exemplifies how psychiatric symptoms, often devalued by the physician, may be the first manifestation of serious neurological disorders, as well as being associated with a medical emergency, as in this case was the acute hydrocephalus.

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