scholarly journals Clinical Improvement by Switching to an Integrase Strand Transfer Inhibitor in Hemophiliac Patients with HIV: The Japan Cohort Study of HIV Patients Infected through Blood Products

2017 ◽  
Vol 11 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Miyuki Kawado ◽  
Shuji Hashimoto ◽  
Shin-ichi Oka ◽  
Katsuyuki Fukutake ◽  
Satoshi Higasa ◽  
...  
Keyword(s):  
Cell Count ◽  
Japanese Patients ◽  
Strand Transfer ◽  
Blood Products ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Transfer Inhibitor ◽  
Cd4 Cell ◽  
Integrase Strand Transfer Inhibitor ◽  
Rna Levels

Objective: This study aimed to determine improvement in HIV RNA levels and the CD4 cell count by switching to an antiretroviral regimen with an integrase strand transfer inhibitor (INSTI) in patients with HIV. Method: This study was conducted on Japanese patients with HIV who were infected by blood products in the 1980s. Data were collected between 2007 and 2014. Data of 564 male hemophiliac patients with HIV from the Japan Cohort Study of HIV Patients Infected through Blood Products were available. Changes in antiretroviral regimen use, HIV RNA levels, and the CD4 cell count between 2007 and 2014 were examined. Results: From 2007 to 2014, the proportion of use of a regimen with an INSTI increased from 0.0% to 41.0%. For patients with HIV who used a regimen, including an INSTI, the proportion of HIV RNA levels <50 copies/mL significantly increased from 58.3% in 2007 to 90.6% in 2014. Additionally, the median CD4 cell count significantly increased from 380/μL to 438/μL. Conclusion: There is a large effect of switching to an antiretroviral regimen with an INSTI for Japanese patients with HIV who are infected by blood products. This suggests that performing this switch in clinical practice will lead to favorable effects.

Ongoing changes in HIV RNA levels during untreated HIV infection: implications for CD4 cell count depletion

AIDS ◽  
2010 ◽  
Vol 24 (10) ◽  
pp. 1561-1567 ◽  
Author(s):  
Andrew N Phillips ◽  
Fiona C Lampe ◽  
Colette J Smith ◽  
Anna-Maria Geretti ◽  
Alison Rodger ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cell Count ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cd4 Cell ◽  
Rna Levels

Effectiveness of boosted darunavir plus rilpivirine in patients with long-lasting HIV-1 infection: DARIL study

2020 ◽  
Vol 75 (7) ◽  
pp. 1955-1960 ◽  
Author(s):  
Jordi Navarro ◽  
Ana González-Cordón ◽  
José Luís Casado ◽  
Jose I Bernardino ◽  
Pere Domingo ◽  
...  
Keyword(s):  
Drug Regimen ◽  
Primary Objective ◽  
Strand Transfer ◽  
Once Daily ◽  
Cd4 Cell Count ◽  
Hiv Resistance ◽  
Transfer Inhibitor ◽  
Pretreated Patients ◽  
Cd4 Cell ◽  
Integrase Strand Transfer Inhibitor

Abstract Background The combination of boosted darunavir plus rilpivirine, once daily, could be a convenient, effective and well-tolerated two-drug regimen to achieve HIV suppression in HIV-infected patients. Methods Multicentre, retrospective cohort study in nine hospitals in Spain. All HIV-infected subjects starting boosted darunavir plus rilpivirine were included, irrespective of their viral load (VL). The primary objective was the percentage of patients with VL &lt;50 copies/mL at 48 weeks. Secondary objectives included changes in CD4+ cell count, lipid profile and renal function. Results Eighty-one of 84 patients reached Week 48. Fifty-nine (70.2%) patients had VL &lt;50 copies/mL at baseline and the rest had a median VL of 202 (IQR 98–340) copies/mL. Subjects had a median of 21 years of infection with six prior regimens. The main reasons for starting boosted darunavir plus rilpivirine were simplification (44%), kidney or bone toxicity (28.6%) and virological failure (17.9%). Historical genotypes from 47 patients showed 41 (87.2%) patients with NRTI RAMs, 21 (44.7%) with NNRTI RAMs, 12 (25.5%) with primary PI RAMs and 7 (14.9%) with integrase strand transfer inhibitor (INSTI) RAMs. One patient had low-level resistance to boosted darunavir and five patients had some resistance to rilpivirine. At 48 weeks, 71 (87.7%) patients had VL &lt;50 copies/mL. According to undetectable or detectable baseline VL, effectiveness was 91.1% or 80%, respectively. There were four virological failures with no emergence of new RAMs. Three of these patients resuppressed viraemia while maintaining the same regimen. Conclusions The combination of boosted darunavir plus rilpivirine has shown good effectiveness and tolerability in this cohort of pretreated patients with a long-lasting HIV infection, exposure to multiple antiretroviral regimens and prior HIV resistance.

scholarly journals Difference of Progression to AIDS According to CD4 Cell Count, Plasma HIV RNA Level and the Use of Antiretroviral Therapy among HIV Patients Infected through Blood Products in Japan

2006 ◽  
Vol 16 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Miyuki Kawado ◽  
Shuji Hashimoto ◽  
Takuhiro Yamaguchi ◽  
Shin-ichi Oka ◽  
Kazuyuki Yoshizaki ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Blood Products ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cd4 Cell

scholarly journals Evaluation of Renal Adverse Effects of Combination Anti-retroviral Therapy including Tenofovir in HIV-infected Patients

2013 ◽  
Vol 16 (3) ◽  
pp. 405 ◽  
Author(s):  
Hiroyuki Tanaka ◽  
Mariko Arai ◽  
Yoshinori Tomoda ◽  
Tatsuhiko Wada ◽  
Kazuo Yago ◽  
...  
Keyword(s):  
Renal Function ◽  
Cell Count ◽  
Renal Dysfunction ◽  
Transcriptase Inhibitor ◽  
Strand Transfer ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Hiv Drugs ◽  
Cd4 Cell ◽  
Rna Concentration

Purpose. In order to maintain plasma HIV-RNA concentration in HIV-infected patients, below the detection limit combination anti-retroviral therapy (cART) are used. Although the nucleoside/nucleotide reverse transcriptase inhibitor, tenofovir disoproxil fumarate (TDF) is a first-line drug commonly used, it is associated with renal dysfunction. Nevertheless, only few clinical studies have focused on TDF in combination with new anti-HIV drugs, including the protease inhibitor (PI) darunavir (DRV), or the integrase strand transfer inhibitor (INSTI) raltegravir (RAL). Here we report the influence of such cART involving TDF on renal function.　Methods. We retrospectively investigated 68 patients under cART that included TDF between November 2004 and May 2012. We used hospital records to establish each patient’s background and characteristics, CD4 cell count, plasma HIV-RNA concentration, drug combinations, renal function, and anti-retrovial therapy history. Results. In all patients who had received cART, the plasma HIV-RNA concentration had fallen to less than 40 copies/mL by week 24 after the start of the therapy, and an increase in the CD4 cell count was observed. For each drug used in combination with TDF, the plasma HIV-RNA concentration and CD4 cell count showed a similar trend. After week 12, the estimated glomerular filtration rate (eGFR) had significantly decreased in all patients. The eGFR was significantly lower in those received PI on week 24 and in those received INSTI on week 12. The eGFR was significantly reduced in PI group who received atazanavir + ritonavir (ATV/RTV) on week 60. The eGFR in the DRV/RTV group tended to decrease. The eGFR in the PI and ATV/RTV group was significantly lower than in the efavirenz (EFV) group on week 96. Conclusion. It selecting drugs to include in combination therapy of HIV-infected patients, consideration should be given to the risk of renal dysfunction. There is a need to monitor renal function when TDF is combined with ATV/RTV, DRV/RTV or RAL. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy

AIDS ◽  
1999 ◽  
Vol 13 (6) ◽  
pp. F35-F43 ◽  
Author(s):  
Steven G. Deeks ◽  
Frederick M. Hecht ◽  
Melinda Swanson ◽  
Tarek Elbeik ◽  
Richard Loftus ◽  
...  
Keyword(s):  
Protease Inhibitor ◽  
Cell Count ◽  
Salvage Therapy ◽  
Inhibitor Therapy ◽  
Protease Inhibitor Therapy ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Count Response ◽  
Cd4 Cell

Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 < 50 cells/mm3 in a resource-limited setting: efficacy and tolerability

2005 ◽  
Vol 16 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Sasisopin Kiertiburanakul ◽  
Weerawat Manosuthi ◽  
Wiphawee Kiatatchasai ◽  
Asda Vibhagool
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Adverse Drug Events ◽  
Opportunistic Infections ◽  
Transcriptase Inhibitor ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Highly Active ◽  
Cd4 Cell

In developing countries, patients often present late with advanced AIDS and a very low CD4 cell count. A retrospective cohort study was conducted in HIV-infected patients who had been initiated into highly active antiretroviral therapy (HAART) with CD4 cell count <50 cells/mm3. There were 159 patients of mean age 36.6 years and 60.4% had previous major opportunistic infections. Mean CD4 was 22 cells/mm3 and 80% had HIV RNA>100,000 copies/mL. The majority of HAART regimens is non-nucleoside reverse transcriptase inhibitor-based (81.8%). In as-treated analysis, 50, 71.2, 79.7, 79.4, and 80.1% of patients achieved undetectable HIV RNA (<50 copies/mL) at 12, 24, 36, 48, and 60 weeks, respectively. The corresponding mean CD4 counts were 95, 125, 166, 201, and 225 cells/mm3. Twenty two patients (13.8%) had adverse drug events and half of these had to discontinue HAART. Initiation of HAART in advanced AIDS with CD4 cell count <50 cells/mm3 is effective, safe, and well tolerated and should not be delayed.

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