Pharmacodynamics of efavirenz 400mg in treatment-naïve Chinese HIV-infected patients in a prospective cohort study

BackgroundThe plasma concentration of efavirenz (EFV) 600mg dose was found to exceed the upper limit of proposed therapeutic window in most Chinese HIV-infected individuals, thus dosage reduction of EFV to 400mg daily warrant consideration. This study aimed at assessing the pharmacodynamics of EFV 400mg for HIV-infected patients in China. MethodTwenty cART-naïve individuals were enrolled in this study. EFV 400mg combined with tenofovir (TDF) and lamivudine (3TC) as initial antiretroviral regimens were administered for 48 weeks. EFV concentration and T-cell subsets as well as HIV RNA load were evaluated at baseline, 4, 12, 24, 48 weeks. Moreover, the neuropsychiatric adverse effects were also assessed by Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI).ResultsEighteen males and two females whose median age was 26 (interquartile range [IQR]: 23-32) years completed 48 weeks of follow-up. The median EFV concentration was 1.88 (IQR: 1.54-2.42), 1.74 (IQR: 1.36-1.93), 1.93 (IQR: 1.66-2.22), 1.85 (IQR: 1.54-2.14) mg/L at week 4, 12, 24, 48, respectively. The viral load was 4.59 (IQR: 4.10-5.19) lg copies/mL at baseline and it decreased by 4.6 (IQR: 3.98-5.18) lg copies/mL from baseline to weeks 48. 3 of 20 (15%), 10 of 20 (50.0%), 17 of 20 (85%), 18 of 19 (95%) participants had a plasma viral load less than 50 copies/mL at weeks 4, 12, 24, 48 respectively. The median CD4 cell count was 330 (IQR: 237-410) cells/µL at baseline and it increased to 473 (IQR: 344-574) cells/µL at 48 weeks. The score of HAMD was 5 (IQR: 3-9.8), 3 (IQR: 2.25-4) at baseline and 48 weeks. And the score of PSQI was 4 (IQR: 2-5.8), 3 (IQR: 2-4) at baseline and 48 weeks. Dizziness was the most common event, occurring in 70% patients within the first two weeks of treatment. ConclusionPatients prescribed with EFV 400mg-containing agents demonstrated favorable virological and immunological responses. And the plasma EFV concentration was within the recommended therapeutic range with less adverse reactions. EFV 400mg was effective and safe in Chinese HIV-infected patients.

COMPARISON BAY LEAF (SYZYGIUM POLYANTHUM (WIGHT) WALP) EXTRACT WITH 400 MG AND 600MG DOSE ON NITRIT OXIDE CONCENTRATION IN DYSLIPIDEMIC PATIENTS

Introduction: Dyslipidemia is a risk factor for cardiovascular disease. Dyslipidemia is known to trigger damage to endothelial blood vessels so that the disruption of nitric oxide production. Nitric oxide in blood vessels acts as an antiaterosclerotic agent, vasodilator, and prevents platelet aggression. Bay leaf extract is reported to be efficacious in reducing cholesterol, triglyceride levels and can increase levels of nitric oxide. This study aims to compare the effects of bay leaf extract at a dose of 400 mg and 600 mg on nitric oxide levels in dyslipidemic patients. Method: Clinical trial research with a prospective design. The first group (n = 15) was given therapy with dose of 400mg and the second group (n = 15) was given 600mg which was chosen randomly selected randomly in double disguised. Before and after 30 days of treatment, lipid profile and nitric oxide were examined. Data were analyzed by T-dependent statistical test and Wilcoxon test using SPSS. Significant difference when p <0.05. Result: Nitric oxide levels before drug administration compared with after treatment. The results of the study found a decrease in group I (41.71 vs 46.62) mmol / L; p = 0.233) and group II ((39.89 vs 52.62) mmol / L; p = 0.006), statistically significant in group II. Increased levels of nitric oxide in group II were greater than group I (∆4.91 vs ∆12.73), and statistically significant; p = 0.001). Conclusion: The used of bay leaf extract (Syzygium polyanthum) 600 mg for 30 days increases nitric oxide levels greater than 400 mg, and is statistically significant.