排序方式: 共有93条查询结果,搜索用时 15 毫秒
1.
2.
Nittaya Phanuphak Nipat Teeratakulpisarn Frits van Griensven Nitiya Chomchey Suteeraporn Pinyakorn James LK Fletcher Rapee Trichavaroj Supanit Pattanachaiwit Nelson Michael Praphan Phanuphak Jerome H Kim Jintanat Ananworanich 《Journal of the International AIDS Society》2015,18(1)
Introduction
HIV transmission risk is highest during acute HIV infection (AHI). We evaluated HIV RNA in the anogenital compartment in men who have sex with men (MSM) during AHI and compared time to undetectable HIV RNA after three-drug versus five-drug antiretroviral therapy (ART) to understand risk for onward HIV transmission.Methods
MSM with AHI (n=54) had blood, seminal plasma and anal lavage collected for HIV RNA at baseline, days 3 and 7, and weeks 2, 4, 12 and 24. Data were compared between AHI stages: 1 (fourth-generation antigen-antibody combo immunoassay [IA]–, third-generation IA–, n=15), 2 (fourth-generation IA+, third-generation IA–, n=9) and 3 (fourth-generation IA+, third-generation IA+, western blot–/indeterminate, n=30) by randomization to five-drug (tenofovir+emtricitabine+efavirenz+raltegravir+maraviroc, n=18) versus three-drug (tenofovir+emtricitabine+efavirenz, n=18) regimens.Results
Mean age was 29 years and mean duration since HIV exposure was 15.4 days. Mean baseline HIV RNA was 5.5 in blood, 3.9 in seminal plasma and 2.6 log10 copies/ml in anal lavage (p<0.001). Blood and seminal plasma HIV RNA were higher in AHI Stage 3 compared to Stage 1 (p<0.01). Median time from ART initiation to HIV RNA <50 copies/ml was 60 days in blood, 15 days in seminal plasma and three days in anal lavage. Compared with the three-drug ART, the five-drug ART had a shorter time to HIV RNA <1500 copies/ml in blood (15 vs. 29 days, p=0.005) and <50 copies/ml in seminal plasma (13 vs. 24 days, p=0.048).Conclusions
Among MSM with AHI, HIV RNA was highest in blood, followed by seminal plasma and anal lavage. ART rapidly reduced HIV RNA in all compartments, with regimen intensified by raltegravir and maraviroc showing faster HIV RNA reductions in blood and seminal plasma. 相似文献3.
Denise?C?HsuEmail author Irini?Sereti Jintanat?Ananworanich 《AIDS research and therapy》2013,10(1):29
Despite the major advances in the management of HIV infection, HIV-infected patients still have greater morbidity and mortality than the general population. Serious non-AIDS events (SNAEs), including non-AIDS malignancies, cardiovascular events, renal and hepatic disease, bone disorders and neurocognitive impairment, have become the major causes of morbidity and mortality in the antiretroviral therapy (ART) era. SNAEs occur at the rate of 1 to 2 per 100 person-years of follow-up. The pathogenesis of SNAEs is multifactorial and includes the direct effect of HIV and associated immunodeficiency, underlying co-infections and co-morbidities, immune activation with associated inflammation and coagulopathy as well as ART toxicities. A number of novel strategies such as ART intensification, treatment of co-infection, the use of anti-inflammatory drugs and agents that reduce microbial translocation are currently being examined for their potential effects in reducing immune activation and SNAEs. However, currently, initiation of ART before advanced immunodeficiency, smoking cessation, optimisation of cardiovascular risk factors and treatment of HCV infection are most strongly linked with reduced risk of SNAEs or mortality. Clinicians should therefore focus their attention on addressing these issues prior to the availability of further data. 相似文献
4.
5.
Although access to antiretroviral therapy (ART) for the treatment of HIV has increased during the last decade, many patients
are still in need of treatment. With limited funds to provide ART to millions of patients worldwide, there is a need for alternative
ways to scale up ART in resource limited settings. This review provides an overview of pharmacokinetic, safety and efficacy
studies of generic and reduced dose ART. The production of generic ART has greatly influenced the decline in drug prices and
the increased in ART access. Generic ART has good pharmacokinetic profile, safety and efficacy. Toxicity is however the main
cause for ART discontinuation. Several dose reduction studies have shown adequate pharmacokinetic parameters and short term
efficacy with reduced dose ART. Ethnicity may affect drug metabolism; several pharmacokinetic studies have confirmed higher
plasma ART concentration in Asians. Randomized efficacy trial of reduced versus standard ART is warranted. 相似文献
6.
7.
Ananworanich J 《The Pediatric infectious disease journal》2004,23(4):375; author reply 375-375; author reply 376
8.
9.
Ananworanich J Pumpradit W Apateerapong W Siangphoe U Saenawat S Phanuphak P Hirschel B 《AIDS care》2008,20(3):327-330
Nineteen patients who completed a 27-month CD4-guided structured treatment interruption (STI) trial that showed similar efficacy in STI and continuous arms were asked to choose CD4-guided versus continuous HAART after the study ended. Six chose STI and 13 chose continuous HAART. Reasons for not choosing STIs were fear of developing HIV-related illnesses (38%), fear of CD4 drop (30.8%), fear of viral load increase (7.7%) and ease (7.7%). Those who preferred CD4-guided HAART had a higher median CD4 count nadir during STI and fewer on-off cycles. This study provides an important insight into the preference of patients towards STI in a resource-limited setting. 相似文献
10.