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[PMID]:25042290
[Au] Autor:Thirumurthy H; Masters SH; Rao S; Bronson MA; Lanham M; Omanga E; Evens E; Agot K
[Ad] Dirección:Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill2Carolina Population Center, University of North Carolina at Chapel Hill....
[Ti] Título:Effect of providing conditional economic compensation on uptake of voluntary medical male circumcision in Kenya: a randomized clinical trial.
[So] Fuente:JAMA;312(7):703-11, 2014 Aug 20.
[Is] ISSN:1538-3598
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:IMPORTANCE: Novel strategies are needed to increase the uptake of voluntary medical male circumcision (VMMC) in sub-Saharan Africa and enhance the effectiveness of male circumcision as an HIV prevention strategy. OBJECTIVE: To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group. INTERVENTIONS: Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (≈ US $2.50), 700 Kenya shillings (≈ US $8.75), or 1200 Kenya shillings (≈ US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation. MAIN OUTCOMES AND MEASURES: VMMC uptake within 2 months. RESULTS: Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%-9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%-12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%-3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%-3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7-10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6-15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (P = .20). CONCLUSIONS AND RELEVANCE: Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01857700.
[Mh] Términos MeSH primario: Circuncisión Masculina/economía
Financiación Personal
Infecciones por VIH/prevención & control
Motivación
[Mh] Términos MeSH secundario: Adulto
Circuncisión Masculina/utilización
Toma de Decisiones
Alimentos/economía
Humanos
Kenia/epidemiología
Masculino
Mediana Edad
[Pt] Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140820
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2014.9087


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[PMID]:25014130
[Au] Autor:Kendall C; Kerr LR; Mota RM; Cavalcante S; Macena RH; Chen S; Gaffga N; Monterosso E; Bastos FI; Serrano D
[Ad] Dirección:*Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; †Department of Community Health, Federal University of Ceará, Fortaleza, Brazil; ‡Department of Epidemiological Surveillance, Ministry of Health, Fortaleza, Fortaleza, Brazil; §Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ‖Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; ¶Director, National Institute of the Fight against AIDS, Luanda, Angola.
[Ti] Título:Population size, HIV, and behavior among MSM in Luanda, Angola: challenges and findings in the first ever HIV and syphilis biological and behavioral survey.
[So] Fuente:J Acquir Immune Defic Syndr;66(5):544-51, 2014 Aug 15.
[Is] ISSN:1944-7884
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:OBJECTIVES: To conduct the first population size estimation and biological and behavioral surveillance survey among men who have sex with men (MSM) in Angola. DESIGN: Population size estimation with multiplier method and a cross-sectional study using respondent-driven sampling. SETTING: Luanda Province, Angola. Study was conducted in a large hospital. PARTICIPANTS: Seven hundred ninety-two self-identified MSM accepted a unique object for population size estimation. Three hundred fifty-one MSM were recruited with respondent-driven sampling for biological and behavioral surveillance survey. METHODS: Interviews and testing for HIV and syphilis were conducted on-site. Analysis used Respondent-Driven Sampling Analysis Tool and STATA 11.0. Univariate, bivariate, and multivariate analyses examined factors associated with HIV and unprotected sex. Six imputation strategies were used for missing data for those refusing to test for HIV. MAIN OUTCOME: A population size of 6236 MSM was estimated. Twenty-seven of 351 individuals were tested positive. Adjusted HIV prevalence was 3.7% (8.7% crude). With imputation, HIV seroprevalence was estimated between 3.8% [95% confidence interval (CI): 1.6 to 6.5] and 10.5% (95% CI: 5.6 to 15.3). Being older than 25 (odds ratio = 10.8, 95% CI: 3.5 to 32.8) and having suffered episodes of homophobia (odds ratio = 12.7, 95% CI: 3.2 to 49.6) significantly increased the chance of HIV seropositivity. CONCLUSIONS: Risk behaviors are widely reported, but HIV seroprevalence is lower than expected. The difference between crude and adjusted values was mostly due to treatment of missing values in Respondent-Driven Sampling Analysis Tool. Solutions are proposed in this article. Although concerns were raised about feasibility and adverse outcomes for MSM, the study was successfully and rapidly completed with no adverse effects.
[Mh] Términos MeSH primario: Infecciones por VIH/epidemiología
Homosexualidad Masculina
Sífilis/epidemiología
[Mh] Términos MeSH secundario: Ciudades/epidemiología
Humanos
Masculino
Densidad de Población
Sexo Seguro
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:IM; X
[Da] Fecha de ingreso para procesamiento:140712
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000213


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[PMID]:24585899
[Au] Autor:Byakwaga H; Boum Y; Huang Y; Muzoora C; Kembabazi A; Weiser SD; Bennett J; Cao H; Haberer JE; Deeks SG; Bangsberg DR; McCune JM; Martin JN; Hunt PW
[Ad] Dirección:Department of Epidemiology and Biostatistics, University of California, San Francisco Faculty of Medicine, Mbarara University of Science and Technology....
[Ti] Título:The kynurenine pathway of tryptophan catabolism, CD4+ T-cell recovery, and mortality among HIV-infected Ugandans initiating antiretroviral therapy.
[So] Fuente:J Infect Dis;210(3):383-91, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Human immunodeficiency virus (HIV) infection-induced indoleamine 2,3-dioxygenase-1 (IDO) expression in activated monocytes and dendritic cells catabolizes tryptophan to kynurenine and other downstream catabolites that inhibit T-cell proliferation and interleukin 17 (IL-17) production. The prognostic significance of this pathway in treated HIV disease is unknown. METHODS: We measured systemic IDO activity (calculated as the ratio of plasma levels of kynurenine to tryptophan; hereafter, the "KT ratio") in HIV-infected Ugandans before and during antiretroviral therapy (ART)-mediated viral suppression and its association with the rate of subsequent CD4(+) T-cell count recovery and mortality. RESULTS: Among 435 participants, a higher pre-ART KT ratio was associated with a higher plasma virus load (P < .001) and lipopolysaccharide level (P = .018), a lower CD4(+) T-cell count (P < .001), and female sex (P = .047). Through month 12 of ART-mediated viral suppression, the plasma KT ratio decreased by approximately 50% (P < .001). After adjustment for pre-ART CD4(+) T-cell count, virus load, age, and sex, a higher month 12 KT ratio predicted a slower rate of subsequent CD4(+) T-cell count recovery (P = .001). Thirty-nine participants died. After adjustment for pre-ART CD4(+) T-cell count, virus load, body mass index, sex, and age, a higher pre-ART and month 6 KT ratio predicted increased mortality (P ≤ .016). CONCLUSIONS: The kynurenine pathway of tryptophan catabolism independently predicts poor CD4(+) T-cell count recovery and increased mortality among HIV-infected Ugandans initiating ART and may be an important target for interventions.
[Mh] Términos MeSH primario: Fármacos Anti-VIH/uso terapéutico
Linfocitos T CD4-Positivos/fisiología
Infecciones por VIH/quimioterapia
Infecciones por VIH/inmunología
Quinurenina/metabolismo
Triptófano/metabolismo
[Mh] Términos MeSH secundario: Adulto
Recuento de Linfocito CD4
Femenino
Infecciones por VIH/epidemiología
Infecciones por VIH/mortalidad
Humanos
Masculino
Uganda/epidemiología
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 343-65-7 (Kynurenine); 8DUH1N11BX (Tryptophan)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu115


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[PMID]:24585896
[Au] Autor:Jose S; Hamzah L; Campbell LJ; Hill T; Fisher M; Leen C; Gilson R; Walsh J; Nelson M; Hay P; Johnson M; Chadwick D; Nitsch D; Jones R; Sabin CA; Post FA; UK Collaborative HIV Cohort Study Steering Committee
[Ad] Dirección:Research Department of Infection and Population Health, University College London....
[Ti] Título:Incomplete reversibility of estimated glomerular filtration rate decline following tenofovir disoproxil fumarate exposure.
[So] Fuente:J Infect Dis;210(3):363-73, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Tenofovir disoproxil fumarate (TDF) has been linked to renal impairment, but the extent to which this impairment is reversible is unclear. We aimed to investigate the reversibility of renal decline during TDF therapy. METHODS: Cox proportional hazards models assessed factors associated with discontinuing TDF in those with an exposure duration of >6 months. In those who discontinued TDF therapy, linear piecewise regression models estimated glomerular filtration rate (eGFR) slopes before initiation of, during, and after discontinuation of TDF therapy. Factors associated with not achieving eGFR recovery 6 months after discontinuing TDF were assessed using multivariable logistic regression. RESULTS: We observed declines in the eGFR during TDF exposure (mean slopes, -15.7 mL/minute/1.73 m(2)/year [95% confidence interval {CI}, -20.5 to -10.9] during the first 3 months and -3.1 mL/minute/1.73 m(2)/year [95% CI, -4.6 to -1.7] thereafter) and evidence of eGFR increases following discontinuation of TDF therapy (mean slopes, 12.5 mL/minute/1.73 m(2)/year [95% CI, 8.9-16.1] during the first 3 months and 0.8 mL/minute/1.73 m(2)/year [95% CI, .1-1.5] thereafter). Following TDF discontinuation, 38.6% of patients with a decline in the eGFR did not experience recovery. A higher eGFR at baseline, a lower eGFR after discontinuation of TDF therapy, and more-prolonged exposure to TDF were associated with an increased risk of incomplete recovery 6 months after discontinuation of TDF therapy. CONCLUSIONS: This study shows that a decline in the eGFR during TDF therapy was not fully reversible in one third of patients and suggests that prolonged TDF exposure at a low eGFR should be avoided.
[Mh] Términos MeSH primario: Adenina/análogos & derivados
Fármacos Anti-VIH/efectos adversos
Tasa de Filtración Glomerular/efectos de drogas
Infecciones por VIH/quimioterapia
Enfermedades Renales/inducido químicamente
Organofosfonatos/efectos adversos
[Mh] Términos MeSH secundario: Adenina/efectos adversos
Adenina/uso terapéutico
Adulto
Fármacos Anti-VIH/uso terapéutico
Estudios de Cohortes
Esquema de Medicación
Femenino
Humanos
Masculino
Mediana Edad
Organofosfonatos/uso terapéutico
Modelos de Riesgos Proporcionales
Carga Viral
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 0 (Organophosphonates); 0 (tenofovir disoproxil); JAC85A2161 (Adenine)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu107


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[PMID]:24585895
[Au] Autor:Gani RA; Yunihastuti E; Krisnuhoni E; Saraswati H; Djauzi S; Lesmana LA; Lee S; Price P
[Ad] Dirección:Department of Internal Medicine, Medical Faculty, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia....
[Ti] Título:Periportal CD4+ cell infiltration increases in HIV/hepatitis C virus-coinfected patients commencing ART, whereas CD8+ cells clear from the liver.
[So] Fuente:J Infect Dis;210(3):405-9, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is common in Asia, but the effects of antiretroviral therapy (ART) are unclear. Histopathological changes in the liver are described in a prospective study of HCV-seropositive HIV-infected patients at Cipto Mangunkusomo Hospital (Jakarta, Indonesia). Liver biopsy specimens were collected at baseline (n = 48) and 48 weeks (n = 34). Ishak scores showed mild but detectable inflammation and/or fibrosis. Levels of portal inflammation declined during ART (P = .03), whereas fibrosis remained (P = .11). Portal infiltration of CD4(+) cells increased during ART (P < .0001), whereas infiltration of CD8(+) cells subsided. Numbers of CD4(+) cells in the liver at baseline correlated with circulating CD4(+) T-cell counts (P = .03-.05). Numbers of liver-infiltrating CD4(+) and CD8(+) cells at baseline were not associates with subsequent experience of an immune restoration disease, which is defined by a rise in alanine transaminase levels during ART.
[Mh] Términos MeSH primario: Fármacos Anti-VIH/uso terapéutico
Linfocitos T CD4-Positivos/fisiología
Linfocitos T CD8-positivos/fisiología
Infecciones por VIH/complicaciones
Infecciones por VIH/quimioterapia
Hepatitis C/complicaciones
Hígado/citología
[Mh] Términos MeSH secundario: Adulto
Humanos
Masculino
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Anti-HIV Agents)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu118


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[PMID]:24585893
[Au] Autor:Lee SA; Sinclair E; Jain V; Huang Y; Epling L; Van Natta M; Meinert CL; Martin JN; McCune JM; Deeks SG; Lederman MM; Hecht FM; Hunt PW
[Ad] Dirección:University of California San Francisco, San Francisco, California....
[Ti] Título:Low proportions of CD28- CD8+ T cells expressing CD57 can be reversed by early ART initiation and predict mortality in treated HIV infection.
[So] Fuente:J Infect Dis;210(3):374-82, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Unlike cytomegalovirus (CMV) infection and aging, human immunodeficiency virus (HIV) decreases the proportion of CD28(-)CD8(+) T cells expressing CD57. Whether this abnormality predicts mortality in treated HIV infection and can be reversed by early antiretroviral therapy (ART) remains unknown. METHODS: We sampled recently HIV-infected individuals (<6 months) and HIV-uninfected controls and compared longitudinal changes in the proportion of CD28(-)CD8(+) T cells expressing CD57 between those who initiated ART early (<6 months) vs later (≥2 years). We also assessed the relationship between this phenotype and mortality in a nested case-control study of ART-suppressed chronically infected individuals. RESULTS: Compared to HIV-uninfected controls (n = 15), individuals who were recently infected with HIV had lower proportions of CD28(-)CD8(+) T cells expressing CD57 (P < .001), and these proportions increased during ART. The early ART group (n = 33) achieved normal levels, whereas the later ART group (n = 30) continued to have lower levels than HIV-uninfected controls (P = .02). Among 141 ART-suppressed participants in the SOCA study, those in the lowest quartile of CD28(-)CD8(+) T cells expressing CD57 had 5-fold higher odds of mortality than those in the highest quartile (95% CI, 1.6-15.9, P = .007). CONCLUSIONS: Abnormally low proportions of CD28(-)CD8(+) T cells expressing CD57 predict increased mortality during treated HIV infection and may be reversed with early ART initiation.
[Mh] Términos MeSH primario: Fármacos Anti-VIH/farmacología
Antígenos CD28/metabolismo
Antígenos CD57/metabolismo
Linfocitos T CD8-positivos/metabolismo
Infecciones por VIH/quimioterapia
[Mh] Términos MeSH secundario: Adulto
Antígenos CD28/genética
Antígenos CD57/genética
Femenino
Infecciones por VIH/sangre
Infecciones por VIH/inmunología
Infecciones por VIH/mortalidad
Humanos
Recuento de Linfocitos
Masculino
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 0 (Antigens, CD28); 0 (Antigens, CD57)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu109


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[PMID]:24550442
[Au] Autor:Petrara MR; Penazzato M; Massavon W; Nabachwa S; Nannyonga M; Mazza A; Gianesin K; Del Bianco P; Lundin R; Sumpter C; Zanchetta M; Giaquinto C; De Rossi A
[Ad] Dirección:Unit of Viral Oncology, Section of Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology AIDS Reference Center....
[Ti] Título:Epstein-Barr virus load in children infected with human immunodeficiency virus type 1 in Uganda.
[So] Fuente:J Infect Dis;210(3):392-9, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: Epstein-Barr Virus (EBV) is involved in a wide range of malignancies, particularly in immunocompromised subjects. In Africa, EBV primary infection occurs during early childhood, but little is known about the EBV load in Human Immunodeficiency Virus type 1 (HIV-1)-infected children. METHODS: Blood samples from 213 HIV-1-infected children, 140 of whom were receiving antiretroviral therapy (ART), were collected at the Nsambya Hospital in Kampala, Uganda, and obtained for dried blood spot analysis. Nucleic acids were extracted and analyzed for quantification of EBV types 1 and 2; 16S ribosomal DNA (rDNA), a marker of microbial translocation; and HIV-1 RNA. RESULTS: Ninety-two of 140 children (66%) receiving ART and 57 of 73 ART-naive children (78%) had detectable EBV DNA levels. Coinfection with both EBV types was less frequent in ART-treated children than in ART-naive children (odds ratio, 0.54 [95% confidence interval {CI}, .30-.98]; P = .042). Mean EBV DNA levels (±standard deviation) were lower in the former (3.99 ± 0.59 vs 4.22 ± 0.54 log10 copies/mL; P = .006) and tended to be inversely associated with ART duration. EBV DNA levels were higher in children with an HIV-1 RNA load of > 3 log10 copies/mL of blood (regression coefficient, 0.32 [95% CI, .05-.59]; P = .020) and correlated with circulating 16S rDNA levels (rs = 0.25 [95% CI, .02-.46]; P = .031). CONCLUSIONS: These findings suggest that ART, by limiting HIV-1 replication, microbial translocation, and related immune activation, prevents superinfection with both EBV types and keeps EBV viremia down, thus potentially reducing the risk of EBV-associated lymphomas.
[Mh] Términos MeSH primario: Infecciones por Virus de Epstein-Barr/virología
Infecciones por VIH/complicaciones
VIH-1/aislamiento & purificación
Herpesvirus Humano 4/aislamiento & purificación
Carga Viral
[Mh] Términos MeSH secundario: Adolescente
Fármacos Anti-VIH/uso terapéutico
Niño
Preescolar
ADN Viral/aislamiento & purificación
Femenino
Infecciones por VIH/sangre
Infecciones por VIH/quimioterapia
Infecciones por VIH/epidemiología
Humanos
Lactante
Masculino
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 0 (DNA, Viral)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu099


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[PMID]:24532602
[Au] Autor:Li H; Margolick JB; Bream JH; Nilles TL; Langan S; Bui HT; Sylwester AW; Picker LJ; Leng SX
[Ad] Dirección:Division of Geriatrics Medicine and Gerontology, Johns Hopkins University School of Medicine....
[Ti] Título:Heterogeneity of CD4+ and CD8+ T-cell responses to cytomegalovirus in HIV-infected and HIV-uninfected men who have sex with men.
[So] Fuente:J Infect Dis;210(3):400-4, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Studies of T-cell immunity to human cytomegalovirus (CMV) primarily reflect anti-CMV pp65 or immediate early antigen 1 (IE-1) activity. We assessed responses of T cells from human immunodeficiency virus (HIV)-negative and HIV-infected men to peptide pools spanning 19 CMV open reading frames selected because they previously correlated with total CMV-specific T-cell responses in healthy donors. Cells producing cytokines in response to pp65 or IE-1 together composed <12% and <40% of the total CD4(+) and CD8(+) T-cell responses to CMV, respectively. These proportions were generally similar regardless of HIV serostatus. Thus, analyses of total CMV-specific T-cell responses should extend beyond pp65 and IE-1 regardless of HIV serostatus.
[Mh] Términos MeSH primario: Linfocitos T CD4-Positivos/fisiología
Linfocitos T CD8-positivos/fisiología
Infecciones por Citomegalovirus/inmunología
Infecciones por VIH/complicaciones
Infecciones por VIH/inmunología
[Mh] Términos MeSH secundario: Adulto
Homosexualidad Masculina
Humanos
Masculino
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu093


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[PMID]:24446523
[Au] Autor:Castagna A; Maggiolo F; Penco G; Wright D; Mills A; Grossberg R; Molina JM; Chas J; Durant J; Moreno S; Doroana M; Ait-Khaled M; Huang J; Min S; Song I; Vavro C; Nichols G; Yeo JM; VIKING-3 Study Group
[Ad] Dirección:San Raffaele Scientific Institute, Milan....
[Ti] Título:Dolutegravir in antiretroviral-experienced patients with raltegravir- and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study.
[So] Fuente:J Infect Dis;210(3):354-62, 2014 Aug 1.
[Is] ISSN:1537-6613
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:BACKGROUND: The pilot phase IIb VIKING study suggested that dolutegravir (DTG), a human immunodeficiency virus (HIV) integrase inhibitor (INI), would be efficacious in INI-resistant patients at the 50 mg twice daily (BID) dose. METHODS: VIKING-3 is a single-arm, open-label phase III study in which therapy-experienced adults with INI-resistant virus received DTG 50 mg BID while continuing their failing regimen (without raltegravir or elvitegravir) through day 7, after which the regimen was optimized with ≥1 fully active drug and DTG continued. The primary efficacy endpoints were the mean change from baseline in plasma HIV-1 RNA at day 8 and the proportion of subjects with HIV-1 RNA <50 c/mL at week 24. RESULTS: Mean change in HIV-1 RNA at day 8 was -1.43 log10 c/mL, and 69% of subjects achieved <50 c/mL at week 24. Multivariate analyses demonstrated a strong association between baseline DTG susceptibility and response. Response was most reduced in subjects with Q148 + ≥2 resistance-associated mutations. DTG 50 mg BID had a low (3%) discontinuation rate due to adverse events, similar to INI-naive subjects receiving DTG 50 mg once daily. CONCLUSIONS: DTG 50 mg BID-based therapy was effective in this highly treatment-experienced population with INI-resistant virus. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov (NCT01328041) and http://www.gsk-clinicalstudywww.gsk-clinicalstudyregister.com (112574).
[Mh] Términos MeSH primario: Farmacorresistencia Viral
Infecciones por VIH/quimioterapia
VIH-1/efectos de drogas
Compuestos Heterocíclicos con 3 Anillos/uso terapéutico
Pirrolidinonas/farmacología
Quinolonas/farmacología
[Mh] Términos MeSH secundario: Adulto
Fármacos Anti-VIH/uso terapéutico
Femenino
Infecciones por VIH/virología
Humanos
Masculino
Mediana Edad
Proyectos Piloto
ARN Viral/sangre
Carga Viral
[Pt] Tipo de publicación:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (Anti-HIV Agents); 0 (Heterocyclic Compounds, 3-Ring); 0 (JTK 303); 0 (Pyrrolidinones); 0 (Quinolones); 0 (RNA, Viral); 22VKV8053U (raltegravir); DKO1W9H7M1 (dolutegravir)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:AIM; IM
[Da] Fecha de ingreso para procesamiento:140711
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiu051


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[PMID]:24872134
[Au] Autor:Tsuchiya K; Hayashida T; Hamada A; Kato S; Oka S; Gatanaga H
[Ad] Dirección:*AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan; †Department of Clinical Pharmacology, Group for Translational Research Support Core, National Cancer Center Research Institute, Tokyo, Japan; ‡Department of Medical Oncology and Translational Research, Kumamoto University, Kumamoto, Japan; §Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan; and ‖Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
[Ti] Título:Low raltegravir concentration in cerebrospinal fluid in patients with ABCG2 genetic variants.
[So] Fuente:J Acquir Immune Defic Syndr;66(5):484-6, 2014 Aug 15.
[Is] ISSN:1944-7884
[Cp] País de publicación:United States
[La] Idioma:eng
[Ab] Resumen:Adenosine triphosphate-binding cassette transporter G2 (ABCG2) is expressed on the cerebrospinal fluid (CSF) side of choroid plexus epithelial cells, which form the blood-CSF barrier. Raltegravir was recently identified as a substrate of ABCG2. In the present study, we analyzed the relationship between single-nucleotide polymorphisms of ABCB1 and ABCG2 genes and raltegravir concentrations in 31 plasma and 14 CSF samples of HIV-infected patients treated with raltegravir-containing regimens. The mean CSF raltegravir concentration was significantly lower in CA (25.5 ng/mL) and AA (<10 ng/mL) genotypes at position 421 in ABCG2 gene compared with CC (103.6 ng/mL) genotype holders (P = 0.016).
[Mh] Términos MeSH primario: Transportadoras de Casetes de Unión a ATP/genética
Fármacos Anti-VIH/farmacocinética
Fármacos Anti-VIH/uso terapéutico
Infecciones por VIH/quimioterapia
Proteínas de Neoplasias/genética
Pirrolidinonas/farmacocinética
Pirrolidinonas/uso terapéutico
[Mh] Términos MeSH secundario: Transportadoras de Casetes de Unión a ATP/metabolismo
Fármacos Anti-VIH/líquido cefalorraquídeo
Regulación de la Expresión Génica
Variación Genética
Genotipo
Infecciones por VIH/líquido cefalorraquídeo
Humanos
Proteínas de Neoplasias/metabolismo
Pirrolidinonas/líquido cefalorraquídeo
[Pt] Tipo de publicación:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nombre de substancia:
0 (ABCG2 protein, human); 0 (Anti-HIV Agents); 0 (Neoplasm Proteins); 0 (Pyrrolidinones); 22VKV8053U (raltegravir)
[Em] Mes de ingreso:1408
[Sb] Subgrupo de revista:IM; X
[Da] Fecha de ingreso para procesamiento:140711
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000222



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