Database : MEDLINE
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PMID:27221274
Author:Andany N; Gold WL
Address:Department of Medicine (Andany, Gold), University of Toronto; Division of Infectious Diseases (Gold), University Health Network, Toronto, Ont.
Title:Single-tablet antiretroviral treatment (once daily).
Source:CMAJ; 188(13):971, 2016 Sep 20.
ISSN:1488-2329
Country of publication:Canada
Language:eng
Publication type:JOURNAL ARTICLE
Name of substance:0 (Anti-HIV Agents); 0 (Dideoxynucleosides); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Emtricitabine, Rilpivirine, Tenofovir Drug Combination); 0 (Heterocyclic Compounds, 3-Ring); 2T8Q726O95 (Lamivudine); DKO1W9H7M1 (dolutegravir); WR2TIP26VS (abacavir)


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PMID:26885802
Author:Ramanathan S; Custodio JM; Wei X; Wang H; Fordyce M; Dave A; Ling KH; Szwarcberg J; Kearney BP
Address:Gilead Sciences, Inc., Foster City, CA.
Title:Pharmacokinetics of Co-Formulated Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil Fumarate After Switch From Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate in Healthy Subjects.
Source:J Acquir Immune Defic Syndr; 72(3):281-8, 2016 Jul 01.
ISSN:1944-7884
Country of publication:United States
Language:eng
Abstract:BACKGROUND: Elvitegravir (EVG), a HIV integrase inhibitor, is metabolized primarily by CYP3A, and secondarily by UGT1A1/3; Efavirenz (EFV), a HIV non-nucleoside reverse transcriptase inhibitor, is metabolized by Cytochrome P450 (CYP) 2B6 and induces CYP3A and uridine diphosphate glucuronosyltransferase (UGT) with residual effects post discontinuation because of long T1/2 (40-55 hours). This study evaluated the pharmacokinetics after switching from efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) to elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF). METHODS: Healthy subjects (n = 32 including n = 8 CYP2B6 poor metabolizers) received EVG/COBI/FTC/TDF (150/150/200/300 mg) on days 1-7, and after a washout, received EFV/FTC/TDF (600/200/300 mg) on days 15-28 and switched to EVG/COBI/FTC/TDF (150/150/200/300 mg) for 5 weeks (days 29-62). Pharmacokinetic assessments occurred on days 7, 28, 35, and 42; trough samples (Ctrough) were collected periodically until day 63. Safety was assessed throughout the study. RESULTS: Twenty-nine subjects completed with 3 adverse events leading to discontinuation; no grade ≥3 adverse events were reported. Post-EFV/FTC/TDF, mean EVG area under concentration (AUCtau) was 37% and 29% lower and mean Ctrough ∼3- and ∼5-fold above IC95, respectively, on days 35 and 42, and 7-8-fold above IC95 by 5 weeks. COBI AUCtau returned to normal by day 42. EVG glucuronide, GS-9200, AUCtau was higher (46% and 32% on days 35 and 42, respectively) postswitch. CYP2B6 poor metabolizers displayed higher EFV AUCtau and Cmax (125% and 91%, respectively) versus non-poor metabolizers, and lower EVG and COBI exposures. EFV Ctrough was >IC90 (10 ng/mL) in all subjects postswitch. FTC and tenofovir (TFV) exposures were unaffected. CONCLUSIONS: After EFV/FTC/TDF to EVG/COBI/FTC/TDF switch, EVG and/or EFV exposures were in an active range. These findings support further evaluation of switching regimens in HIV-1 patients.
Publication type:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE
Name of substance:0 (Anti-HIV Agents); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination)


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PMID:26867536
Author:Moodley T; Moodley D; Sebitloane M; Maharaj N; Sartorius B
Address:Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa. theronmoodley@gmail.com.
Title:Improved pregnancy outcomes with increasing antiretroviral coverage in South Africa.
Source:BMC Pregnancy Childbirth; 16:35, 2016 Feb 11.
ISSN:1471-2393
Country of publication:England
Language:eng
Abstract:BACKGROUND: Universal multi drug antiretroviral treatment in pregnancy is a global priority in our bid to eliminate paediatric HIV infections although few studies have documented the impact of antiretroviral coverage on overall pregnancy outcomes. METHODS: We conducted a maternity audit at a large regional hospital in South Africa during July-December 2011 and January-June 2014 with an aim to determine an association between pregnancy outcomes and the ARV treatment guidelines implemented during those specific periods. During 2011, women received either Zidovudine/sd Nevirapine or Stavudine/Lamivudine/Nevirapine if CD4+ count was < 350 cells/ml. During 2014, all HIV positive pregnant women were eligible for a fixed dose combination (FDC) of triple ARVs (Tenofovir/Emtracitabine/Efavirenz). RESULTS: In 2011, 622 (35.9%) of 1732 HIV positive pregnant women received triple antiretrovirals (D4T/3TC/NVP) and in 2014, 2104 (94.8%) of 2219 HIV positive pregnant women received the fixed dose combination (TDF/FTC/EFV). We observed a reduction in the proportion of unregistered pregnancies, caesarean delivery rate, still birth rate, very low birth weight rate, and very premature delivery rate in 2014. In a bivariate analysis of all 9,847 deliveries, unregistered pregnancies (2.2%) and HIV infection (37.8%) remained significant risk factors for SB(OR 6.36 and 1.43 respectively), PTD(OR 4.23 and 1.26 respectively),LBW (OR 4.07 and 1.26 respectively) and SGA(OR 2.17 and 1.151 respectively). In a multivariable analysis of HIV positive women only, having received AZT/NVP or D4T/3TC/NVP or EFV/TDF/FTC as opposed to not receiving any ARV was significantly associated with reduced odds of a SB (OR 0.08, 0.21 and 0.18 respectively), PTD (OR 0.52, 0.68 and 0.56 respectively) and LBW(0.37, 0.61 and 0.52 respectively). CONCLUSION: An improvement in birth outcomes is likely associated with the increased coverage of triple antiretroviral treatment for pregnant women. And untreated HIV infected women and women who do not seek antenatal care should be considered most at risk for poor birth outcomes.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Anti-Retroviral Agents); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (stavudine, lamivudine, nevirapine drug combination); 2T8Q726O95 (Lamivudine); 4B9XT59T7S (Zidovudine); 99DK7FVK1H (Nevirapine); BO9LE4QFZF (Stavudine)


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PMID:26489045
Author:Wilkins EL; Cohen CJ; Trottier B; Esser S; Smith DE; Haas B; Brinson C; Garner W; Chuck S; Thorpe D; De-Oertel S
Address:a North Manchester General Hospital , Crumpsall , Manchester , UK.
Title:Patient-reported outcomes in the single-tablet regimen (STaR) trial of rilpivirine/emtricitabine/tenofovir disoproxil fumarate versus efavirenz/emtricitabine/tenofovir disoproxil fumarate in antiretroviral treatment-naive adults infected with HIV-1 through 48 weeks of treatment.
Source:AIDS Care; 28(3):401-8, 2016.
ISSN:1360-0451
Country of publication:England
Language:eng
Abstract:This 96-week, randomized, open-label study was designed to assess the efficacy and safety of two single-tablet regimens in treatment naïve HIV-1-infected adults: rilpivirine (RPV) + emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) and efavirenz (EFV) + FTC/TDF. Assessments included patient-reported Medication Adherence Self-Report Inventory, SF-12v2 Quality of Life assessment, HIV Treatment Satisfaction Questionnaire, and HIV Symptom Index Questionnaire through Week 48. Additional evaluations included study drug discontinuations due to treatment-emergent adverse events (TEAEs). A total of 786 participants (n=394 RPV/FTC/TDF, n=392 EFV/FTC/TDF) were included. Fewer RPV/FTC/TDF-treated than EFV/FTC/TDF-treated participants discontinued study drug due to TEAEs (2.5% vs. 8.7%), with 41% (14/34) TEAE-related discontinuations in the EFV/FTC/TDF group occurring within the first four weeks of treatment. Treatment adherence and satisfaction remained high through Week 48 and quality of life improved from baseline in both groups. There were no significant between-group differences in virologic success (HIV-1 RNA <50 copies/mL) regardless of adherence (<95% or ≥95%). Significant between-group differences favouring RPV/FTC/TDF were observed for the HIV SIQ symptoms of difficulty falling or staying asleep (p = .022) and diarrhea or loose bowel movements (p = .002). In conclusion, 48-week treatment with RPV/FTC/TDF or EFV/FTC/TDF was associated with high adherence, high treatment satisfaction, and improved quality of life. TEAE-related discontinuations and patient-reported symptoms indicate that RPV/FTC/TDF may be somewhat better tolerated than EFV/FTC/TDF.
Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
Name of substance:0 (Anti-HIV Agents); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Emtricitabine, Rilpivirine, Tenofovir Drug Combination); 0 (RNA, Viral); 0 (Tablets)


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PMID:26487641
Author:Ndolo SM; Sichilongo K; Massele A; Sepako E; Vento S
Address:Department of Science, Molepolole College of Education, P/Bag 008 Molepolole, Gaborone 00267, Botswana.
Title:An Investigation of Liquid Chromatography-Mass Spectral Attributes and Analytical Performance Characteristics of Tenofovir, Emtricitabine and Efavirenz in Human Plasma.
Source:J Anal Toxicol; 40(1):49-57, 2016 Jan-Feb.
ISSN:1945-2403
Country of publication:England
Language:eng
Abstract:Liquid chromatography (LC) and mass spectral behavior and analytical performance characteristics of efavirenz (EFV), emtricitabine (EMT) and tenofovir (TFV), i.e., individual components of Atripla(®), were probed. This was followed by estimation of their analytical performance characteristics employing LC and a parallel direct infusion sample introduction procedure. Performance characteristics using both types of sample introduction procedures were compared. Using liquid chromatography-mass spectrometry (LC-MS), linearities, i.e., correlation coefficients of the calibration curves of EFV, EMT and TFV, ranged between 0.9300 and 0.9990 in the full scan, selected ion monitoring and mass spectrometry/mass spectrometry (MS-MS) modes. The limits of detection (LODs) ranged between 0.5 and 11.6 µg/L. The lower limits of quantification (LLOQs) and the upper limits of quantification (ULOQs) were in the ranges of 0.9-23.2 and 1.6-38.7 µg/L, respectively. The LODs ranged between 0.8 and 114.7 µg/L. The LLOQs and the ULOQs were in the ranges of 1.6-29.4 and 2.7-49.0 µg/L, respectively. In the case of EMT, sodiated molecular ion at m/z 270 was used to adduce analytical performance characteristics from which lower detection limits were obtained compared with those in the literature where [M+H](+) at m/z 248 was used.
Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Name of substance:0 (Benzoxazines); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 99YXE507IL (Tenofovir); G70B4ETF4S (Emtricitabine); JE6H2O27P8 (efavirenz)


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PMID:26427554
Author:Martínez-Bonet M; Clemente MI; Álvarez S; Díaz L; García-Alonso D; Muñoz E; Moreno S; Muñoz-Fernández MÁ
Address:Laboratorio de InmunoBiología Molecular, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), C/ Dr. Esquerdo 46, 28007 Madrid, Spain. Electronic ad
Title:Antiretroviral drugs do not interfere with bryostatin-mediated HIV-1 latency reversal.
Source:Antiviral Res; 123:163-71, 2015 Nov.
ISSN:1872-9096
Country of publication:Netherlands
Language:eng
Abstract:Although an effective combination of antiretroviral therapy (cART) controls HIV-1 viraemia in infected patients, viral latency established soon after infection hinders HIV-1 eradication. It has been shown that bryostatin-1 (BRY) inhibits HIV-infection in vitro and reactivates the latent virus through the protein kinase C-NF-κB pathway. We determined the in vitro potential effect of BRY in combination with currently used antiretroviral drugs. BRY alone or in combination with maraviroc (MVC)/Atripla (ATP) was tested for its capacity to reactivate latent virus and inhibit new infections. JLTRG-R5 cells and two latent HIV-1-infected cell lines, J89GFP and THP89GFP, were used as latency models. To quantify HIV infection, the reporter cell line TZM-bl was used. We found that BRY reactivates HIV-1 even in combination with MVC or ATP. Antiretroviral combinations with BRY do not interfere with BRY activity (i.e., the reactivation of latently infected cells) or with the antiviral activity of antiretroviral drugs. In addition, BRY-mediated down-modulation of surface CD4 and CXCR4 was not affected when it was used in combination with other antiretrovirals, and no hyperactivation or high-proliferation effects were observed in primary T cells. Moreover, the BRY treatment was able to reactivate HIV-1 in CD4+ T cells from HIV-1-infected patients under cART. Thus, we propose the use of BRY to purge the viral reservoir and recommend its combination with current antiretroviral treatments.
Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Name of substance:0 (Anti-Retroviral Agents); 0 (Bryostatins); 0 (Cyclohexanes); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Triazoles); MD6P741W8A (maraviroc)


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PMID:25934146
Author:Peng S; Tafazzoli A; Dorman E; Rosenblatt L; Villasis-Keever A; Sorensen S
Address:a a Evidera , Bethesda , MD , USA.
Title:Cost-effectiveness of DTG + ABC/3TC versus EFV/TDF/FTC for first-line treatment of HIV-1 in the United States.
Source:J Med Econ; 18(10):763-76, 2015.
ISSN:1941-837X
Country of publication:England
Language:eng
Abstract:OBJECTIVE: Data from the SINGLE trial demonstrated that 88% of treatment-naïve HIV-1 patients treated with dolutegravir and abacavir/lamivudine (DTG + ABC/3TC) achieved viral suppression at 48 weeks compared with 81% of patients treated with efavirenz/tenofovir disoproxil fumarate/emtricitabine (EFV/TDF/FTC). It is unclear how this difference in short-term efficacy impacts long-term cost-effectiveness of these regimens. This study sought to evaluate long-term cost-effectiveness of DTG + ABC/3TC vs EFV/TDF/FTC from a US payer perspective. METHODS: This study is an individual discrete-event simulation which tracked the disease status and treatment pathway of HIV-1 patients. The model simulated treatment over a lifetime horizon by tracking change in patients' CD4 count, clinical events occurrence (opportunistic infections, cancer, and cardiovascular events), treatment switch, and death. The model included up to four lines of treatment. Baseline patient characteristics, efficacy, and safety of DTG + ABC/3TC and EFV/TDF/FTC were informed by data from the SINGLE trial. The efficacy of subsequent treatment lines, clinical event risks, mortality, cost, and utility inputs were based on literature and expert opinion. Outcomes were lifetime discounted medical costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). RESULTS: Compared with EFV/TDF/FTC, DTG + ABC/3TC increased lifetime costs by $19,153 and per person survival by 0.12 QALYs, resulting in an ICER of $158,890/QALY. ICERs comparing DTG + ABC/3TC to EFV/TDF/FTC remained above the traditional, US willingness-to-pay threshold of $50,000/QALY gained in all scenarios, and above $100,000 or $150,000/QALY gained in most scenarios. LIMITATIONS: Due to data limitations, the treatment patterns, CD4 count during viral rebound and treatment switch, viral rebound after trial end, and long-term adverse event-related treatment discontinuation were based on assumptions, presented to and approved by clinical experts. CONCLUSIONS: Compared with EFV/TDF/FTC, DTG + ABC/3TC resulted in higher cost and only slightly increased QALYs over a lifetime, with an ICER that exceeded the standard cost-effectiveness threshold. This indicates that the incremental benefit in effectiveness associated with DTG + ABC/3TC may not be worth the incremental increase in costs.
Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
Name of substance:0 (Anti-HIV Agents); 0 (Dideoxynucleosides); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (abacavir, lamivudine drug combination); 2T8Q726O95 (Lamivudine)


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PMID:24902520
Author:Mocroft A; Reiss P; Rakhmanova A; Banhegyi D; Phillips AN; De Wit S; Ristola M; Lundgren JD; Grarup J; Kirk O; EuroSIDA in EuroCOORD
Address:Department of Infection and Population Health, University College London, Rowland Hill St, London, NW3 2PF, UK, a.mocroft@ucl.ac.uk.
Title:A survey of ATRIPLA use in clinical practice as first-line therapy in HIV-positive persons in Europe.
Source:Infection; 42(4):757-62, 2014 Aug.
ISSN:1439-0973
Country of publication:Germany
Language:eng
Abstract:ATRIPLA is licensed for use only in HIV-positive persons whose viral loads <50 for ≥ 3 months. We investigated the use of ATRIPLA as first-line antiretroviral therapy (ART) in EuroSIDA using a web-based survey performed in Autumn 2012. 96/112 clinics (85.7 %) completed the survey. Recommendations when initiating first-line ART was TRUVADA plus efavirenz in 36 (37.5 %), ATRIPLA in 35 (36.5 %), a different first-line regimen in 12 clinics (12.5 %), and no recommendation in 7 clinics (7.3 %). ATRIPLA was commonest in Northern (15/21 clinics; 71.4 %), and least common in Eastern Europe (2/31 clinics; 6.5 %; p < 0.0001). Over one-third of the participating clinics in this survey were using ATRIPLA as first-line antiretroviral therapy, despite EMA recommendations.
Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
Name of substance:0 (Anti-HIV Agents); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Organophosphonates); 0 (Oxazines); 0W860991D6 (Deoxycytidine); JAC85A2161 (Adenine)


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PMID:24518210
Author:Calza L; Vanino E; Salvadori C; Manfredi R; Colangeli V; Cascavilla A; Di Bari MA; Motta R; Viale P
Address:Department of Medical and Surgical Sciences, Section of Infectious Diseases, "Alma Mater Studiorum" University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
Title:Tenofovir/emtricitabine/efavirenz plus rosuvastatin decrease serum levels of inflammatory markers more than antiretroviral drugs alone in antiretroviral therapy-naive HIV-infected patients.
Source:HIV Clin Trials; 15(1):1-13, 2014 Jan-Feb.
ISSN:1528-4336
Country of publication:England
Language:eng
Abstract:OBJECTIVES: Statins are lipid-lowering drugs that exhibit anti-Inflammatory and immune-modulatory properties, leading to a reduction of serum levels of C-reactive protein (CRP) in the general population. DESIGN: To assess the anti-inflammatory effects of statins in HIV-infected patients, because very limited data are available today. METHODS: Longitudinal, observational study of HIV-infected adult patients naive to antiretroviral therapy who started tenofovir/emtricitabine/efavirenz and were followed-up for 48 weeks. Patients with baseline normal cholesterol level and taking only antiretroviral drugs (group A) were compared to those with baseline hypercholesterolemia who received rosuvastatin (10 mg daily) in association with antiretroviral treatment (group B). The primary observation was change in serum markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin-6 [IL-6], interleukin-8 [IL-8]) and tumor necrosis factor-α [TNF- α]) in both groups, whereas secondary observations include variations in CD4 lymphocyte count, HIV viral load, and occurrence of adverse events. RESULTS: Eighty-six patients were enrolled into the study: 46 in group A and 40 in group B. After 48 weeks, patients treated with antiretroviral therapy plus rosuvastatin had significantly greater decreases in serum concentrations of all Inflammatory markers than those taking antiretroviral therapy only. Changes in mean levels of hsCRP and TNF-α were -35.1% and -22.4% in group B and -8.2% and 5.4% in group A, respectively (P < .001, for both parameters). No significant differences in immunovirological parameters and safety profile were reported across the compared groups. CONCLUSIONS: Our findings suggest that tenofovir/emtricitabine/efavirenz plus rosuvastatin has a greater antiInflammatory effect than antiretroviral drugs only.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Anti-Retroviral Agents); 0 (Biomarkers); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Fluorobenzenes); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Interleukin-6); 0 (Organophosphonates); 0 (Oxazines); 0 (Pyrimidines); 0 (Sulfonamides); 0 (Tumor Necrosis Factor-alpha); 0W860991D6 (Deoxycytidine); 83MVU38M7Q (Rosuvastatin Calcium); 9007-41-4 (C-Reactive Protein); 97C5T2UQ7J (Cholesterol); JAC85A2161 (Adenine)


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PMID:24278992
Author:Gupta SK; Mi D; Moe SM; Dubé MP; Liu Z
Title:Effects of switching from efavirenz to raltegravir on endothelial function, bone mineral metabolism, inflammation, and renal function: a randomized, controlled trial.
Source:J Acquir Immune Defic Syndr; 64(3):279-83, 2013 Nov 01.
ISSN:1944-7884
Country of publication:United States
Language:eng
Abstract:We performed a randomized controlled trial in 30 HIV-infected participants to either continue tenofovir/emtricitabine/efavirenz (Continuation Group) or switch to tenofovir/emtricitabine/raltegravir (Switch Group) for 24 weeks. There were no significant differences in the changes in flow-mediated dilation, 25(OH) vitamin D, or parathyroid hormone levels. Total cholesterol, high sensitivity C-reactive protein, serum alkaline phosphatase, sCD14 levels, and renal function significantly declined in the Switch Group compared with the Continuation Group; however, sCD163 levels significantly increased in the Switch Group. These findings suggest that raltegravir is not inherently more beneficial to endothelial function compared with efavirenz but may impact renal function and monocyte activation.
Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
Name of substance:0 (Anti-HIV Agents); 0 (Biomarkers); 0 (Drug Combinations); 0 (Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination); 0 (Organophosphonates); 0 (Oxazines); 0 (Pyrrolidinones); 0W860991D6 (Deoxycytidine); 43Y000U234 (Raltegravir Potassium); 9007-41-4 (C-Reactive Protein); 97C5T2UQ7J (Cholesterol); EC 3.1.3.1 (Alkaline Phosphatase); JAC85A2161 (Adenine)



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