932 research outputs found
Signals were broadly positive for months, but never definitive: the tocilizumab story
No full textMost COVID-19 treatment guidelines currently recommend tocilizumab in combination with dexamethasone in critically ill patients who are exhibiting rapid respiratory decompensation
Re: 'methodological evaluation of bias in observational COVID-19 studies on drug effectiveness' by Wolkewitz et al
No full textA comparison between abacavir and efavirenz as the third drug used in combination with a background therapy regimen of 2 nucleoside reverse-transcriptase inhibitors in patients with initially suppressed viral loads
No full textBackground. Our objective was to compare the rate of viral rebound and therapy failure in patients receiving abacavir or efavirenz as the third drug ( in addition to 2 non-abacavir nucleosides) in combination antiretroviral therapy ( cART) and to compare the rate of metabolic alteration associated with these regimens.Methods. We conducted a multicohort prospective observational study of human immunodeficiency virus infected patients who had attained viral loads <= 80 copies/mL while receiving cART, without having previously received antiretrovirals. The rates of virological rebound, therapy failure, and lipid-level alteration during follow-up were calculated as the number of events divided by person-years of follow-up ( PYFU). A multivariable analysis was performed using a Poisson regression model.Results. We studied a total of 744 patients; the median age was 37 years, 27% of the patients were female, and 41% were heterosexual. There was a total of 854 PYFU spent receiving efavirenz and 285 spent receiving abacavir. The nucleoside reverse-transcriptase inhibitor pairs most frequently used were zidovudine/lamivudine ( 66% of PYFU), stavudine/lamivudine ( 17.6%), and stavudine/didanosine ( 5.4%). The adjusted relative rates of virological failure and therapy failure for abacavir, compared with those for efavirenz, were 2.17 ( 95% confidence interval [ CI], 1.12 - 4.18;) and 1.41 ( 95% CI, 1.01 - 2.01;), respectively. P = .02 P = .05Conclusions. Patients with virological suppression while receiving regimens containing abacavir appear more likely to experience virological and therapy failure than those receiving efavirenz as their third drug. Although this is a selected group of adherent patients, bias cannot be ruled out, because this is a nonrandomized comparison
Positive Results of Immunoglobulin G Cytomegalovirus Serologic Testing and Risk of Severe Non-AIDS-Related Complications in HIV-Infected Patients Reply
No full textComputer-Aided Optimization of Combined Anti-Retroviral Therapy for HIV: New Drugs, New Drug Targets and Drug Resistance
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Access to new generation DAA treatment in HIV-negative and HIV-positive individuals with F3-F4 stage of liver disease.results from PITER and Icona/HepaICONA cohorts
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Multiple viral infections
No full textIndividuals at risk of HIV are concomitantly at risk of acquiring parenterally or sexually transmitted viruses. Multiple hepatitis co-infection (HBV+HCV; HBV+HDV; HBV+HDV+HCV) has not been systematically sought after in the large cohorts of HIV-infected patients, but has been reported in 0.4% to more than 50% of patients. HIV-infected patients with multiple hepatitis have a higher rate of liver-related morbidity and mortality than patients with HIV infection alone or with a single hepatitis co-infection. The degree of immunodepression is an important factor in liver disease progression. Since GBV-C virus is transmitted parenterally or by sexual contact, a high prevalence was found in chronic hepatitis C and in HIV-infected patients. Patients with multiple hepatitis have been excluded from randomised therapeutic trials of viral hepatitis in HIV-infected and HIV-negative patients. Thus, the therapeutic approach is based on the results of a small series and empirically oriented toward the prevailing infection. HIV-infected patients should be tested for hepatitis B, C and D systematically and hepatitis B vaccination should be considered for those with HCV co-infection and absence of HBV markers. Studies are needed to assess treatment strategies
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