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1. Incidence of cancer and overall risk of mortality in individuals treated with raltegravir‐based and non‐raltegravir‐based combination antiretroviral therapy regimens

Author

Cozzi‐Lepri, A, Zangerle, R, Machala, L, Zilmer, K, Ristola, M, Pradier, C, Kirk, O, Sambatakou, H, Fätkenheuer, G, Yust, I, Schmid, P, Gottfredsson, M, Khromova, I, Jilich, D, Flisiak, R, Smidt, J, Rozentale, B, Radoi, R, Losso, MH, Lundgren, JD, Mocroft, A, Kundro, M., Schmied, B., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Sedlacek, D., Kronborg, G., Benfield, T., Gerstoft, J., Katzenstein, T., Møller, N. F., Pedersen, C., Ostergaard, L., Wiese, L., Nielsen, L. N., Aho, I., Viard, J.‐P., Girard, P.‐M., Fontas, E., Duvivier, C., Rockstroh, J., Schmidt, R., Degen, O., Stellbrink, H. J., Stefan, C., Bogner, J., Chkhartishvili, N., Gargalianos, P., Xylomenos, G., Lourida, P., Szlávik, J., Mulcahy, F., Turner, D., Burke, M., Shahar, E., Hassoun, G., Elinav, H., Haouzi, M., Elbirt, D., Sthoeger, Z. M., DʼArminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Zaccarelli, M., Antinori, A., Acinapura, R., Plazzi, M., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Reiss, P., Ormaasen, V., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Horban, A., Bakowska, E., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak‐Was, B., Beniowski, M., Mularska, E., Smiatacz, T., Gensing, M., Jablonowska, E., Malolepsza, E., Wojcik, K., Mozer‐Lisewska, I., Caldeira, L., Mansinho, K., Maltez, F., Oprea, C., Panteleev, A., Panteleev, O., Yakovlev, A., Trofimora, T., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Jevtovic, D., Tomazic, J., Gatell, J. M., Miró, J. M., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Paredes, R., Tural, C., Puig, J., Bravo, I., Domingo, P., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Falconer, K., Thalme, A., Sonnerborg, A., Blaxhult, A., Flamholc, L., Scherrer, A., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Kuznetsova, A., Kyselyova, G., Sluzhynska, M., Gazzard, B., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Weber, J., Scullard, G., Clarke, A., Leen, C., Thiebaut, R., Burger, D., Peters, L., Matthews, C., Fischer, A. H., Bojesen, A., Raben, D., Kristensen, D., Grønborg Laut, K., Larsen, J. F., Podlekareva, D., Shepherd, L., Schultze, A., and Amele, S.

Published
2018
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2. Promoting high standards of care for women living with HIV: position statement from the Women Against Viruses in Europe Working Group

Author

Kowalska, JD, Aebi‐Popp, K, Loutfy, M, Post, FA, Perez‐Elias, MJ, Johnson, M, Mulcahy, F, dʼArminio Monforte, A., Branco, T., Latysheva, K., Seed, A., Verluyten, J., Geretti, A. M., Dagnall, R., Anderson, J., De Jesus Albino Caixa, U., Gatell, J. M., Gjonbalaj, A., Gokengin, A. D., Haberl, A., Lyons, F., Mardarescu, M., Oprea, C., Papadopulous, A., Stoycheva, M., Voronin, E., Youle, M., Dixon‐Williams, E., Konopnicki, D., Krasniqi, V., Lacombe, K., Mussini, C., Boffito, M., Battegay, M., Friis‐MØller, N., Gilleece, Y., Mackie, N., and Tariq, S.

Published
2018
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6. Long‐term effectiveness of recommended boosted protease inhibitor‐based antiretroviral therapy in Europe

Author

Santos, J. R., Cozzi-Lepri, A., Phillips, A., De Wit, S., Pedersen, C., Reiss, P., Blaxhult, A., Lazzarin, A., Sluzhynska, M., Orkin, C., Duvivier, C., Bogner, J., Gargalianos-Kakolyris, P., Schmid, P., Hassoun, G., Khromova, I., Beniowski, M., Hadziosmanovic, V., Sedlacek, D., Paredes, R., Lundgren, J. D., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., Delforge, M., Florence, E., Vandekerckhove, L., Begovac, J., Machala, L., Jilich, D., Kronborg, G., Benfield, T., Gerstoft, J., Katzenstein, T., Moller, N. F., Ostergaard, L., Wiese, L., Nielsen, L. N., Zilmer, K., Smidt, J., Ristola, M., Aho, I., Viard, J. -P., Girard, P. -M., Pradier, C., Fontas, E., Rockstroh, J., Schmidt, R., Degen, O., Stellbrink, H. J., Stefan, C., Fatkenheuer, G., Chkhartishvili, N., Gargalianos, P., Xylomenos, G., Lourida, P., Sambatakou, H., Szlavik, J., Gottfredsson, M., Mulcahy, F., Yust, I., Turner, D., Burke, M., Shahar, E., Elinav, H., Haouzi, M., Elbirt, D., Sthoeger, Z. M., D'Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Zaccarelli, M., Antinori, A., Acinapura, R., Plazzi, M., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Rozentale, B., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Ormaasen, V., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Horban, A., Bakowska, E., Flisiak, R., Grzeszczuk, A., Parczewski, M., Pynka, M., Maciejewska, K., Mularska, E., Smiatacz, T., Gensing, M., Jablonowska, E., Malolepsza, E., Wojcik, K., Mozer-Lisewska, I., Caldeira, L., Mansinho, K., Maltez, F., Radoi, R., Panteleev, A., Panteleev, O., Yakovlev, A., Trofimora, T., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Jevtovic, D., Tomazic, J., Gatell, J. M., Miro, J. M., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Tural, C., Puig, J., Bravo, I., Domingo, P., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Falconer, K., Thalme, A., Sonnerborg, A., Flamholc, L., Scherrer, A., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Kuznetsova, A., Kyselyova, G., Gazzard, B., Johnson, A. M., Simons, E., Edwards, S., Johnson, M. A., Mocroft, A., Weber, J., Scullard, G., Clarke, A., Leen, C., Gatell, J., Ledergerber, B., Kirk, O., Peters, L., Matthews, C., Fischer, A. H., Bojesen, A., Raben, D., Kristensen, D., Gronborg Laut, K., Larsen, J. F., Podlekareva, D., Shepherd, L., Schultze, A., Thiebaut, R., Burger, D., Santos, J. R., Cozzi-Lepri, A., Phillips, A., De Wit, S., Pedersen, C., Reiss, P., Blaxhult, A., Lazzarin, A., Sluzhynska, M., Orkin, C., Duvivier, C., Bogner, J., Gargalianos-Kakolyris, P., Schmid, P., Hassoun, G., Khromova, I., Beniowski, M., Hadziosmanovic, V., Sedlacek, D., Paredes, R., Lundgren, J. D., Castagna, A, on behalf of the EuroSIDA study, Group, AII - Infectious diseases, APH - Aging & Later Life, Infectious diseases, Global Health, and Amsterdam institute for Infection and Immunity

Subjects
Male, 0301 basic medicine, antiretroviral therapy-naïve patients, Lopinavir/ritonavir, darunavir, HIV Infections, Antiretroviral therapy-experienced patient, Gastroenterology, antiretroviral therapy-experienced patients, 0302 clinical medicine, atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir, Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Europe, Female, Humans, Middle Aged, Prospective Studies, Treatment Outcome, Pharmacology (medical), 030212 general & internal medicine, atazanavir, Antiretroviral therapy-naïve patient, Health Policy, Lopinavir, Antiretroviral Therapy, Highly Active/methods, ritonavir, Infectious Diseases, Viral load, medicine.drug, medicine.medical_specialty, HIV Infections/drug therapy, Infectious Disease, antiretroviral therapy-naive patients, 03 medical and health sciences, Internal medicine, medicine, Protease inhibitor (pharmacology), Darunavir, business.industry, 030112 virology, Atazanavir, lopinavir, Regimen, Anti-HIV Agents/therapeutic use, Ritonavir, business
Abstract

OBJECTIVES: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens.METHODS: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan-Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches.RESULTS: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART.CONCLUSIONS: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.

Published
2018
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7. Comparison of two HIV testing strategies in primary care centres: indicator-condition-guided testing vs. testing of those with non-indicator conditions

Author

Menacho, I, Sequeira, E, Muns, M, Barba, O, Leal, L, Clusa, T, Fernandez, E, Moreno, L, Raben, D, Lundgren, J, Gatell, J M, Garcia, F, Cayuelas, L, Aragunde, V, Vergara, M, Catalan, M, Moreno, M A, Hormigo, G, Siso, A, Herreras, Z, Sebastian, L, Benito, L, Picas, A, Hoyo, J, Giner, M J, Cararach, D, Moles, E, Moro, M L, Arrabal, P, Roca, D, Prego, S, Ferrer, X, Egido, A, Ventosa, C, Garcia, S, Muñoz, S, Massana, A, Sole, J, Curiel, M, Heras, F, and Leon, A

Published
2013
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13. Incidence of cancer and overall risk of mortality in individuals treated with raltegravir-based and non-raltegravir-based combination antiretroviral therapy regimens

Author

Cozzi-Lepri, A., Zangerle, R., Machala, L., Zilmer, K., Ristola, M., Pradier, C., Kirk, O., Sambatakou, H., Fatkenheuer, G., Yust, I., Schmid, P., Gottfredsson, M., Khromova, I., Jilich, D., Flisiak, R., Smidt, J., Rozentale, B., Radoi, R., Losso, M. H., Lundgren, J. D., Mocroft, A., Kundro, M., Schmied, B., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Sedlacek, D., Kronborg, G., Benfield, T., Gerstoft, J., Katzenstein, T., Moller, N. F., Pedersen, C., Ostergaard, L., Wiese, L., Nielsen, L. N., Aho, I., Viard, J. -P., Girard, P. -M., Fontas, E., Duvivier, C., Rockstroh, J., Schmidt, R., Degen, O., Stellbrink, H. J., Stefan, C., Bogner, J., Chkhartishvili, N., Gargalianos, P., Xylomenos, G., Lourida, P., Szlavik, J., Mulcahy, F., Turner, D., Burke, M., Shahar, E., Hassoun, G., Elinav, H., Haouzi, M., Elbirt, D., Sthoeger, Z. M., D'Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Zaccarelli, M., Antinori, A., Acinapura, R., Plazzi, M., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Reiss, P., Ormaasen, V., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Horban, A., Bakowska, E., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Beniowski, M., Mularska, E., Smiatacz, T., Gensing, M., Jablonowska, E., Malolepsza, E., Wojcik, K., Mozer-Lisewska, I., Caldeira, L., Mansinho, K., Maltez, F., Oprea, C., Panteleev, A., Panteleev, O., Yakovlev, A., Trofimora, T., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Jevtovic, D., Tomazic, J., Gatell, J. M., Miro, J. M., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Paredes, R., Tural, C., Puig, J., Bravo, I., Domingo, P., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Falconer, K., Thalme, A., Sonnerborg, A., Blaxhult, A., Flamholc, L., Scherrer, A., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Kuznetsova, A., Kyselyova, G., Sluzhynska, M., Gazzard, B., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Weber, J., Scullard, G., Clarke, A., Leen, C., Thiebaut, R., Burger, D., Peters, L., Matthews, C., Fischer, A. H., Bojesen, A., Raben, D., Kristensen, D., Gronborg Laut, K., Larsen, J. F., Podlekareva, D., Shepherd, L., Schultze, A., Amele, S., Cozzi-lepri, A, Zangerle, R, Machala, L, Zilmer, K, Ristola, M, Pradier, C, Kirk, O, Sambatakou, H, Fätkenheuer, G, Yust, I, Schmid, P, Gottfredsson, M, Khromova, I, Jilich, D, Flisiak, R, Smidt, J, Rozentale, B, Radoi, R, Losso, M. H, Lundgren, J. D, Mocroft, A, Eurosida Study, Group, Castagna, A, Lazzarin, A, AII - Infectious diseases, APH - Aging & Later Life, Infectious diseases, Global Health, Amsterdam institute for Infection and Immunity, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland, Clinicum, Department of Medicine, and HUS Inflammation Center

Subjects
Male, 0301 basic medicine, observational treatment comparison, HIV Infections, Rate ratio, propensity scores, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Neoplasms, Medicine and Health Sciences, Risk of mortality, AIDS-DEFINING, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Original Research, EXPERIENCED, ddc:616, IMMUNODEFICIENCY, Incidence, Health Policy, Incidence (epidemiology), risk of cancer, Middle Aged, 3. Good health, Infectious Diseases, Anti-Retroviral Agents, SAFETY, EXPERIENCED PATIENTS, Cohort, AIDS-DEFINING CANCERS, Female, Historical Cohort, medicine.drug, Adult, Alnæmi, medicine.medical_specialty, animal structures, CANCERS, HIV INTEGRASE INHIBITORS, 030106 microbiology, Antiretroviral Therapy, survival, Risk Assessment, HIV-1-INFECTED PATIENTS, MALIGNANCIES, 03 medical and health sciences, Lyf, Raltegravir Potassium, Internal medicine, PATIENTS, medicine, Humans, COHORT, Highly Active, propensity score, Krabbamein, OPTIMIZED BACKGROUND THERAPY, business.industry, observational treatment, Raltegravir, Survival Analysis, Odds ratio, INFECTED INDIVIDUALS, comparison, 3121 General medicine, internal medicine and other clinical medicine, business
Abstract

Publisher's version (útgefin grein), Objectives There are currently few data on the long‐term risk of cancer and death in individuals taking raltegravir (RAL). The aim of this analysis was to evaluate whether there is evidence for an association. Methods The EuroSIDA cohort was divided into three groups: those starting RAL‐based combination antiretroviral therapy (cART) on or after 21 December 2007 (RAL); a historical cohort (HIST) of individuals adding a new antiretroviral (ARV) drug (not RAL) to their cART between 1 January 2005 and 20 December 2007, and a concurrent cohort (CONC) of individuals adding a new ARV drug (not RAL) to their cART on or after 21 December 2007. Baseline characteristics were compared using logistic regression. The incidences of newly diagnosed malignancies and death were compared using Poisson regression. Results The RAL cohort included 1470 individuals [with 4058 person‐years of follow‐up (PYFU)] compared with 3787 (4472 PYFU) and 4467 (10 691 PYFU) in the HIST and CONC cohorts, respectively. The prevalence of non‐AIDS‐related malignancies prior to baseline tended to be higher in the RAL cohort vs. the HIST cohort [adjusted odds ratio (aOR) 1.31; 95% confidence interval (CI) 0.95–1.80] and vs. the CONC cohort (aOR 1.89; 95% CI 1.37–2.61). In intention‐to‐treat (ITT) analysis (events: RAL, 50; HIST, 45; CONC, 127), the incidence of all new malignancies was 1.11 (95% CI 0.84–1.46) per 100 PYFU in the RAL cohort vs. 1.20 (95% CI 0.90–1.61) and 0.83 (95% CI 0.70–0.99) in the HIST and CONC cohorts, respectively. After adjustment, there was no evidence for a difference in the risk of malignancies [adjusted rate ratio (RR) 0.73; 95% CI 0.47–1.14 for RALvs. HIST; RR 0.95; 95% CI 0.65–1.39 for RALvs. CONC] or mortality (adjusted RR 0.87; 95% CI 0.53–1.43 for RALvs. HIST; RR 1.14; 95% CI 0.76–1.72 for RALvs. CONC). Conclusions We found no evidence for an oncogenic risk or poorer survival associated with using RAL compared with control groups., EuroSIDA was supported by the European Union's Seventh Framework Programme for research, technological development and demonstration under EuroCoord grant agreement no. 260694. Current support includes unrestricted grants from Bristol‐Myers Squibb, Gilead, GlaxoSmithKline LLC, Janssen R&D, Merck and Co. Inc. and Pfizer Inc. The participation of centres from Switzerland was supported by The Swiss National Science Foundation (Grant 108787). The study is also supported by a grant (grant number DNRF126) from the Danish National Research Foundation.

Published
2017
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19. Intrathoracic fat in HIV-infected patients

Author

Blanco, J L, Biglia, A, Martinez, E, Sánchez, M, de Lazzari, E, Leon, A, Milinkovic, A, Larrousse, M, Lonca, M, Laguno, M, Mallolas, J, and Gatell, J M

Published
2006

22. Subclinical cardiovascular disease in patients starting contemporary protease inhibitors.

Author

González‐Cordón, A., Doménech, M., Camafort, M., Martínez‐Rebollar, M., Torres, B., Laguno, M., Rojas, J., Loncà, M., Blanco, J. L., Mallolas, J., Gatell, J. M., de Lazzari, E., and Martínez, E.

Subjects
AORTA physiology, THERAPEUTIC use of protease inhibitors, ANTIRETROVIRAL agents, EMTRICITABINE, DARUNAVIR, ATAZANAVIR, TENOFOVIR, RITONAVIR, BIOMARKERS, CARDIOVASCULAR diseases, CARDIOVASCULAR diseases risk factors, CONFIDENCE intervals, CLINICAL drug trials, HIV, HIV infections, MEDICAL cooperation, MULTIVARIATE analysis, REGRESSION analysis, RESEARCH, PILOT projects, RANDOMIZED controlled trials, TREATMENT effectiveness, DISEASE progression, CAROTID intima-media thickness, THERAPEUTICS
Abstract

Objectives: The aim of the study was to assess changes in and factors associated with anatomical [carotid artery intima‐media thickness (CIMT)] and functional (arterial stiffness) markers of subclinical cardiovascular disease progression in antiretroviral‐naïve patients starting triple combination antiretroviral therapy containing contemporary protease inhibitors. Methods: This was a planned substudy of the ATADAR (Metabolic Effects of Atazanavir/Ritonavir Versus Darunavir/Ritonavir in Combination With Tenofovir/Emtricitabine in naïve HIV‐1 Infected Patients) clinical trial (ClinicalTrials.gov identifier NCT01274780). ATADAR is a multicentre, randomized, open‐label clinical trial comparing the effects of ritonavir‐boosted atazanavir and darunavir, both with tenofovir/emtricitabine, in antiretroviral‐naïve HIV‐infected patients. Common CIMT and aortic augmentation index (AIx@75) were measured at baseline and after 12 months of follow‐up. Antiretroviral treatment, traditional cardiovascular risk factors and HIV‐related factors were assessed as potential predictors of CIMT and Aix@75 changes using linear regression analysis. Results: Thirty‐three patients were included in this pilot study. While CIMT significantly increased in the pooled population [median (interquartile range (IQR)) 68 (−13, 128) μm; P = 0.0511], AIx@75 did not [median (IQR) 1 (−6, 5)%; P = 0.8964]. Patients on darunavir showed a trend to faster CIMT progression than those on atazanavir [median change (IQR) 117 (−2, 143) vs. −6 (−58, 89) μm, respectively; P = 0.0917]. However, after adjustment in the multivariate analysis, a higher baseline Framingham score was the only factor associated with CIMT progression (coefficient 16.02; 95% confidence interval –1.04, 33.08; P = 0.064). AIx@75 change was not associated with any baseline factor. Conclusions: CIMT was a more sensitive marker of subclinical vascular disease progression than arterial stiffness in antiretroviral‐naïve patients starting antiretroviral therapy with contemporary protease inhibitors. Classical risk factors but not antiretroviral therapy were associated with faster CIMT progression. [ABSTRACT FROM AUTHOR]

Published
2018
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23. Effects of highly active antiretroviral therapy on vaccine-induced humoral immunity in HIV-infected adults.

Author

González, R., Castro, P., García, F., Plana, M., Bayas, J. M., Lafuente, S., Serrano, B., Mora, B., Argelich, R., Gatell, J. M., and Vilella, A.

Subjects
HIGHLY active antiretroviral therapy, PREVENTION of communicable diseases, ANTIVIRAL agents, HIV infections, VACCINATION
Abstract

Objectives The acquisition of adequate vaccine-induced humoral immunity is especially important in HIV-infected individuals, who are at increased risk of infections. The aim of the study was to assess the safety of administering a complete vaccination programme to successfully treated HIV-infected adults and to evaluate specific humoral responses and the effect of highly active antiretroviral therapy (HAART) interruption on these responses. Methods A placebo-controlled, double-blind clinical trial was designed and 26 HIV-infected adults enrolled. Study participants were randomized to receive either a complete immunization schedule with commercial vaccines or placebo for 12 months. HAART was then discontinued for 6 months. Specific humoral responses were evaluated at baseline, at month 12 and after HAART interruption and compared between groups. Results There were neither local nor systemic secondary effects related to vaccination. Specific humoral responses to vaccines were adequate, but a loss of immunoglobulin G titres was observed after HAART interruption in 12 study participants. Conclusions HAART interruption may cause impairment of previously acquired vaccine-induced immunity in HIV-infected adults. [ABSTRACT FROM AUTHOR]

Published
2010
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24. Impact of switching to raltegravir and/or adding losartan in lymphoid tissue fibrosis and inflammation in people living with HIV. A randomized clinical trial.

Author

Torres B, Guardo AC, Squarcia M, Diaz A, Fabra A, Caballero M, Ugarte A, Leal L, Gatell JM, Plana M, and Garcia F

Subjects
Fibrosis, Humans, Inflammation chemically induced, Inflammation drug therapy, Losartan therapeutic use, Lymphoid Tissue, Raltegravir Potassium therapeutic use, Viral Load, Anti-HIV Agents therapeutic use, HIV Infections complications, HIV Infections drug therapy
Abstract

Background: Persistent inflammation and immune activation are associated with lymph node fibrosis and end-organ diseases in treatment-suppressed people living with HIV (PLWH). We investigated the effect of switching to raltegravir and/or adding losartan on lymphoid tissue fibrosis and on the inflammatory/immune-activation mediators in treated HIV patients., Methods: Chronic HIV-infected patients treated with two nucleoside reverse transcriptase inhibitors (2NRTI) and one non-NRTI (NNRTI) or protease inhibitor (PI) during at least 48 weeks were randomized to four groups (n = 48): 2NRTI + efavirenz (EFV), 2NRTI + EFV + losartan, 2NRTI + raltegravir and 2NRTI + raltegravir + losartan for 48 weeks. Tonsillar biopsy and peripheral blood markers of CD4 and CD8 T-lymphocyte activation and senescence, monocyte activation and soluble markers of inflammation were determined at baseline and at week 48 and compared between groups., Results: No changes in lymphoid tissue architecture were observed. Adding losartan had no impact on lymphocyte subsets. Conversely, patients who switched to raltegravir showed a higher decrease in all activated [CD4+CD38+HLA-DR+, -0.3 vs. 0.48 (P = 0.033); CD8+CD38+ HLA-DR+, -1.6 vs. 1.3 (P = 0.02)] and senescent [CD4+CD28-CD57+, -0.3 vs. 0.26 (P = 0.04); CD8+CD28-CD57+, -6.1 vs. 3.8 (P = 0.002)] T lymphocytes. In addition, the median CD4/CD8 ratio increased by 0.35 in patients in the raltegravir group vs. 0.03 in the other arms (P = 0.002). Differences between groups in monocyte subpopulations or soluble inflammation markers were not observed., Conclusions: Losartan had no effect on lymphoid fibrosis or immune activation/inflammation. Conversely, switching to a regimen with raltegravir significantly decreased activated and senescent T-lymphocyte subpopulations and increased CD4/CD8 ratio in successfully treated PLWH., (© 2021 British HIV Association.)

Published
2021
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25. Kidney disease in antiretroviral-naïve HIV-positive adults with high CD4 counts: prevalence and predictors of kidney disease at enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.

Author

Achhra AC, Mocroft A, Ross MJ, Ryom L, Lucas GM, Furrer H, Neuhaus J, Somboonwit C, Kelly M, Gatell JM, and Wyatt CM

Subjects
Adult, CD4 Lymphocyte Count, Chronic Disease, Cross-Sectional Studies, Female, Glomerular Filtration Rate, HIV Infections immunology, Humans, Male, Middle Aged, Prevalence, Risk Factors, HIV Infections complications, HIV Infections pathology, Kidney Diseases diagnosis, Kidney Diseases epidemiology
Abstract

Objectives: HIV infection has been associated with an increased risk of chronic kidney disease (CKD). Little is known about the prevalence of CKD in individuals with high CD4 cell counts prior to initiation of antiretroviral therapy (ART). We sought to address this knowledge gap., Methods: We describe the prevalence of CKD among 4637 ART-naïve adults (mean age 36.8 years) with CD4 cell counts > 500 cells/μL at enrolment in the Strategic Timing of AntiRetroviral Treatment (START) study. CKD was defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) and/or dipstick urine protein ≥ 1+. Logistic regression was used to identify baseline characteristics associated with CKD., Results: Among 286 [6.2%; 95% confidence interval (CI) 5.5%, 6.9%] participants with CKD, the majority had isolated proteinuria. A total of 268 participants had urine protein ≥ 1+, including 41 with urine protein ≥ 2+. Only 22 participants (0.5%) had an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) , including four who also had proteinuria. Baseline characteristics independently associated with CKD included diabetes [adjusted odds ratio (aOR) 1.73; 95% CI 1.05, 2.85], hypertension (aOR 1.82; 95% CI 1.38, 2.38), and race/ethnicity (aOR 0.59; 95% CI 0.37, 0.93 for Hispanic vs. white)., Conclusions: We observed a low prevalence of CKD associated with traditional CKD risk factors among ART-naïve clinical trial participants with CD4 cell counts > 500 cells/μL., (© 2015 British HIV Association.)

Published
2015
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