Search

Background: Integrase inhibitors (INIs)-based antiretroviral therapies (ART) are more recommended than efavirenz (EFV)-based ART for people living with HIV/AIDS (PLWHA). Yet, the advantage of integrase inhibitors in treating TB/HIV coinfection is uncertain. Therefore, the objective of this systematic review is to evaluate the effects and safety of INIs- versus EFV-based ART in TB/HIV coinfection, and demonstrate the feasibility of the regimens. Methods: Four electronic databases were systematically searched through September 2020. Fixed-effects models were used to calculate pooled effect size for all outcomes. The primary outcomes were virologic suppression and bacteriology suppression for INIs- versus EFV-based ART. Secondary outcomes included CD4+ cell counts change from baseline, adherence and safety. Results: Three trials (including 672 TB/HIV patients) were eligible. ART combining INIs and EFV had similar effects for all outcomes, with none of the point estimates argued against the INIs-based ART on TB/HIV patients. Compared to EFV-based ART as the reference group, the RR was 0.94 (95% CI 0.85 to 1.05) for virologic suppression, 1.00 (95% CI 0.95 to 1.05) for bacteriology suppression, 0.98 (95% CI 0.95 to 1.01) for adherence. The mean difference in CD4+ cell counts increase between the two groups was 14.23 cells/μl (95% CI 0− 6.40 to 34.86). With regard to safety (adverse events, drug-related adverse events, discontinuation for drugs, grade 3–4 adverse events, IRIS (grade 3–4), and death), INIs-based regimen was broadly similar to EFV-based regimens. The analytical results in all sub-analyses of raltegravir- (RAL) and dolutegravir (DTG) -based ART were valid. Conclusion: This meta-analysis demonstrates similar efficacy and safety of INIs-based ART compared with EFV-based ART. This finding supports INIs-based ART as a first-line treatment in TB/HIV patients. The conclusions presented here still await further validation owing to insufficient data. [ABSTRACT FROM AUTHOR]

Annual atmospheric nitrogen (N) deposition in China increased approximately 8 kg N ha−1 from the 1980s to the 2000s, which may have greatly affected soil respiration (R s) and its temperature sensitivity (Q 10). Although numerous individual studies have been conducted, the responses of R s to simulated N deposition remain controversial. To reconcile the conflicting results of R s and expand our knowledge about the response of Q 10 to N addition, a dataset with 333 independent observations in China was compiled, and a meta-analysis was performed. Our results showed that N addition increased R s by 7.1% (P < 0.05) across all biomes. The positive response degree of R s in croplands (27.0%, P < 0.05) was significantly greater than those in the grassland and forest biomes, which indicated that R s in anthropogenic ecosystems might be more sensitive to N enrichment. In contrast to low and medium N levels (≤20 g m−2 yr−1), high N addition levels (>20 g m−2 yr−1) inhibited R s due to a decrease in plant fine root biomass (RB). Compared with ammonium nitrate, urea is more likely to stimulate the release of soil C. Regression models showed that the R s response ratio (RR) was positively correlated with pH and the RR s of microbial biomass carbon (MBC) and RB. Increases in both plant roots and microbial biomass induced by N addition directly promoted R s , and N enrichment likely increases R s in soil with a high pH. The temperature sensitivity parameter, Q 10 , decreased by 3.7% (P < 0.05) across all biomes and showed an overall negative response for different biomes (except wetlands and deserts), N addition levels and N types. The Q 10 response ratio was positively correlated with the RR of pH. Soil acidification induced by proton release during N fertilizer transformation might accelerate the decomposition of recalcitrant organic matter and further decrease the Q 10 value. Our study provides valuable information to Chinese environmental policy- and decision-makers in their attempts to evaluate the effects of N deposition on terrestrial ecosystem C cycle. • N addition increased R s by 7.1% and decreased Q 10 by 3.7% across all biomes. • Relative to grassland and forest, R s of cropland was more sensitive to N addition. • Contrary to low and medium N addition levels, high N addition levels inhibited R s. • Soil acidification induced by N addition increased R s and decreased the Q 10 value. [ABSTRACT FROM AUTHOR]