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Objectives: Our aim is to describe the impact of emtricitabine (FTC)/tenofovir (TDF) versus other nucleoside reverse transcriptase inhibitor (NRTIs)-based regimens on renal function of human immunodeficiency virus (HIV) naïve patients >50 years old who started combination antiretroviral therapy (cART). Design: National, retrospective cohort analysis of patients >50 years old when they started cART (January 1, 2006–December 31, 2009). Methods: We compared renal safety (changes in estimated glomerular filtration rate [eGFR] during the first year, and time to renal events during 4 years of follow-up) in FTC/TDF versus non-FTC/TDF users. Among FTC/TDF users, we compared protease inhibitors vs non-nucleoside reverse transcriptase inhibitors and Lopinavir/ritonavir vs Efavirenz. Results: We included 103 patients: median age: 54.9 years, 84% males, median CD4 count 247 cells/μl, median viral load 4.7 log; median follow up 18 months (max: 48 months); 73 started with FTC/TDF and 30 with other NRTIs. Change in eGFR was significantly worse for ritonavir-boosted lopinavir (LPV/r) vs efavirenz (EFV) users in the FTC/TDF group (71.2 vs 98.9 ml/min/1.73 m2 at month 12, P < 0.05). The risk of renal events (progression to an Chronic Kidney Disease Epidemiology Collaboration value < 60 ml/min/1.73 m2 in subjects with baseline values >60) was comparable for FTC/TDF users and non users, but was higher and almost significant for LPV/r as compared to EFV users in the FTC/TDF group (adjusted hazard ratio 6.1, 95% CI 0.8–45.5). Conclusions: In our study with a population of HIV infected subjects ≥ 50 years old, renal safety was similar for FTC/TDF and other NRTI-based regimens, but worse for LPV/r as compared to other regimens. [ABSTRACT FROM AUTHOR]

Objectives: Current antiretroviral guidelines state that being older than 50 to 55 years of age is an indication to start antiretroviral therapy (ART), regardless of CD4 status. However, no references to the preferred combination ART (cART) for these patients have been described. Our study compares emtricitabine and tenofovir diso-proxil fumarate (FTC/TDF) versus other nucleoside reverse transcriptase inhibitor (NNRTI) regimens in HIV ART-naïve patients who are >50 years. Design: National, ret-rospective cohort analysis of patients who were >50 years old when they began the first cART (January 1, 2006 to December 31, 2009). Methods: We compared safety, effectiveness, and persistence of treatment in FTC/TDF versus non-FTC/TDF users. Among FTC/TDF users, we compared protease inhibitor (PI) versus NNRTI users and lopinavir/r versus efavirenz users. Results: We included 161 patients: median age was 54.6 years, 83% were men, median CD4 count was 191 cells/|jL, median viral load was 4.7 log, and median follow-up was 19 months (maximum, 48 months). Of these participants, 112 started with FTC/TDF and 49 with other nucleotide reverse transcriptase inhibitors (NRTIs). During follow-up, 21.9% of subjects developed at least one laboratory event >grade 3, 5.6% interrupted cART due to adverse events, 19.3% had virologie failure, and 49.1% modified cART. There were no statistically significant differences between FTC/TDF and non-FTC/TDF users for any output except for persistence: The proportion of subjects who changed cART was 71.4% for non-FTC/TDF users and 38.6% for FTC/TDF users (log rank 0.001 ; adjusted hazard ratio, 2.10; 95% CI, 1.34-3.29). Conclusions: In a population of HIV-infected sub-jects who were >50 years old, our study suggests that the use of FTC/TDF is gener-ally safe and effective, with a longer persistence as compared to other regimens. [ABSTRACT FROM AUTHOR]

To investigate the effects of HIV infection on mitochondrial DNA (mtDNA) content and other mitochondrial parameters, we used peripheral blood mononuclear cells (PBMCs) from 25 asymptomatic antiretroviral-naive human immunodeficiency virus (HIV)-infected patients and from 25 healthy control subjects. HIV-infected patients had significant decreases in mtDNA content (decrease, 23%; P < .05) and in the activities of mitochondrial respiratory chain (MRC) complex II (decrease, 41%; P < .001), MRC complex III (decrease, 38%; P < .001), MRC complex IV (decrease, 19%; p = .001), and glycerol-3-phosphate dehydrogenase (decrease, 22%; P < .001), along with increased lipid peroxidation of PBMC membranes (P = .007). Therefore, HIV infection is associated not only with mtDNA depletion, but also with extensive MRC disturbances and increased oxidative damage. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the efficacy and safety of switching from boosted lopinavir (LPV/r) to boosted atazanavir (ATV/r) in virologically suppressed HIV-infected patients receiving a LPV/r-containing highly active antiretroviral therapy (HAART). The randomized, open-label, noninferiority trial found balanced baseline characteristics. Moreover, the study also found that switching to ATV/r provided comparable efficacy and safety profile with improved lipid parameters.

Determines whether homeostatic mechanisms are able to compensate for mitochondrial DNA (mtDNA) depletion in patients receiving stavudine plus didanosine, an antiretroviral combination with great in vitro and in vivo capacity to decrease mtDNA. Nucleoside reverse transcriptase inhibitors; Measurement of the cytochrome C oxidase subunit II of cytochrome C oxidase; Peripheral blood mononuclear cells; DNA gamma-polymerase.