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Background: Renally adjusted lamivudine dosages are effective. However, some of the kidney failure patients managed with lamivudine-containing regimens are failing to suppress HIV in peritoneal dialysis (CAPD) effluent. The steady-state lamivudine pharmacokinetics among these patients was evaluated. Methods: This overnight open-label pharmacokinetic study enrolled participants living with HIV and managed with CAPD. Lamivudine levels in blood serum and CAPD effluent samples were quantified using liquid chromatography coupled with a mass spectrometer. Pharmacokinetic measures were obtained through non-compartmental analysis. Results: Twenty-eight participants were recruited with a median antiretroviral (ARV) drug duration of 8 (IQR,4.5–10.5) years and a CAPD duration of 13.3 (IQR,3.3–31.9) months. 14.3% (4/28) had detectable unsuppressed HIV-1 viral load in CAPD effluents. The majority (78,6%,22/28) of participants received a 50 mg dose, while 10.7% (3/28), and another 10.7% (3/28) received 75 mg and 300 mg dosages, respectively. Among those treated with 75 and 300 mg, 66.7% (2/3) and 33.3% (1/3) had detectable HIV-VL in CAPD, respectively. The peritoneal membrane characteristics and CAPD system strengths were variable across the entire study population. Lamivudine exposure was increased in blood serum (50 mg-AUC0-24 h, 651.3 ng/mL; 75 mg-AUC0-24 h, 677.84 ng/mL; 300 mg-AUC0-24 h, 3135.89 ng/mL) compared to CAPD effluents (50 mg-AUC0-24 h, 384.91 ng/mL; 75 mg-AUC0-24 h, 383.24 ng/mL; 300 mg-AUC0-24 h, 2001.60 ng/mL) among the entire study population. The Cmax (50 mg, 41.5 ng/mL; 75 mg, 53.2 ng/mL; 300 mg, 199.1 ng/mL) and Cmin (50 mg, 17.8 ng/mL; 75 mg, 16.4 ng/mL; 300 mg, 76.4 ng/mL) measured in serum were within the therapeutic levels. Conclusions: Steady-state lamivudine pharmacokinetic measures were variable among the entire study population. However, the total lamivudine exposure was within the therapeutic levels. Key Learning Points: What was known: steady-state lamivudine pharmacokinetics in persons living with HIV (PLHIV) and managed with peritoneal dialysis (PD). This study adds: HIV-1 shedding into CAPD effluents is not necessarily contributed by reduced lamivudine dosages pharmacokinetics. Potential impact: Renally adjusted lamivudine dosages are effective even in patients shedding HIV-1 into CAPD effluents. [ABSTRACT FROM AUTHOR]

HIV drug resistance mutations (HIVDRMs) are important determinants of therapeutic effects and outcomes even in end‐stage kidney failure (ESKF) people living with HIV (PLWHIV). This study evaluated the prevalence of HIVDRMs and their effect on the shedding of HIV‐1 into peritoneal dialysis (PD) effluents. This cross‐sectional study of PLWHIV and having ESKF and managed with antiretroviral therapy (ART) and PD, collected enrolled patients' demographic information, clinical and laboratory data, and sequenced HIV‐1 RNA in unsuppressed plasma and PD effluent samples. HIV viral load and HIVDRMs were determined using qualitative polymerase chain reaction (qPCR) and Stanford University HIVDRM Database, respectively. There were 60 participants recruited with a median age of 43.0 (interquartile range [IQR], 38.0–47) years and were predominantly on abacavir (88.3%), lamivudine (98.3%), and efavirenz (70%) for a median duration of 8 (IQR, 5–11) years. Among participants with detectable HIV‐1 in PD effluents, the prevalence of HIVDRMs was 62.5% (5/8) compared to 7.7% (4/52) among those with undetectable HIV‐1 (p = 0.001) with non‐nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations predominating. On Spearman's correlation analysis, high plasma HIV levels (ρ = 0.649, p < 0.001), T‐cell CD4 count (ρ = −0370, p < 0.004), serum creatinine (ρ = −0.396, p < 0.002), and white blood cell count (ρ = −0.294, p < 0.023) levels were significant factors correlated with the detection of HIV‐1 in PD effluents. Moreover, HIVDRMs presence (ρ = 0.504, p < 0.001) particularly NNRTI resistance (ρ = 0.504, p < 0.001) were also significantly correlated with detection of HIV‐1 in PD effluents. The presence of HIVDRMs, high plasma HIV viral load, and T‐cell CD4 count were correlated with HIV‐1 shedding into PD effluents. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Limitations Conclusion We aimed to document the treatment outcomes of African patients treated with low‐intensity electrodesiccation for DPN's. Other treatment options for DPN's include snip excision, light curettage, cryotherapy, and lasers devices such as PDL, Nd: YAG, KTP, and CO2, which are generally unsafe for darker skin types and come with high costs.Nonprobability convenience sampling of patient records was used to extract retrospective data on demographics and treatment outcomes according to the inclusion criteria. The retrospective data analysis included chi‐squared tests for associations, Kaplan–Meier survival analysis, and logistic regression analysis to examine relationships between dependent and independent variables.A total of 137 patients were included in the study, with the majority being female (n = 129; 94.16%) compared with their male counterparts (n = 8; 5.84%). Most patients were under 40 years of age (n = 74; 54.00%), whereas the remaining were above 40 years of age (n = 63; 46.00%). The majority of patients had Fitzpatrick skin type V (n = 99; 72.26%). Adverse events such as milia (n = 4) and scarring (n = 2) were observed, but these were not associated with age, sex, or survival rate (p value > 0.05).The study was conducted at a single center, which limits the ability to generalize the results.The low‐intensity electrodesiccation technique was found to be a safe and cost‐effective method for treating DPN's in African patients. [ABSTRACT FROM AUTHOR]

Background: Nevus of Hori (HN) has been primarily reported in patients of Eastern Asian descent, with a paucity of data regarding HN occurring in African patients. In this study, we report on South African patients with HN initially thought to have melasma., Objective: To characterize the histopathological and clinical phenotypes of HN in African patients., Methods: Retrospective data were collected from patients who met the inclusion criteria. These data entailed the clinical distribution, demographic data, Fitzpatrick skin phototype, and histopathologic features of African patients diagnosed with HN from a single private aesthetic center in Bloemfontein, South Africa., Results: Thirty patients with an average age of 49 ± 7.37 were included in this analysis. The majority of patients were female ( n = 29; 96.67%), and most patients were of Fitzpatrick skin phototype V ( n = 22; 73.3%). The most common clinical distribution pattern was bitemporal (76.7%), followed by the zygomatic pattern (20%), mixed type (16.7%), and finally the central forehead pattern (3.3%). Histopathologically, the dendritic cell type of melanocytes was observed in the majority of patients ( n = 25; 83.3%), while spindle-shaped cells were observed in few patients ( n = 7; 23.33%), and none of the patients had bipolar-type melanocytes., Limitations: This study has limitations inherent to small sample size and its inability to accurately generalize the findings., Conclusion: HN can clinically mimic melasma in African patients. The most common clinical presentation was bitemporal. To our knowledge, this study is the largest regarding the clinicopathological profile of HN in African patients and it is likely to be the first to report these compelling findings., Competing Interests: None., (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Women’s Dermatologic Society.)