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C Status (c + status)
Selected AbstractsNon-medically supervised treatment interruptions among participants in a universally accessible antiretroviral therapy programmeHIV MEDICINE, Issue 5 2010DM Moore Background We examined clinical outcomes, patient characteristics and trends over time of non-medically supervised treatment interruptions (TIs) from a free-of-charge antiretroviral therapy (ART) programme in British Columbia (BC), Canada. Methods Data from ART-naïve individuals ,18 years old who initiated triple combination highly active antiretroviral therapy (HAART) between January 2000 and June 2006 were analysed. Participants having ,3 month gap in HAART coverage were defined as having a TI. Cox proportional hazards modelling was used to examine factors associated with TIs and to examine factors associated with resumption of treatment. Results A total of 1707 participants were study eligible and 643 (37.7%) experienced TIs. TIs within 1 year of ART initiation decreased from 29% of individuals in 2000 to 19% in 2006 (P<0.001). TIs were independently associated with a history of injection drug use (IDU) (P=0.02), higher baseline CD4 cell counts (P<0.001), hepatitis C co-infection (P<0.001) and the use of nelfinavir (NFV) (P=0.04) or zidovudine (ZDV)/lamivudine (3TC) (P=0.009) in the primary HAART regimen. Male gender (P<0.001), older age (P<0.001), AIDS at baseline (P=0.008) and having a physician who had prescribed HAART to fewer patients (P=0.03) were protective against TIs. Four hundred and eighty-eight (71.9%) participants eventually restarted ART with male patients and those who developed an AIDS-defining illness prior to their TI more likely to restart therapy. Higher CD4 cell counts at the time of TI and unknown hepatitis C status were associated with a reduced likelihood of restarting ART. Conclusion Treatment interruptions were associated with younger, less ill, female and IDU participants. Most participants with interruptions eventually restarted therapy. Interruptions occurred less frequently in recent years. [source] Increased serum lipids are associated with higher CD4 lymphocyte count in HIV-infected womenHIV MEDICINE, Issue 7 2006M Floris-Moore Objective Highly active antiretroviral therapy (HAART) has been associated with dyslipidaemia; however, the roles of immune status and non-HIV-disease risk factors remain unclear. Methods A cross-sectional analysis of fasting lipids was carried out for 231 women, of whom 132 were HIV-infected and 99 were uninfected. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein B (apo B) were measured. CD4 lymphocyte count, hepatitis C status, demographics, diet, and anthropometrics were also assessed. Results A total of 132 women were HIV-infected [30 were antiretroviral-naive, 68 were on protease inhibitors (PIs), and 34 were on non-PI HAART]. HIV infection was associated with higher triglycerides, lower HDL-C, and, among obese women, higher total cholesterol and LDL-C. Non-PI and PI HAART were each independently associated with higher total cholesterol, LDL-C, and apo B, compared with being ART-naive. Among HIV-infected women, after adjustment for HAART use, women with a CD4 lymphocyte count,500 cells/,L had total cholesterol 41.8 mg/dL (P=0.002) and LDL-C 28.8 mg/dL (P=0.01) higher, on average, than women with a CD4 count <200 cells/,L. Women with a CD4 count of 200,499 cells/,L had total cholesterol 26.31 mg/dL higher, on average, than those with a CD4 count <200 cells/,L (P=0.04), although differences in LDL-C did not reach significance (15.51 mg/dL; P=0.12). A higher CD4 count was also associated with higher apo B (P<0.001). Active hepatitis C infection was associated with lower total cholesterol, LDL-C, triglycerides, and apo B. Conclusions Higher CD4 lymphocyte counts were associated with higher lipid levels, suggesting that immune competence may independently affect the dyslipidaemia seen in the HAART era. In addition, it is important that hepatitis C status be assessed in studies of dyslipidaemia in the HIV-infected population. [source] Daclizumab induction therapy in liver transplant recipients with renal insufficiencyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2010S. K. Asrani Summary Background, The role of interleukin 2 (IL-2) receptor antibodies to avoid the nephrotoxic effects of calcineurin inhibitors in the early post-liver transplant (LT) period is not well defined. Aim, To examine the use of daclizumab induction in LT recipients with renal insufficiency. Methods, Between 2002 and 2005, 62 patients (median pre-LT creatinine 2.4 mg/dL, IQR 1.9,3.7) received daclizumab induction with tacrolimus being administered when serum creatinine was <2.0 mg/dL. A concurrent comparison group (n = 221, 2002,2005) received tacrolimus-based immunosuppression without daclizumab (median pre-LT creatinine 1.1 mg/dL, IQR 0.9,1.4). A second historical comparison group (n = 103, 1995,2005) not receiving daclizumab was matched to the daclizumab patients by pre-LT serum creatinine (2.2 mg/dL, IQR 1.8,3.1). All patients received mycophenolate mofetil and steroids. Results, Serum creatinine improved in the daclizumab group (,1.0 mg/dL, IQR ,2.2 to ,0.4) and worsened in the concurrent comparison group (+0.2 mg/dL, IQR 0,0.5) from pre-LT to 4 months. However, there was no difference when daclizumab group was compared with the historical comparison group matched on pre-LT creatinine (median change: ,0.8 mg/dL vs. ,0.7 mg/dL). Daclizumab induction was not associated with improvement in renal function at 4 months (P = 0.34) after adjusting for pre-LT creatinine, age, gender, hepatitis C status and simultaneous liver kidney transplantation. Conclusion, The incremental benefit offered by induction therapy with IL-2 receptor antibodies to preserve renal function is questionable. [source] Identification of a 150 bp cis -acting element of the AtNRT2.1 promoter involved in the regulation of gene expression by the N and C status of the plantPLANT CELL & ENVIRONMENT, Issue 11 2007THOMAS GIRIN ABSTRACT The Arabidopsis thaliana AtNRT2.1 gene, which encodes a NO3 - transporter involved in high-affinity uptake by the roots, is a molecular target of several mechanisms responsible for the regulation of root NO3 - acquisition by the N status of the plant. All levels of AtNRT2.1 expression (promoter activity, transcript level, protein accumulation, transport activity) are coordinately up-regulated in the presence of NO3 - , and repressed by downstream N metabolites. Transgenic plants expressing the GUS reporter gene under the control of upstream sequences of AtNRT2.1 have been studied to identify elements targeted by these two regulatory mechanisms. A 150 bp sequence located upstream of the TATA box that is required for both stimulation by NO3 - and repression by N metabolites of the promoter has been identified. This sequence is able to confer these two regulations to a minimal promoter. Split-root experiments indicate that the stimulation of the chimaeric promoter by NO3 - occurs only at the local level, whereas its repression by N metabolites is mediated by a systemic signal spread to the whole plant. The activity of the cis -acting 150 bp element is also regulated by sucrose supply to the roots, suggesting a possible interaction between N and C signalling within this short region. Accordingly, multiple motifs potentially involved in regulations by N and/or C status are identified within this sequence by bioinformatic approaches. This is the first report of such a cis -acting element in higher plants. [source] | ||||||||||