Home About us Contact
|
Home About us Contact | ||
|
|
||
HIV Treatment (hiv + treatment)
Selected AbstractsMethadone maintenance therapy promotes initiation of antiretroviral therapy among injection drug usersADDICTION, Issue 5 2010Sasha Uhlmann ABSTRACT Aims Despite proven benefits of antiretroviral therapy (ART), many human immunodeficiency virus (HIV)-infected injection drug users (IDU) do not access treatment even in settings with free health care. We examined whether methadone maintenance therapy (MMT) increased initiation and adherence to ART among an IDU population with free health care. Design We examined prospectively a cohort of opioid-using antiretroviral-naive HIV-infected IDU and investigated factors associated with initiation of antiretroviral therapy as well as subsequent adherence. Factors associated independently with time to first initiation of antiretroviral therapy were modelled using Cox proportional hazards regression. Findings Between May 1996 and April 2008, 231 antiretroviral-naive HIV-infected opioid-using IDU were enrolled, among whom 152 (65.8%) initiated ART, for an incidence density of 30.5 [95% confidence interval (CI): 25.9,35.6] per 100 person-years. After adjustment for time-updated clinical characteristics and other potential confounders, use of MMT was associated independently with more rapid uptake of antiretroviral therapy [relative hazard = 1.62 (95% CI: 1.15,2.28); P = 0.006]. Those prescribed methadone also had higher rates of ART adherence after first antiretroviral initiation [odds ratio = 1.49 (95% CI: 1.07,2.08); P = 0.019]. Conclusion These results demonstrate that MMT contributes to more rapid initiation and subsequent adherence to ART among opioid-using HIV-infected IDU. Addressing international barriers to the use and availability of methadone may increase dramatically uptake of HIV treatment among this population. [source] Boosted protease inhibitors as a therapeutic option in the treatment of HIV-infected childrenHIV MEDICINE, Issue 9 2009JT Ramos Objective Paediatric HIV treatment must address various special considerations. Administration of pharmacokinetically enhanced protease inhibitors (PIs) can improve paediatric therapeutic outcomes. The objective of this study was to review the use of boosted PI regimens in children. Methods Systematic literature searches of published manuscripts and conference databases using generic drug names and specific keywords were performed to ensure thorough and balanced reporting of available data. Results Boosted PI regimens offer multiple options across a range of ages and are efficacious in naïve and experienced children; safety and tolerability are similar to those observed in adults. Novel boosted PI simplification approaches may foster adherence and diminish resistance. Conclusions Boosted PIs are key components of first- and second-line treatments in children. Identifying factors associated with the response to highly active antiretroviral therapy in children may ultimately permit individualized therapies. [source] Adherence to HIV treatment: results from a 1-year follow-up studyHIV MEDICINE, Issue 1 2002M Martini Summary We evaluated adherence to HIV treatments every 4 months during one year in 63 HIV-infected subjects using combination therapies including a protease inhibitor. A total of 18 subjects reported a high level of adherence, 14 in two evaluations, and eight a low level of adherence in all the three evaluations. The remaining 23 subjects (36.5%) reported different levels of adherence to treatment in the three evaluations. These findings suggest that the level of adherence to treatment changes markedly for each patient over time. [source] The chemokine system and CCR5 antagonists: potential in HIV treatment and other novel therapiesJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2009H. Dhami PharmD (Student) Summary Since the recognition of human acquired immune deficiency syndrome, numerous classes of pharmacologic therapeutics have been developed to manage the disease. Current therapy includes co-administration of combinations of drugs classified by their mechanism of action as ,transcriptase inhibitors', ,protease inhibitors', ,integrase inhibitors' and the more recent ,fusion inhibitors'. This review focuses on the chemokine system and the recognition of chemokine receptors as targets for anti-human immunodeficiency virus (HIV) therapy. The FDA-approved chemokine (C,C motif) receptor 5 (CCR5) antagonist maraviroc (Selzentry®) is discussed in detail, along with another compound vicriviroc, currently in clinical trials. The mechanism of action, pharmacokinetics, toxicity and current status of research on CCR5 antagonists is described. Further, potential therapeutic uses of these agents other than anti-HIV therapy are discussed. [source] Impact of beliefs about HIV treatment and peer condom norms on risky sexual behavior among gay and bisexual menJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2006John L. Peterson The association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behavior was examined in a large urban sample ( N = 454) of gay and bisexual men in the Southeast. Results partially confirmed the hypothesis that men who endorsed new HIV treatment beliefs would report lower norms for condom use and higher HIV sexual risk behaviors than men who failed to endorse HIV treatment beliefs but with casual, and not main, partners. Moreover, results confirmed the hypothesis that the association between HIV treatment beliefs and unprotected sex would be partially mediated by peer condom norms. Results suggest social interventions are needed to promote condom norms in the social context of new HIV treatments. © 2006 Wiley Periodicals, Inc. [source] Synthesis of five nevirapine metabolitesJOURNAL OF HETEROCYCLIC CHEMISTRY, Issue 2 2000Karl G. Grozinger Nevirapine (1) is a non-nucleoside reverse transcriptase inhibitor marketed for HIV treatment by Boehringer Ingelheim as Viramune® since 1996. In vitro studies of nevirapine biotransformation using human liver microsomes demonstrated the formation of five major metabolites. This paper describes the syntheses of these metabolites. [source] Oral lesions in HIV-positive dental patients , one more argument for tobacco smoking cessationORAL DISEASES, Issue 3 2007HY Sroussi Objective:, To determine the prevalence of oral lesions associated with human immunodeficiency virus (HIV) in a population of dental patients and analyze its association with psycho-social variables and biological markers. Study design:, The dental charts of 415 dental patients consecutively treated between May and July 2005 in a dedicated HIV dental clinic were reviewed. Oral soft tissue examinations, psycho-social and medical variables were extracted and recorded for each patient. Ethnicity, gender, HIV treatment, peripheral CD4 counts and tobacco usage were analyzed in correlation with oral lesions associated with HIV. Results:, Fifty-five percent of all subjects had at least one oral lesion associated with HIV, with oral candidiasis, salivary gland enlargement and oral hairy leukoplakia being the most commonly observed conditions. Gender and ethnicity did not correlate with a higher prevalence in lesions. However, tobacco smoking correlated significantly with a higher prevalence of oral lesions, independent of CD4 counts. Conclusions:, These findings suggest that oral lesions remain commonly observed morbidities among HIV-infected dental patients independent of gender and ethnicity and that tobacco usage is a major and often underestimated risk factor for those lesions. [source] The burden of silicosis, pulmonary tuberculosis and COPD among former Basotho goldminersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2008Brendan V. Girdler-Brown MBChB, FCPHM(SA) Abstract Background The burden of silicosis, pulmonary tuberculosis and COPD is described in 624 South African gold miners 18 months after cessation of work. Methods This was a prevalence study. Questionnaires were administered, and spirometry, chest radiography, tuberculosis investigations, and urine HIV antibody assays were performed. Results Attendance was 80.1% (624/779), mean age 49.4 years, and mean employment duration 25.6 years. Most subjects had had medium (26.5%) or high (65.4%) dust-exposure jobs. Current smoking rate was 35%, with ever smoking 61%. HIV antibodies were detected in the urine in 22.3%. Prevalences were: silicosis 24.6%, past tuberculosis 26%, current tuberculosis 6.2%, airflow obstruction 13.4%, and chronic productive cough 17.7%. Almost 50% of these miners had at least one of these respiratory conditions. Conclusions A heavy burden of silicosis, tuberculosis and COPD was present in this group of former goldminers. Intensification of work place dust control measures and TB and HIV prevention activities are needed on South African gold mines. In labor sending communities investment is needed in silicosis and tuberculosis surveillance as well as HIV treatment and care. Am. J. Ind. Med. 51:640,647, 2008. Published 2008 Wiley-Liss, Inc. [source] Adherence to HIV treatment: results from a 1-year follow-up studyHIV MEDICINE, Issue 1 2002M Martini Summary We evaluated adherence to HIV treatments every 4 months during one year in 63 HIV-infected subjects using combination therapies including a protease inhibitor. A total of 18 subjects reported a high level of adherence, 14 in two evaluations, and eight a low level of adherence in all the three evaluations. The remaining 23 subjects (36.5%) reported different levels of adherence to treatment in the three evaluations. These findings suggest that the level of adherence to treatment changes markedly for each patient over time. [source] Impact of beliefs about HIV treatment and peer condom norms on risky sexual behavior among gay and bisexual menJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2006John L. Peterson The association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behavior was examined in a large urban sample ( N = 454) of gay and bisexual men in the Southeast. Results partially confirmed the hypothesis that men who endorsed new HIV treatment beliefs would report lower norms for condom use and higher HIV sexual risk behaviors than men who failed to endorse HIV treatment beliefs but with casual, and not main, partners. Moreover, results confirmed the hypothesis that the association between HIV treatment beliefs and unprotected sex would be partially mediated by peer condom norms. Results suggest social interventions are needed to promote condom norms in the social context of new HIV treatments. © 2006 Wiley Periodicals, Inc. [source] Influences on HIV testing among young African-American men who have sex with men and the moderating effect of the geographic settingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2004Andrew J. Mashburn This study examined the influence of demographic characteristics, risk behaviors, knowledge, and psychosocial variables on HIV testing among a sample (n = 551) of young African-American men who have sex with men (MSM) from three cities,Atlanta (n = 241), Birmingham (n = 174), and Chicago (n = 136). Among the entire sample of young men, age, knowledge of HIV treatments, knowledge of a comfortable place for an HIV test, and social support were related positively to rates of HIV testing. Furthermore, men who had sex with both main male partner(s) and non-main male partner(s) during the past year had significantly higher rates of HIV testing than men who had non-main male partner(s) only. Geographic setting moderated the effect on HIV testing behavior. In particular, social support, peer norms about condom use, and knowledge of HIV treatments were not associated with HIV testing in Atlanta, but were associated positively with HIV testing in either Birmingham, Chicago, or both. The strongest influence on HIV testing across all three settings was knowledge of a comfortable place for an HIV test. Implications of these findings for designing interventions to increase HIV testing are discussed. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 45,60, 2004. [source] | ||||||||||