Estudio primario
No clasificado
Este artículo está incluido en 2 Revisiones sistemáticas Revisiones sistemáticas (2 referencias)
Highly active antiretroviral therapy (HAART) has contributed to decreased mortality and morbidity associated with HIV/AIDS1, 2. Non-adherence to antiretroviral medications is associated with virological failure, clinical disease progression and mortality; therefore good adherence to HAART is a critical determinant of its success3. To maximize the likelihood of success, clinicians have increasingly considered adherence and adverse events (AEs) in their treatment decisions4, 5. Therapy simplification, including reduced pill count, is a regimen-related strategy to improve adherence6. z As a once-daily (QD) fixed dose combination, abacavir/lamivudine (ABC/3TC) has shown favorable efficacy and safety in conjunction with a variety of background therapies. The tolerability of QD dosing is mostly comparable to that of ABC and 3TC administered BID. However, at least one study noted a higher rate of hypersensitivity to abacavir (ABC HSR), including severe ABC HSR in subjects on the QD versus BID regimen7. The evaluation of safety endpoints, especially ABC HSR in a “real world” population is of particular interest, as the incidence of suspected HSR varies across studies. z The aim of the Abacavir Lamivudine Once-daily HIV Assessment (ALOHA) Study was to evaluate the short-term (12-week) safety of ABC/3TC (EPZICOM™) in antiretroviral-naïve subjects, when administered as a part of an investigator-selected HAART regimen. The study duration was based on the short window of time after initiation of ABC and 3TC during which safety endpoints associated with these drugs are known to occur. In addition to safety and tolerability, adherence, patient satisfaction and efficacy endpoints were also evaluated.
Estudio primario
No clasificado
Este artículo está incluido en 1 Revisión sistemática Revisiones sistemáticas (1 referencia)
Background: Switching a thymidine analogue to a non-thymidine analogue or changing to a nucleoside-sparing regimen has been shown to partially reverse peripheral lipoatrophy. The current study evaluated both approaches. Methods: Subjects at 15 AIDS Clinical Trial Group sites receiving thymidine analogue stavudine- or zidovudine-containing regimens with plasma HIV RNA ≤500 copies/mL and lipoatrophy were prospectively randomized to: (i) switch the thymidine analogue to abacavir; (ii) discontinue all antiretrovirals and switch to lopinavir/ritonavir plus nevirapine (LPV/r+NVP); or (iii) delay switching for 24 weeks (ClinicalTrials.gov identifier: NCT00028314). Single-slice computer tomography of mid-thigh and abdominal fat and metabolic and virological/ immunological parameters were measured at baseline and weeks 24 and 48. Results: Among the 101 patients enrolled, there were significant subcutaneous thigh fat and subcutaneous abdominal tissue (SAT) increases over time and decreases in visceral adipose tissue to total adipose tissue (
Estudio primario
No clasificado
Este artículo está incluido en 2 Revisiones sistemáticas Revisiones sistemáticas (2 referencias)
Estudio primario
No clasificado
Este artículo está incluido en 4 Revisiones sistemáticas Revisiones sistemáticas (4 referencias)
Revisión sistemática
No clasificado
Sin referencias
La mortalidad relacionada a SIDA ha sido controlada, durante la última dÚcada, gracias a la introducción de la TARV altamente activa. Sin embargo, a poco de desarrollar el primer ITRN, comenzaron a describirse múltiples efectos adversos secundarios. Estos son, con frecuencia, el principal punto de preocupación para los pacientes infectados con VIH que están en terapia antiretroviral, dado que otro problemas como son las infecciones oportunistas han pasado a ser infrecuentes y el SIDA, a comportarse como una afección crónica. Un efecto colateral típico es la toxicidad mitocondrial, la que puede expresarse como una hiperlactatemia asintomático o una acidosis láctica que amenaza la vida. Otros efectos adversos de ITRN son lipodistrofia (un complejo síndrome morfometabólico), quizás una neuropatía periférica, pancreatitis y reacción de hipersensibilidad a abacavir. Esta revisión explora la fisiopatología, aspectos clínicos y opciones terapéutica para cada uno de los principales efectos laterales de los ITRN, excepto AZT.
Estudio primario
No clasificado
Este artículo está incluido en 1 Revisión sistemática Revisiones sistemáticas (1 referencia)
Anti-HIV drug regimens have dramatically improved the rates of prevention of mother-to-child transmission (MTCT) of HIV in developed countries. However, little is known of the effectiveness of such regimens in developing countries, such as Botswana. This study will determine whether Trizivir (TZV), a single pill containing abacavir sulfate, lamivudine, and zidovudine (ABC/3TC/ZDV), or lopinavir/ritonavir (LPV/r) and lamivudine/zidovudine (3TC/ZDV) is more effective in reducing HIV-1 viral load and preventing MTCT among HIV infected pregnant women in Botswana.
Estudio primario
No clasificado
Este artículo está incluido en 1 Revisión sistemática Revisiones sistemáticas (1 referencia)
A 38-year-old Caucasian woman with uncontrolled human immunodeficiency virus (HIV) infection was treated with highly active antiretroviral therapy (HAART) consisting of zidovudine, lamivudine, and nevirapine. Because her therapeutic response was inadequate, the HAART regimen was changed to abacavir, lamivudine, and lopinavir-ritonavir. Three months after this therapy was started, the patient developed progressive and notable hair loss. Her hair became fair and thin, and her appearance deteriorated considerably. Hair loss due to HAART was diagnosed. Lopinavir-ritonavir was stopped, and efavirenz was substituted; abacavir and lamivudine were continued. After 4 weeks, her hair growth substantially improved, as evidenced by rapid growth of new hair. Her general condition also improved. No relapse was observed with the new HAART regimen, and the patient's hair loss completely reversed in 8 weeks. Alopecia is a possible adverse event in HIV-infected patients treated with protease inhibitors, particularly indinavir. Our patient's severe and generalized alopecia was temporally related to the initiation and discontinuation of lopinavir-ritonavir. On the basis of the Naranjo adverse drug reaction probability scale, the adverse reaction was considered probable. Although generalized hair loss due to lopinavir-ritonavir is rare, clinicians should be aware of this potential adverse reaction of this widely used drug. If alopecia is severe or particularly distressing to the patient, the offending drug should be discontinued, and therapy with another HIV drug should be started.
Estudio primario
No clasificado
Este artículo está incluido en 2 Revisiones sistemáticas Revisiones sistemáticas (2 referencias)
BACKGROUND. The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti-HIV drugs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. METHODS. Poisson regression models were adjusted for cardiovascular risk factors, cohort, calendar year, and use of other antiretroviral drugs and assessed the association between MI risk and cumulative (per year) or recent (current or in the past 6 months) use of antiretroviral drugs, with >30,000 person-years of exposure. RESULTS. Over 178,835 person-years, 580 patients developed MI. There were no associations between use of tenofovir, zalcitabine, zidovudine, stavudine, or lamivudine and MI risk. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir-ritonavir was associated with an increased risk of MI (relative rate [RR] per year, 1.12 and 1.13, respectively). These increased risks were attenuated slightly (RR per year, 1.08 [95% confidence interval {CI}, 1.02-1.14] and 1.09 [95% CI, 1.01-1.17], respectively) after adjustment for lipids but were not altered further after adjustment for other metabolic parameters. CONCLUSIONS. Of the drugs considered, only indinavir, lopinavir-ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI. As with any observational study, our findings must be interpreted with caution (given the potential for confounding) and in the context of the benefits that these drugs provide.
Estudio primario
No clasificado
Este artículo está incluido en 4 Revisiones sistemáticas Revisiones sistemáticas (4 referencias)