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Over Exposure to Efavirenz Plasma Concentrations among Beninese hiv Patients Treated by A 600 mg Daily Dose

Journal of Pharmacy and Pharmacology 2017年第9期5卷 628-635页

作者： Allabi Aurel Constant Kiki Mikal Zannou Marcel Onifade El-Fatai Alvarez Jean Claude Laboratoire de Pharmacologie et de Toxicologie Facultd des Sciences de la Sant~ Universit~ d'Abomey-Calavi (FSS/UAC)Cotonou 01BP188 Benin Laboratoire National des Stupefiants et de Toxicologie CBRSI Cotonou 01BP188 Benin centre de Traitement Ambulatoire des PVVIH-CNHU-HKM de Cotonou CNHU-HKM Cotonou 06BP416 Benin Service de Pharmacologic et de Toxicologic Centre Hospitalier Universitaire (CHU) Raymond Poincard Garches 92380 France

Therapeutic plasma concentrations of EFV （efavirenz） are between 1,000 ng/mL and 4,000 ng/mL. Concentrations below 1000 ng/mL are associated with higher risk of treatment failure, and concentrations above 4,000 ng/mL are associated with toxicity. The aim of the study was to appreciate EFV plasmas concentrations profile and the association between plasma levels and various characteristics in Beninese patients treated by a 600 mg standard daily-dose. Blood samples were collected and EFV plasma levels were measured by liquid chromatography coupled with mass spectrometry detection in hiv-infected patients receiving EFV in combination with other antiretroviral drugs for at least 14 days. Adverse effects occurring during treatment were collected through a questionnaire. An over-exposure to EFV among Beninese hiv patients were observed, with 46.4% of patients presenting EFV concentration above 4,000 ng/mL, although adverse effects were tolerated indicating that antiretroviral treatment is safe. The measurement of plasma concentration at the steady-state could contribute to early detection of treatment failure and adapt treatment in subjects presenting serious adverse effects within context of therapeutic drug monitoring.

关键词： hiv efavirenz plasma concentrations adverse effects Benin.

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Progress towards universal hiv testing among TB patients in Viet Nam:a retrospective cohort evaluation of TB/hiv surveillance,2011-2017

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Infectious Diseases of Poverty 2019年第2期8卷 80-86页

作者： Nguyen Binh Hoa Nguyen Viet Nhung Viet Nam National Lung Hospital National Tuberculosis Programme Viet Nam463 Hoang Hoa Tham streetBadinh DistrictHanoiViet Nam centre for Operational Research International Union Against Tuberculosis and Lung DiseaseParisFrance Hanoi Medical University HanoiViet Nam

Background:Tuberculosis(TB)and hiv remain a major causes of morbidity and mortality *** conducted an analysis of TB/hiv surveillance data to describe the trends in hiv testing coverage and hiv positivity rate among TB patients in Viet Nam,*** text:This was a descriptive study based on review and analysis of surveillance data from the National Tuberculosis Control Programme from 2011 to *** this period,721342 TB cases were *** these,520490(72.2%)had a previously documented hiv status or were tested for hiv during TB care and *** proportion of TB patients whose hiv status was reported increased,from 58.5%in 2011 to 82.9%in 2017(P value for trend=0.014).The proportion of TB patients infected with hiv decreased,from 8.0%in 2011 to 3.7%in 2017(P value for trend=0.018).Conclusions:The proportion of TB patients with a reported hiv status was increased from 2011 to 2017,however hiv testing coverage remained below the National Tuberculosis Control Programme targets(>90%).National Tuberculosis Control Programme needs to focus on ensuring eveny registered TB patients has a documented hiv status,ensuring full coverage of hiv testing as part of routine TB care.

关键词： Tuberculosis hiv Trend Viet Nam

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2次/d应用钙泊三醇软膏和1次/d短期应用地蒽酚乳膏治疗:一项按日间用药程序指导性治疗寻常型银屑病的随机对照试验

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世界核心医学期刊文摘（皮肤病学分册） 2006年第12期2卷 15-16页

作者： Van De Kerkhof P.C.M. Van Der Valk P.G.M. Swinkels O.Q.J 周少娜 Department of Dermatology Radboud University Nijmegen Medical Centre PO Box 9101 6500 HB Nijmegen Netherlands

Background: Calcipotriol has become a first-line treatment for psoriasis. Its efficacy and safety have been shown in many comparative clinical trials carried out in outpatients. In a comparative study in patients visiting the outpatient department once every 14 days, it was shown that calcipotriol was more effective and better tolerated compared with dithranol. Objectives: To compare the clinical efficacy of calcipotriol ointment with that of dithranol cream in a supervised treatment regimen. Methods: In a multicentre randomized controlled trial in six centres in the Netherlands, 106 patients with chronic plaque psoriasis were included, 54 receiving calcipotriol ointment twice daily and 52 dithranol cream once daily. Patients were treated at the day-care centre, using the care instruction principle of daily visits during the first week and twice-weekly visits subsequently for up to 12 weeks. Results: This study failed to prove that calcipotriol is as efficacious as dithranol when used in a day-care setting (noninferiority test). The mean percentage reduction in Psoriasis Area and Severity Index from baseline to end of treatment was 57.0%in the calcipotriol group vs. 63.6%in the dithranol group. However, the two-sided test for superiority indicated no statistically significant difference between the treatment groups (P = 0.39). At the end of treatment, 15%of the patients treated with calcipotriol ointment and 25%of those treated with dithranol cream did not require any further treatment. Although calcipotriol ointment appeared to be more effective during the first 8 weeks, a difference was no longer apparent at 12 weeks. In comparison with the high number of drop-outs due to cutaneous side-effects in the calcipotriol group, the frequency of a tolerable degree of irritation appeared to be higher in patients treated with dithranol. However, concomitant corticosteroid treatment of dithranol irritation in seven patients may have contributed to this difference between bot

关键词：钙泊三醇卡泊三醇地蒽酚乳膏软膏膏剂用药随机对照试验程序

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Compliance with First-Line AntiRetroViral treatment (ART) for hiv Infection in the Era of Dolutegravir in Kinshasa, Democratic Republic of the Congo

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World Journal of AIDS 2023年第1期13卷 11-17页

作者： Berry Ikolango Bongenya Marie-Thérèse Ayanne Safi Sombo Guy Makila Mabe Bumoko Benoit Obel Kabengele Mariano Manzo Lusakibanza Gauthier Kahunu Mesia Erick Ntambwe Kamangu Faculty of Medicine Bel Campus Technological University Kinshasa Democratic Republic of the Congo “hiv/AIDS Focus” Research Group Kinshasa Democratic Republic of the Congo Department of Neurology Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Internal Medicine University Clinic Faculty of Medicine University of Kinshasa Democratic Republic of the Congo Clinical Pharmacology Service Department of Pharmacovigilance Faculty of Pharmaceutical Sciences University of Kinshasa Kinshasa Democratic Republic of the Congo Service of Molecular Biochemistry Department of Basic Sciences Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo

Context: Two years after the transition to Dolutegravir (DTG), at the national level, data on compliance with the execution of this transition and the rational use of the new molecule are not available. Objective: The objective of this study was to determine compliance with first-line ART prescriptions among People Living with hiv starting AntiRetroViral treatment in Kinshasa during the Dolutegravir era. Methods: This study is a descriptive cross-sectional study to determine compliance with first-line ART prescriptions among people living with hiv during the Dolutegravir era in Kinshasa. Sixteen outpatients treatment Centers (OTCs) were included in the study for their expertise in the care of PLhiv, their technical collection platform and their accessibility. The parameters of interest were: age, sex, outpatient treatment centers, and medical prescription. Results: One hundred and nineteen (119) patients were included in this work in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients included is 39.87 ± 12.36 years with extremities of 18 to 69 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). One hundred and nineteen (119) patients were received from 16 centers in Kinshasa, according to 6 OTC for the district of Funa, 4 OTC for Tshangu and 3 OTC respectively for Lukunga and Mont-Amba. All the centers respect the new recommendations of the National Program;all patients (100%) are on the Tenofovir (TDF) + Lamivudine (3TC) + Dolutegravir (DTG) combination. Conclusion: Compliance with the prescription of DTG as a first-line ARV in the DRC is effective in the city province of Kinshasa.

关键词： ART Profile Dolutegravir Kinshasa

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Hepatitis B and Hepatitis C among Human Immunodeficiency Virus Infected Patients at a District Hospital in Mwanza, Tanzania

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World Journal of AIDS 2019年第1期9卷 1-10页

作者： Mariam M. Mirambo Benson R. Kidenya Vitus Silago Emmanuel Mkumbo Awadh Mujuni Kennedy J. Mmanga Japhet J. Mwihambi Shimba Henerico Carolyne A. Minja Stephen E. Mshana Department of Microbiology and Immunology Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania Department of Biochemistry and Molecular Biology Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania Bugando Medical centre Mwanza Tanzania

Human immunodeficiency virus (hiv), hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections have been a major public health problem. hiv patients with HBV and HCV infection are at high risk of liver diseases which is associated with increased mortality. This study aims at determining the prevalence of hepatitis B surface antigen (HBsAg), HCV antibodies and HBV antibodies (anti-HBsAg) among hiv seropositive adults attending care and treatment clinic at Sengerema district hospital in Mwanza, Tanzania. A cross-sectional hospital based study was conducted between February and March 2017 among 243 hiv adult patients at Sengerema designated district hospital, Mwanza, Tanzania. Socio-demographic and other relevant information were collected using pre-tested questionnaires. Detection of HBsAg and HCV antibodies was done by commercial rapid immunochromatographic test while the detection of anti-HBsAg was done using enzyme linked immunosorbent assay. Data were analyzed by using STATA version 13. The median age of the study participants was 43, interquartile range (IQR): 37 - 51 years. The majority 172 (70.8) of study participants were female and the majority (88%) of participants had CD4 count of greater than 200 counts/μl. The prevalence of HBsAg, HCV antibodies and anti-HBsAg were 26/243 (10.7%, 95% confidence interval [CI]: 7 - 14), 20/243 (8.2%, 95% CI: 4.7 - 11.6) and (100/243) 41.2%, 95% CI: 35 - 47, respectively. Co-infection with HCV (OR: 4.45, 95% CI: 1.51 - 13.21, P = 0.007) was independenlty found to predict HbsAg positivity. History of blood transfusion (OR: 2.34, 95% CI: 1.08 - 5.06, P = 0.028) was significantly associated with anti-HBsAg among hiv infected individuals while, the rate of anti-HBsAg was found to decrease by 2.02 IU/L in a year increase in age. About one tenth of hiv infected individuals are co-infected with HCV and HBV with more than one third being positive for anti-HBsAg. There is a paramount need to emphasize the need for regular screeni

关键词： Hepatitis B Hepatitis C hiv Sengerema Tanzania

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Praziquantel efficacy against Schistosoma mansoni among hiv-1 infected and uninfected adults living in fishing villages along Lake Victoria, Northwest Tanzania

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Infectious Diseases of Poverty 2014年第1期3卷 440-448,439页

作者： Humphrey D Mazigo David W Dunne Safari M Kinung’hi Fred Nuwaha Department of Medical Parasitology and Entomology School of MedicineCatholic University of Health and Allied SciencesP.O.Box 1464MwanzaTanzania Department of Disease Control and Environmental Health School of Public HealthCollege of Health SciencesMakerere UniversityP.O.Box 7072KampalaUganda Department of Pathology Division of Microbiology and ParasitologyCambridge UniversityTennis Court RoadCambridge CB21QPUK National Institute for Medical Research Mwanza Research CentreP.O.Box 1462 MwanzaTanzania

Background:Animal studies have demonstrated that functional immune responses,as determined by the levels of CD4+cell counts and anti-schistosome antibodies responses,determine the efficacy of *** on this evidence,it has been hypothesised that the immunodeficiency effects of the human immunodeficiency virus(hiv)-1 infection may affect the efficacy of praziquantel in co-infected human ***,the present study assessed the efficacy of praziquantel by comparing parasitological cure rates and the reduction in infection intensity in hiv-1 seronegative individuals infected with *** and hiv-1 seropositive individuals co-infected with ***,following treatment with a single oral dose of ***:This was a prospective longitudinal study which included,at baseline,555 *** infected adults aged 21-55 years,who were either co-infected or not with hiv-1 and who lived in fishing villages along Lake Victoria in Northwest *** individuals were treated with a single oral dose of praziquantel(40 mg/kg)and,at 12 weeks,single stool samples were obtained and examined for *** eggs using the Kato-Katz *** prick and venous blood samples were collected for hiv-1 screening and CD4+cell ***:The parasitological cure rate did not differ significantly from the hiv-1 serostatus(P=0.12):among the co-infected individuals,the cure rate was 48.3%(14/29),and among the individuals infected only with ***,the cure rate was 62.6%(329/526).The egg reduction rate did not vary with the hiv-1 serostatus(P=0.22):77.22%for hiv-1 seronegative and 75%for hiv-1 seropositive *** level of CD4^(+) cell counts(median 228 cells/μL:range 202-380 cells)did not influence the cure rate(P=0.23)or the reduction in the intensity of the infection(P=0.37).Conclusion:The hiv-1 infection per se or its moderate immunodeficiency effects,demonstrated by the range of CD4^(+) cell counts observed in co-infected individuals,d

关键词： hiv-1 S.mansoni Co-infection Praziquantel Efficacy Tanzania

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Pediatric hiv Infection in Togo: Situation of Child Care in the Central Region from 2008 to 2015

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World Journal of AIDS 2017年第4期7卷 260-268页

作者： F. Agbeko T. Guedehoussou K. D. Azoumah O. E. Takassi M. Fiawoo K. A. R. Segbedji O. B. Tchagbele M. Kpegouni K. Tongon K. E. Djadou D. Y. Atakouma A. D. Agbere Service de Pédiatrie CHR-Lomé Commune Lomé Togo Service de Pédiatrie CHU Kara Kara Togo Service de Pediatrie CHU-Sylvanus Olympio Lomé Togo Service de Pédiatrie Centre Des Armées Lomé Togo

This piece of work covers thirteen (13) AIDS assistance programs sites over the period 1st January 2008 to 31st December 2015. The study is retrospective, descriptive, and cross-sectional based on 292 clinical cases of hiv infected children aged between 0 and 14 years old. A regional committee was charged to validate antiretroviral treatment (ART) prescriptions on a weekly basis. We have also used data from the regional committee register. hiv infected children represent 5.1% of casework on ART. The average starting age for ART was 4.5 years (1 - 180 months) with a sex ratio (Male/Female) of 0.9. The clinical classifications according to WHO guidelines were: Stage III (52.3%) and Stage IV (20.3%). The most frequent opportunistic infections were: wasting (40.12%), digestive candida infection (29.0%), acute respiratory infections (22.8%) and skin diseases (17.9%). The hiv type 1 was detected on all of the children (100%). The average rate of CD4 at the beginning of the ART was 552.98 cells/mm3, leading to a severe immuno-suppression in many cases (44.8%). The initial ART was essentially NEVIRAPINE + LAMIVUDINE + STAVUDINE. hiv infections diagnosis are usually late in the Central Region of Togo and will therefore be improved by the UNAIDS 90-90-90 strategic plan by 2020, through various initiatives. These are: the Prevention of Mother to Child hiv Transmission (PMTCT), the Early Infection Diagnosis (EID) based on Polymerase Chain Reaction (PCR) and the Provider Initiated Testing and Counseling (PITC).

关键词： hiv AIDS ART Children Togo

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Sensitive detection of hiv-1 resistance to Zidovudine and impact on treatment outcomes in low-to middle-income countries

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Infectious Diseases of Poverty 2017年第1期6卷 1449-1461页

作者： Richard M.Gibson Gabrielle Nickel Michael Crawford Fred Kyeyune Colin Venner Immaculate Nankya Eva Nabulime Emmanuel Ndashimye Art F.Y.Poon Robert A.Salata Cissy Kityo Peter Mugyenyi Miguel E.Quinones-Mateu Eric J.Arts Department of Microbiology and Immunology University of Western Ontario1151 Richmond St.Dental Sciences Bldg.Rm 3014LondonOntario N6A 5C1Canada Division of Infectious Diseases Department of MedicineCase Western Reserve UniversityClevelandOHUSA Department of Molecular Biology and Microbiology Case Western Reserve UniversityClevelandOHUSA Department of Pathology Case Western Reserve UniversityClevelandOHUSA Center for AIDS Research Uganda Laboratories Joint Clinical Research CentreKampalaUganda Department of Pathology and Laboratory Medicine University of Western OntarioKampalaUganda TREAT Joint Clinical Research CentreKampalaUganda

Background:Thymidine analogs,namely AZT(Zidovudine or Retrovir^(TM))and d4T(Stavudine or Zerit^(TM))are antiretroviral drugs still employed in over 75%of first line combination antiretroviral therapy(cART)in Kampala,Uganda despite aversion to prescribing these drugs for cART in high income countries due in part to adverse *** this study,we explored how the continued use of these thymidine analogs in cART could impact emergence of drug resistance and impact on future treatment success in Uganda,a low-income ***:We examined the drug resistance genotypes by Sanger sequencing of 262 hiv-infected patients failing a first line combined antiretroviral treatment containing either AZT or d4T,which represents approximately 5%of the patients at the Joint Clinical Research Center receiving a AZT or d4T containing *** generation sequencing(DEEPGEN^(TM)hiv)and multiplex oligonucleotide ligation assays(AfriPOLA)were then performed on a subset of patient samples to detect low frequency drug resistant ***4 cell counts,viral RNA loads,and treatment changes were analyzed in a cohort of treatment success and ***:Over 80%of patients failing first line AZT/d4T-containing cART had predicted drug resistance to 3TC(Lamivudine)and non-nucleoside RT inhibitors(NNRTIs)in the treatment regimen but only 45%had resistance AZT/d4T associated resistance mutations(TAMs).TAMs were however detected at low frequency within the patients hiv quasispecies(1-20%)in 21 of 34 individuals who were failing first-line AZT-containing cART and lacked TAMs by *** to lack of TAMs by Sanger,AZT was typically maintained in second-line therapies and these patients had a low frequency of subsequent virologic ***:Our findings suggest that continued use of AZT and d4T in first-line treatment in low-to-middle income countries may lead to misdiagnosis of hiv-1 drug resistance and possibly enhance a succession of second-and third-line treatment failu

关键词： Antiretroviral treatment Drug resistance Uganda

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Consensus statement on human immunodeficiency virus pre-exposure prophylaxis in China

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Chinese Medical Journal 2020年第23期133卷 2840-2846页

作者： Jun-Jie Xu Xiao-Jie Huang Xin-Chao Liu Li-Ming Wang Yao-Kai Chen Hui Wang Fu-Jie Zhang Hao Wu Tai-Sheng Li Meng-Jie Han Fang Zhao Hai-Bo Ding Jun-Yi Duan Gen-Shen Sheng Hong Shang National Health Commission(NHC)Key Laboratory of AIDS Immunology(China Medical University) National Clinical Research Center for Laboratory MedicineThe First Affiliated Hospital of China Medical UniversityShenyangLiaoning 110001China Key Laboratory of AIDS Immunology Chinese Academy of Medical SciencesShenyangLiaoning 110001China Key Laboratory of AIDS Immunology of Liaoning Province ShenyangLiaoning 110001China Collaborative Innovation Center for Diagnosis and treatment of Infectious Diseases HangzhouZhejiang 310003China Center for Infectious Diseases Beijing Youan HospitalCapital Medical UniversityBeijing 100069China Department of Infection Peking Union Medical College HospitalBeijing 100730China Beijing Ditan Hospital Capital Medical UniversityBeijing 100015China Chongqing Public Health Medical Center Chongqing 400036China Department of Infectious Diseases National Clinical Center for Infectious DiseasesThird People’s Hospital of Shenzhen(Second Affiliated Hospital of Southern University of Science and Technology)ShenzhenGuangdong 518112China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and PreventionBeijing 102206China Shenzhen Rainbow 258 centre For Men ShenzhenGuangdong 518001China

Introduction Although the global human immunodeficiency virus(hiv)epidemic has been effectively curbed,preventing and managing hiv infection in high-risk populations remains challenging.[1]In China,hiv is primarily transmitted through sexual contact.[1,2]Pre-exposure prophylaxis(PrEP)is a new and effective method for preventing hiv infection using antiretroviral drugs[3];data from multiple clinical trials worldwide have shown that using antiretroviral drugs for PrEP can limit hiv transmission.[4,5,6,7]The World Health Organization(WHO)issued guidelines in 2015 recommending PrEP in populations with an hiv incidence above 3/100 person-years(PY)and in individuals engaging in high-risk behaviors.[3]According to existing studies,the hiv incidence among key populations in China was 5.6/100 PY for men who have sex with men(MSM),[8]1.6/100 PY for intravenous drug users(IDUs),[9]and 1.4/100 PY for female sex workers.[10,11]As of July 2020,54 countries and regions have issued PrEP guidelines for adults to prevent hiv infection,and 36 of these have also published guidelines for children and ***,there are no PrEP guidelines or related consensus statement in *** such,there is a strong need for standardized guidance on the implementation of PrEP pertaining to medical selection criteria,PrEP timing,drug safety,and consultation and testing *** we present the consensus statement on the implementation of PrEP in China based on the opinions and suggestions of health policy-makers,scientists,clinical experts,community-based organizations of key populations,and the latest reports in PrEP researches.

关键词： drugs statement exposure

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Survival of Antiretroviral Therapy Patients at the outpatient treatment centre of the Community University Hospital of Bangui from 2015 to 2020

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Advances in Infectious Diseases 2023年第3期13卷 389-406页

作者： Sylvain Honore Woromogo Paulette Rose Josephat Mbay Yamotende Jesse Saint Saba Antaon Derguedbé Nebardoum Hermann Ngouakam Pierre Marie Tebeu Inter-State centre for Higher Education in Public Health of Central Africa Brazzaville Republic of Congo Unit for Research and Intervention in Public Health Department of Public Health Faculty of Health Sciences Bangui Central African Republic Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with hiv in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among hiv-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the outpatient treatment centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with hiv combined with better quality of care would improve their survival.

关键词： Survival Patients Antiretroviral treatment Bangui

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