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Tiwari G, Chauhan MS, Sharma D. Estimation of Binding Sites of Efavirenz with 3EO9 Receptor: In Silico Molecular Docking and Molecular Dynamics Studies. Polycycl Aromat Compd 2021. [DOI: 10.1080/10406638.2021.1998148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Gargi Tiwari
- Department of Physics, Patna University, Patna, India
| | | | - Dipendra Sharma
- Department of Physics, DDU Gorakhpur University, Gorakhpur, India
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2
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Maria S, Yunihastuti E, Saldi SRF, Djoerban Z. Factors Affecting Virological Outcome When First-Line Antiretroviral Therapy Is Reintroduced After Unplanned Interruption. J Int Assoc Provid AIDS Care 2021; 19:2325958219899534. [PMID: 31928123 PMCID: PMC6958649 DOI: 10.1177/2325958219899534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
There is no guideline concerning choice of antiretroviral therapy (ART) for HIV-infected patients after unplanned interruption. We conducted a retrospective cohort study of HIV-infected patients reintroduced to first-line ART after having unplanned interruption for at least 1 month. Viral load was evaluated at 6 to 18 months after the reintroduction. There were 100 patients included in our study, and 55 of them achieved virological success. History of single interruption (adjusted odds ratio [aOR] 5.51%, 95% confidence interval [CI] 1.82-16.68, P = .003) and CD4 count ≥200 cell/mm3 at the time of reintroduction (aOR 4.33, 95% CI 1.14-16.39, P = .031) increased likelihood to achieve virological success.
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Affiliation(s)
- Suzy Maria
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,HIV Integrated Service, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Evy Yunihastuti
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,HIV Integrated Service, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Siti Rizny F Saldi
- Center for Clinical Epidemiology and Evidence Based Medicine (CEEBM), Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Zubairi Djoerban
- HIV Integrated Service, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Kamal S, Urata J, Cavassini M, Liu H, Kouyos R, Bugnon O, Wang W, Schneider MP. Random forest machine learning algorithm predicts virologic outcomes among HIV infected adults in Lausanne, Switzerland using electronically monitored combined antiretroviral treatment adherence. AIDS Care 2020; 33:530-536. [PMID: 32266825 DOI: 10.1080/09540121.2020.1751045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Machine Learning (ML) can improve the analysis of complex and interrelated factors that place adherent people at risk of viral rebound. Our aim was to build ML model to predict RNA viral rebound from medication adherence and clinical data. Patients were followed up at the Swiss interprofessional medication adherence program (IMAP). Sociodemographic and clinical variables were retrieved from the Swiss HIV Cohort Study (SHCS). Daily electronic medication adherence between 2008-2016 were analyzed retrospectively. Predictor variables included: RNA viral load (VL), CD4 count, duration of ART, and adherence. Random Forest, was used with 10 fold cross validation to predict the RNA class for each data observation. Classification accuracy metrics were calculated for each of the 10-fold cross validation holdout datasets. The values for each range from 0 to 1 (better accuracy). 383 HIV+ patients, 56% male, 52% white, median (Q1, Q3): age 43 (36, 50), duration of electronic monitoring of adherence 564 (200, 1333) days, CD4 count 406 (209, 533) cells/mm3, time since HIV diagnosis was 8.4 (4, 13.5) years, were included. Average model classification accuracy metrics (AUC and F1) for RNA VL were 0.6465 and 0.7772, respectively. In conclusion, combining adherence with other clinical predictors improve predictions of RNA.
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Affiliation(s)
- Susan Kamal
- Community pharmacy, School of pharmaceutical sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland.,Community pharmacy, Department of ambulatory care & community medicine, University of Lausanne, Lausanne, Switzerland.,Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,University of California Institute for Prediction Technology, University of California, Los Angeles, CA, USA
| | - John Urata
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,University of California Institute for Prediction Technology, University of California, Los Angeles, CA, USA
| | - Matthias Cavassini
- Infectious Disease Service, Lausanne university hospital, University of Lausanne, Lausanne, Switzerland
| | - Honghu Liu
- Division of Public Health and Community Dentistry, School of Dentistry, University of California, Los Angeles, CA, USA.,Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Roger Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Olivier Bugnon
- Community pharmacy, School of pharmaceutical sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland.,Community pharmacy, Department of ambulatory care & community medicine, University of Lausanne, Lausanne, Switzerland
| | - Wei Wang
- University of California Institute for Prediction Technology, University of California, Los Angeles, CA, USA.,Department of Computer Science, University of California, Los Angeles, CA, USA
| | - Marie-Paule Schneider
- Community pharmacy, School of pharmaceutical sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland.,Community pharmacy, Department of ambulatory care & community medicine, University of Lausanne, Lausanne, Switzerland
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Young I, Davis M, Flowers P, McDaid LM. Navigating HIV citizenship: identities, risks and biological citizenship in the treatment as prevention era. HEALTH, RISK & SOCIETY 2019; 21:1-16. [PMID: 31105468 PMCID: PMC6494283 DOI: 10.1080/13698575.2019.1572869] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023]
Abstract
The use of HIV Treatment as Prevention (TasP) has radically changed our understandings of HIV risk and revolutionised global HIV prevention policy to focus on the use of pharmaceuticals. Yet, there has been little engagement with the very people expected to comply with a daily pharmaceutical regime. We employ the concept of HIV citizenship to explore responses by people living with HIV in the UK to TasP. We consider how a treatment-based public health strategy has the potential to reshape identities, self-governance and forms of citizenship, domains which play a critical role not only in compliance with new TasP policies, but in how HIV prevention, serodiscordant relationships and (sexual) health are negotiated and enacted. Our findings disrupt the biomedical narrative which claims an end to HIV through scaling up access to treatment. Responses to TasP were framed through shifting negotiations of identity, linked to biomarkers, cure and managing treatment. Toxicity of drugs - and bodies - were seen as something to manage and linked to the shifting possibilities in serodiscordant environments. Finally, a sense of being healthy and responsible, including appropriate use of resources, meant conflicting relationships with if and when to start treatment. Our research highlights how HIV citizenship in the TasP era is negotiated and influenced by intersectional experiences of community, health systems, illness and treatment. Our findings show that the complexities of HIV citizenship and ongoing inequalities, and their biopolitical implications, will intimately shape the implementation and sustainability of TasP.
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Affiliation(s)
- Ingrid Young
- Centre for Biomedicine, Self and Society, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mark Davis
- School of Social Sciences, Monash University, Melbourne
| | - Paul Flowers
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lisa M. McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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5
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Sall FB, Germini D, Kovina AP, Ribrag V, Wiels J, Toure AO, Iarovaia OV, Lipinski M, Vassetzky Y. Effect of Environmental Factors on Nuclear Organization and Transformation of Human B Lymphocytes. BIOCHEMISTRY (MOSCOW) 2018; 83:402-410. [DOI: 10.1134/s0006297918040119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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6
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Sayan M, Gündüz A, Ersöz G, İnan A, Deveci A, Özgür G, Sargın F, Karagöz G, İnci A, İnan D, Ülçay A, Karaoğlan I, Kaya S, Kutlu SS, Süer K, Çağatay A, Akalın H. Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients. HIV CLINICAL TRIALS 2016; 17:109-13. [PMID: 27125365 DOI: 10.1080/15284336.2016.1153303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients. METHODS This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations. RESULT INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%). CONCLUSIONS The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
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Affiliation(s)
- M Sayan
- a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.,b Research Center of Experimental Health Sciences, University of Near East , Nicosia , Northern Cyprus
| | - A Gündüz
- c Clinic of Infectious Diseases , Sisli Etfal, Educational and Research Hospital , Istanbul , Turkey
| | - G Ersöz
- d Faculty of Medicine, Department of Infectious Diseases , University of Mersin , Mersin , Turkey
| | - A İnan
- e Clinic of Infectious Diseases , Haydarpasa Numune, Educational and Research Hospital , Istanbul , Turkey
| | - A Deveci
- f Faculty of Medicine, Department of Infectious Diseases , University of 19 Mayis , Samsun , Turkey
| | - G Özgür
- g Clinic of Infectious Diseases , Samsun Educational and Research Hospital , Samsun , Turkey
| | - F Sargın
- h Clinic of Infectious Diseases , Medeniyet University, Goztepe Educational and Research Hospital , Istanbul , Turkey
| | - G Karagöz
- i Clinic of Infectious Diseases , Umraniye Educational and Research Hospital , İstanbul , Turkey
| | - A İnci
- j Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Educational and Research Hospital , Istanbul , Turkey
| | - D İnan
- k Faculty of Medicine, Department of Infectious Diseases , University of Akdeniz , Antalya , Turkey
| | - A Ülçay
- l Clinic of Infectious Diseases , Gulhane Military Medical Academy , Istanbul , Turkey
| | - I Karaoğlan
- m Faculty of Medicine, Department of Infectious Diseases , University of Gaziantep , Gaziantep , Turkey
| | - S Kaya
- n Faculty of Medicine, Department of Infectious Disease , University of Karadeniz Technical , Trabzon , Turkey
| | - S S Kutlu
- o Faculty of Medicine, Department of Infectious Diseases , University of Pamukkale , Denizli , Turkey
| | - K Süer
- p Faculty of Medicine, Department of Infectious Diseases , University of Near East , Nicosia , Northern Cyprus
| | - A Çağatay
- q Faculty of Medicine, Department of Infectious Diseases , University of Istanbul , İstanbul , Turkey
| | - H Akalın
- r Faculty of Medicine, Department of Infectious Diseases , University of Uludag , Bursa , Turkey
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7
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Hernández Arroyo MJ, Cabrera Figueroa SE, Valverde Merino MP, Hurlé ADG. A pharmacist’s role in the individualization of treatment of HIV patients. Per Med 2016; 13:169-188. [DOI: 10.2217/pme.15.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The pharmacological treatment of HIV is complex and varies considerably among patients, as does the response of patients to therapy, requiring treatment plans that are closely tailored to individual needs. Pharmacists can take an active role in individualizing care by employing their knowledge of pharmacokinetics and pharmacogenetics and by interacting directly with patients in counseling sessions. These strategies promote the following: maintenance of plasma concentrations of antiretroviral agents within therapeutic ranges, prediction of pharmacological response of patients with certain genetic characteristics, and clinical control of HIV through the correct use of antiretroviral treatments. Together, these strategies can be used to tailor antiretroviral therapy to individual patients, thus improving treatment efficacy and safety.
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Affiliation(s)
| | - Salvador Enrique Cabrera Figueroa
- Pharmacy Institute, University Austral of Chile, Valdivia, Chile
- Pharmacy Service, University Hospital of Salamanca, Paseo de San Vicente 58, 37007 Salamanca, Spain
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Kakuda TN, Crauwels H, Opsomer M, Tomaka F, van de Casteele T, Vanveggel S, Iterbeke K, de Smedt G. Darunavir/cobicistat once daily for the treatment of HIV. Expert Rev Anti Infect Ther 2016; 13:691-704. [PMID: 25962100 DOI: 10.1586/14787210.2015.1033400] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A current focus in HIV management is improving adherence by minimizing pill burden with convenient formulations, including fixed-dose combinations (FDCs). Darunavir, a HIV protease inhibitor, co-administered with low-dose ritonavir (800/100 mg once daily), is recommended in guidelines in combination with other antiretrovirals for HIV patients with no darunavir resistance-associated mutations. Cobicistat is an alternative agent to ritonavir for boosting plasma drug levels of darunavir among other antiretrovirals. Cobicistat is a more specific cytochrome P450 3A inhibitor than ritonavir without enzyme-inducing properties. This review describes the differing effects of cobicistat and ritonavir on metabolic enzymes, which explains their differing drug-drug interactions, and summarizes some of the studied drug-drug interactions for cobicistat. It also outlines the clinical development and data for a once-daily darunavir/cobicistat FDC. This FDC thus allows for a once-daily treatment regimen (including background antiretrovirals) with reduced pill burden.
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Grewal R, Cucuianu A, Swanepoel C, Dima D, Petrushev B, Pop B, Berindan-Neagoe I, Abayomi EA, Tomuleasa C. The role of microRNAs in the pathogenesis of HIV-related lymphomas. Crit Rev Clin Lab Sci 2015. [PMID: 26218036 DOI: 10.3109/10408363.2015.1030063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The incidence of HIV-related lymphomas (HRLs) is increased by 60-100 times in patients with HIV. When compared to the general population, patients with HRLs often present with extranodal lymphoid proliferation, most frequently of the gastrointestinal tract, central nervous system, liver and bone marrow. MicroRNAs (miRs) are non-coding double-stranded RNA molecules of 18-25 nucleotides that regulate post-translational gene expression by inhibiting translation or promoting degradation of messenger RNA complementary sequences. Before their discovery, tumorigenesis was thought to have been caused by the alteration of protein-coding oncogenes and tumor-suppressor genes, but once identified in B-cell chronic lymphocytic leukemia, miRs function as either oncogenes or tumor-suppressor genes was confirmed in different types of malignancies. Since miRs are clearly involved in tumorigenesis in many cancers, their role in HRLs is now receiving attention. A few studies have been conducted thus far in some HRLs on the involvement of miR in the pathogenesis of lymphoid malignancies. Since B-cell lymphomas arise from various stages of B-cell development in both HIV-infected and HIV-naïve patients, investigators have tried to determine the different miR signatures in B-cell development. As classic immunohistochemistry staining is sometimes not enough for the differential diagnosis of HRLs, in the present review, we have described the potential use of miRs in the prognosis and diagnosis of these diseases.
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Affiliation(s)
- Ravnit Grewal
- a Division of Hematopathology , Tygerberg Academic Hospital , Tygerberg , South Africa
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Cory TJ, Midde NM, Rao P, Kumar S. Investigational reverse transcriptase inhibitors for the treatment of HIV. Expert Opin Investig Drugs 2015; 24:1219-28. [PMID: 26088266 DOI: 10.1517/13543784.2015.1058357] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION While considerable advances have been made in the development of antiretroviral agents, there is still work to be done. Reverse transcriptase inhibitors are important drugs for the treatment of HIV, and considerable research is currently ongoing to develop new agents and to modify currently existing agents. AREAS COVERED Herein, the authors discuss both investigational nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), including agents that are in various stages of development. They also discuss novel formulations that are being investigated for currently available drugs, and discuss the advantages that these new formulations may provide. EXPERT OPINION New formulations and co-formulations of currently existing antiretrovirals will represent an important area of development, as a means to improve adherence for HIV-positive individuals. New formulations will continue to be developed, with a focus on allowing for less-frequent administration, as well increasing drug concentrations at local sites such as vaginal tissue, rectal tissue and sites in the immune system.
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Affiliation(s)
- Theodore J Cory
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy , 881 Madison Avenue, Memphis, TN 38163 , USA +1 901 448 7216 ; +1 901 448 1741 ;
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Keogh P, Dodds C. Pharmaceutical HIV prevention technologies in the UK: six domains for social science research. AIDS Care 2015; 27:796-803. [PMID: 25559236 PMCID: PMC4732466 DOI: 10.1080/09540121.2014.989484] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 11/12/2014] [Indexed: 11/13/2022]
Abstract
The development of pharmaceutical HIV prevention technologies (PPTs) over the last five years has generated intense interest from a range of stakeholders. There are concerns that these clinical and pharmaceutical interventions are proceeding with insufficient input of the social sciences. Hence key questions around implementation and evaluation remain unexplored whilst biomedical HIV prevention remains insufficiently critiqued or theorised from sociological as well as other social science perspectives. This paper presents the results of an expert symposium held in the UK to explore and build consensus on the role of the social sciences in researching and evaluating PPTs in this context. The symposium brought together UK social scientists from a variety of backgrounds. A position paper was produced and distributed in advance of the symposium and revised in the light this consultation phase. These exchanges and the emerging structure of this paper formed the basis for symposium panel presentations and break-out sessions. Recordings of all sessions were used to further refine the document which was also redrafted in light of ongoing comments from symposium participants. Six domains of enquiry for the social sciences were identified and discussed: self, identity and personal narrative; intimacy, risk and sex; communities, resistance and activism; systems, structures and institutions; economic considerations and analyses; and evaluation and outcomes. These are discussed in depth alongside overarching consensus points for social science research in this area as it moves forward.
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Affiliation(s)
- Peter Keogh
- School of Health and Social Care, University of Greenwich, London, UK
| | - Catherine Dodds
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
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Flanagan S, Crawford-Jones A, Orkin C. Simeprevir for the treatment of hepatitis C and HIV/hepatitis C co-infection. Expert Rev Clin Pharmacol 2014; 7:691-704. [PMID: 25209158 DOI: 10.1586/17512433.2014.956091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Hepatitis C virus (HCV) is a major cause of chronic hepatitis in 170 million people worldwide and can progress to fibrosis, cirrhosis, liver failure and hepatocellular carcinoma, a disease process accelerated in HIV co-infection. Approximately 25% of HIV infected people are co-infected with HCV (worldwide prevalence 4-5 million) and up to 16.7% of deaths in this population are attributable to HCV co-infection. Previous treatment options for HCV were limited to pegylated interferon and ribavirin (PEG-IFN/RBV), a combination that demonstrated lower successful cure rates in genotype 1 HCV mono-infection and HIV/HCV co-infection, and is also associated with a considerable adverse side-effect profile. The development of directly acting antivirals (DAAs) offers the first class of drug to achieve good viral suppression in previously hard-to-treat patient groups. We review the benefits, tolerability and drug interactions with concomitant drugs of the DAA simeprevir for patients who have HCV mono-infection and hep C/HIV co-infection.
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Affiliation(s)
- Stuart Flanagan
- Department of Infection and Immunology, Royal London Hospital, Whitechapel Road, London E1 1BB
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