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Effect of Anti-CD4 Antibody UB-421 on HIV-1 Rebound after Treatment Interruption. Administration of a single broadly neutralizing human immunodeficiency virus (HIV)-specific antibody to HIV-infected persons leads to the development of antibody-resistant virus in the absence of antiretroviral therapy (ART). It is possible that monotherapy with UB-421, an antibody that blocks the virus-binding site on human CD4+ T cells, could induce sustained virologic suppression without induction of resistance (...) in HIV-infected persons after analytic treatment interruption.We conducted a nonrandomized, open-label, phase 2 clinical study evaluating the safety, pharmacokinetics, and antiviral activity of UB-421 monotherapy in HIV-infected persons undergoing analytic treatment interruption. All the participants had undetectable plasma viremia (<20 copies of HIV RNA per milliliter) at the screening visit. After discontinuation of ART, participants received eight intravenous infusions of UB-421, at a dose
Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. Emerging evidence suggests that risk of bacterial sexually transmitted infections (STIs) increases among gay and bisexual men following initiation of HIV preexposure prophylaxis (PrEP).To describe STI incidence and behavioral risk factors among a cohort of predominantly gay and bisexual men who use PrEP, and to explore changes in STI incidence following (...) PrEP commencement.The Pre-exposure Prophylaxis Expanded (PrEPX) Study, a multisite, open-label intervention study, was nested within the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) clinic network. A total of 4275 participants were enrolled (July 26, 2016-April 1, 2018) in Victoria, Australia. Of these, 2981 enrolled at 5 ACCESS clinics (3 primary care, 1 sexual health, and 1 community-based HIV rapid testing service), had at least 1 follow-up visit, and were
Risks and Benefits of Dolutegravir- and Efavirenz-Based Strategies for South African Women With HIV of Child-Bearing Potential: A Modeling Study. Dolutegravir is superior to efavirenz for HIV antiretroviral therapy (ART) but may be associated with an increased risk for neural tube defects (NTDs) in newborns if used by women at conception.To project clinical outcomes of ART policies for women of child-bearing potential in South Africa.Model of 3 strategies: efavirenz for all women of child (...) -bearing potential (EFV), dolutegravir for all women of child-bearing potential (DTG), or World Health Organization (WHO)-recommended efavirenz without contraception or dolutegravir with contraception (WHO approach).Published data on NTD risks (efavirenz, 0.05%; dolutegravir, 0.67% [Tsepamo study]), 48-week ART efficacy with initiation (efavirenz, 60% to 91%; dolutegravir, 96%), and age-stratified fertility rates (2 to 139 per 1000 women).3.1 million South African women with HIV (aged 15 to 49 years
Yield and Efficiency of Novel Intensified Tuberculosis Case-Finding Algorithms for People Living with HIV The recommended tuberculosis (TB) intensified case finding (ICF) algorithm for people living with HIV (symptom-based screening followed by Xpert MTB/RIF [Xpert] testing) is insufficiently sensitive and results in unnecessary Xpert testing.To evaluate whether novel ICF algorithms combining C-reactive protein (CRP)-based screening with urine Determine TB-LAM (TB-LAM), sputum Xpert (...) , and/or sputum culture could improve ICF yield and efficiency.We compared the yield and efficiency of novel ICF algorithms inclusive of point-of-care CRP-based TB screening and confirmatory testing with urine TB-LAM (if CD4 count ≤100 cells/μl), sputum Xpert, and/or a single sputum culture among consecutive people living with HIV with CD4 counts less than or equal to 350 cells/μl initiating antiretroviral therapy in Uganda.Of 1,245 people living with HIV, 203 (16%) had culture-confirmed TB including 101 (49
Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (HIV-infected children) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Elvitegravir/Cobicistat/Emtricitabin/Tenofovir- alafenamid (HIV-Infektion bei Kindern) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 12 April 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German (...) original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A18-01 Elvitegravir/cobicistat/ emtricitabine/tenofovir alafenamide (HIV-infected children) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A18-01 Version 1.0 EVG/COBI/FTC/TAF (HIV-infected children) 12 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic
Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids? Chiefs’ Inquiry Corner – March 17th, 2019 – Clinical Correlations Search Chiefs’ Inquiry Corner – March 17th, 2019 March 18, 2019 3 min read Propofol is a short-acting, intravenous sedative-hypnotic that is metabolized by the liver and excreted in the urine as conjugates of 2,6-diisopropyl-1,4 quinol. The pharmacokinetics of propofol favor its use for the induction/maintenance of anesthesia (...) with other causes of immunocompromise, especially in those with solid organ or liquid transplants, chronic steroid use, chemotherapeutics, and other immunosuppressive medications. As the use of immunosuppressive agents has increased in recent years, so has the rate of non-HIV associated Pneumocystis pneumonia (PCP). The use of steroids in HIV-infected patients with PCP has been well established, but the role of steroids in HIV-uninfected patients is much less clear. Patients with PCP who are not infected
The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities | The Ontario HIV Treatment Network The Ontario HIV Treatment Network The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities , , Questions What (...) is the impact of geographical location on implementation of HIV/STI prevention programs or interventions among LGBTQ communities? Key take-home messages The characteristics of a location, including segregation, community-level stigma, and infrastructural resources, may influence HIV service utilization and the HIV continuum of care among men who have sex with men (1). Implementation of HIV prevention interventions may be affected by whether a location is convenient, allows for anonymity, and makes one
The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV , , , Questions What is the efficacy of PEP when used for non-occupational exposure? What is the efficacy of PEP when used for occupational exposure? Are specific PEP regimens more efficacious than others (...) ? What are key factors implicated in the efficacy or inefficacy of PEP? Key take-home messages PEP initiated soon after exposure can reduce the risk of HIV seroconversion after occupational and non-occupational exposures, provided adherence to medications is sufficient (1–4). Evidence suggests that individuals prescribed tenofovir-based two- or three-drug regimens are more likely to complete a course of PEP and have lower discontinuation rates due to adverse events compared to zidovudine-based
Doravirine (Pifeltro) - for the treatment of adults infected with human immunodeficiency virus-1 (HIV-1) Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity
One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis. Tuberculosis is the leading killer of patients with human immunodeficiency virus (HIV) infection. Preventive therapy is effective, but current regimens are limited by poor implementation and low completion rates.We conducted a randomized, open-label, phase 3 noninferiority trial comparing the efficacy and safety of a 1-month regimen of daily rifapentine plus isoniazid (1-month group) with 9 months of isoniazid alone (9 (...) -month group) in HIV-infected patients who were living in areas of high tuberculosis prevalence or who had evidence of latent tuberculosis infection. The primary end point was the first diagnosis of tuberculosis or death from tuberculosis or an unknown cause. Noninferiority would be shown if the upper limit of the 95% confidence interval for the between-group difference in the number of events per 100 person-years was less than 1.25.A total of 3000 patients were enrolled and followed for a median
Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain? Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises (...) and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain.A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman
Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV Some opioids are known immunosuppressants; however, the association of prescribed opioids with clinically relevant immune-related outcomes is understudied, especially among people living with HIV.To assess the association of prescribed opioids with community-acquired pneumonia (CAP) by opioid properties and HIV status.This nested case-control study used data from patients (...) in the Veterans Aging Cohort Study (VACS) from January 1, 2000, through December 31, 2012. Participants in VACS included patients living with and without HIV who received care in Veterans Health Administration (VA) medical centers across the United States. Patients with CAP requiring hospitalization (n = 4246) were matched 1:5 with control individuals without CAP (n = 21 146) by age, sex, race/ethnicity, length of observation, and HIV status. Data were analyzed from March 15, 2017, through August 8, 2018
HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Human immunodeficiency virus; Infant; Intrapartum transmission; Pregnancy; Screening
Routine investigation and monitoring of adult HIV-1-positive individuals (2019 interim update) BHIVA guidelines on the routine investigation and monitoring of HIV-1-positive adults 1 BHIVA guidelines for the routine investigation and monitoring of adult HIV-1-positive individuals (2019 interim update) Writing Group Brian Angus (Chair) Gary Brook (Vice-chair) Funmi Awosusi, Gary Barker, Marta Boffito, Satyajit Das, Lucy Dorrell, Esther Dixon-Williams, Charlotte Hall, Bridie Howe, Sebastian (...) Kalwij, Nashaba Matin, Eleni Nastouli, Frank Post, Melinda Tenant-Flowers, Erasmus Smit, Dan Wheals BHIVA guidelines on the routine investigation and monitoring of HIV-1-positive adults 2 Table of Contents 1. Introduction 4 2. Auditable targets 5 3. Tables summarising the monitoring of patients at different stages of their HIV care 6 3.1 Baseline/initial assessment for all newly diagnosed HIV-positive patients 6 3.2 Monitoring asymptomatic patients who currently do not want ART 7 3.3 Monitoring
British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae 1 British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae (2019) Helen Fifer, John Saunders, Suneeta Soni, S Tariq Sadiq, Mark FitzGerald British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018) Suneeta Soni, Paddy Horner, Michael (...) Health and HIV (BASHH), which provided funding for the literature search. No other funding was obtained. CONFLICT OF INTEREST All authors have signed BASHH conflict of interest forms. AUTHOR AFFILIATION Helen Fifer, Consultant Microbiologist, National Infection Service, Public Health England; John Saunders, Consultant in Sexual Health, National Infection Service, Public Health England and Central and North West London NHS Foundation Trust; Suneeta Soni, Consultant in Sexual Health, Brighton & Sussex
HIV self-testing alone or with additional interventions, including financial incentives, and linkage to care or prevention among male partners of antenatal care clinic attendees in Malawi: An adaptive multi-arm, multi-stage cluster randomised trial Conventional HIV testing services have been less comprehensive in reaching men than in reaching women globally, but HIV self-testing (HIVST) appears to be an acceptable alternative. Measurement of linkage to post-test services following HIVST remains (...) HIVST kits for their partners; the second and third arms provided 2 HIVST kits along with a conditional fixed financial incentive of $3 or $10; the fourth arm provided 2 HIVST kits and a 10% chance of receiving $30 in a lottery; and the fifth arm provided 2 HIVST kits and a phone call reminder for the women's partners. The primary outcome was the proportion of male partners who were reported to have tested for HIV and linked into care or prevention within 28 days, with referral for antiretroviral
Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV , , Questions What is the cost-effectiveness of HIV post-exposure prophylaxis? What is the cost-effectiveness of HIV pre-exposure prophylaxis? What are the gaps (...) in literature? Key take-home messages Economic evaluations of health care interventions can inform resource allocation and policy development. However, interpreting and generalizing results can be challenging (1). PrEP can be cost-effective or cost-saving depending on the local context, adherence rates, and program coverage (1). Interventions that target individuals at high risk of HIV exposure may improve the cost-effectiveness of PrEP (1–3). Non-occupational PEP may be cost-effective, or even cost-saving
Single therapy an option for adults with suppressed HIV Single therapy an option for adults with suppressed HIV Discover Portal Discover Portal Single therapy an option for adults with suppressed HIV Published on 28 June 2016 doi: For adults with HIV who have achieved a low level of the HIV virus after initial treatment, further treatment with a protease inhibitor alone instead of standard triple drug therapy does not reduce future drug options. It is also cost-effective for long-term (...) management of HIV. In this large NIHR funded trial, switching to single therapy after the virus level is suppressed did not lead to treatment resistance compared to triple therapy, as earlier evidence had suggested. A return to detectable levels, called a rebound increase, was ten-fold higher on single therapy but this was managed with a change in drug regime. There was no difference between the groups in terms of quality of life, disease complications or side effects up to five years. Single therapy