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HIV Drug Therapy in the Americas 16-18 April 2015, Mexico City, Mexico.

- J Int AIDS Soc (2015)

View Article: PubMed Central - PubMed

ABSTRACT

Antiretroviral therapies have proved life-saving in HIV infection, dramatically reducing morbidity and mortality. With longer survival, morbidities and mortalities in HIV infection are increasingly similar to the morbidities and mortalities associated with ageing. In treated HIV infection, the risk of these morbidities and mortalities is linked to immune activation, inflammation and coagulation indices. And in persons with treated HIV infection, failure to restore circulating CD4 T cell numbers is associated with a greater risk of morbidities and mortalities as well as to heightened levels of inflammation and coagulation. The drivers of immune activation, inflammation and coagulation in treated HIV infection are incompletely defined and could be related to sustained low levels of viral replication in tissues, to translocation of microbial products across a damaged gut mucosa, to replication of co-pathogens such as cytomegalovirus, to increased levels of inflammatory lipids, or to homeostatic responses to lymphocytopenia that may drive expansion of CD8 T cell numbers. We present here models that link inflammation and coagulation to morbid outcomes as well as to the pathogenesis of CD4 T cell restoration failure and CD8 T cell expansion.

No MeSH data available.


E/C/F/TAF in adolescents: virologic success and CD4 recovery.
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F0001_20157: E/C/F/TAF in adolescents: virologic success and CD4 recovery.

Mentions: The trial enrolled 48 adolescents with a median age of 15 years, median weight of 52 kg, 58% female, 88% Black, 13% Asian, 67% vertically infected, 35% with HIV-1 RNA >100,000 c/ml, median CD4 count 468 cells/µl and median serum creatinine (sCr) 0.57 mg/dl. TAF, TFV, EVG, COBI and FTC PK profiles of adolescents were consistent in adults. Of 23 subjects followed to Week 24, 21 (91%) had HIV-1 RNA <50 c/ml (Figure 1). No deaths or AE-related discontinuations occurred. The most frequent AEs were nausea (23%), upper respiratory infection (21%) and diarrhoea (17%). One serious AE of visual impairment and intermediate uveitis occurred and resolved without interruption of E/C/F/TAF. The median change in sCr was +0.08 mg/dl at Week 24, consistent with cobicistat's inhibition of renal tubular Cr secretion. No renal failure or proximal renal tubulopathy occurred. From baseline to Week 24, the change in median spine BMD was +2.8% with a change in height-adjusted (HA) Z-score of +0.02 and 2/23 subjects (9%) having a decrease of ≥4%. The change in median total body less head BMD was +0.3% with a change in HA Z-score of +0.09 and no decreases of ≥4%. No fractures occurred.


HIV Drug Therapy in the Americas 16-18 April 2015, Mexico City, Mexico.

- J Int AIDS Soc (2015)

E/C/F/TAF in adolescents: virologic success and CD4 recovery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401943&req=5

F0001_20157: E/C/F/TAF in adolescents: virologic success and CD4 recovery.
Mentions: The trial enrolled 48 adolescents with a median age of 15 years, median weight of 52 kg, 58% female, 88% Black, 13% Asian, 67% vertically infected, 35% with HIV-1 RNA >100,000 c/ml, median CD4 count 468 cells/µl and median serum creatinine (sCr) 0.57 mg/dl. TAF, TFV, EVG, COBI and FTC PK profiles of adolescents were consistent in adults. Of 23 subjects followed to Week 24, 21 (91%) had HIV-1 RNA <50 c/ml (Figure 1). No deaths or AE-related discontinuations occurred. The most frequent AEs were nausea (23%), upper respiratory infection (21%) and diarrhoea (17%). One serious AE of visual impairment and intermediate uveitis occurred and resolved without interruption of E/C/F/TAF. The median change in sCr was +0.08 mg/dl at Week 24, consistent with cobicistat's inhibition of renal tubular Cr secretion. No renal failure or proximal renal tubulopathy occurred. From baseline to Week 24, the change in median spine BMD was +2.8% with a change in height-adjusted (HA) Z-score of +0.02 and 2/23 subjects (9%) having a decrease of ≥4%. The change in median total body less head BMD was +0.3% with a change in HA Z-score of +0.09 and no decreases of ≥4%. No fractures occurred.

View Article: PubMed Central - PubMed

ABSTRACT

Antiretroviral therapies have proved life-saving in HIV infection, dramatically reducing morbidity and mortality. With longer survival, morbidities and mortalities in HIV infection are increasingly similar to the morbidities and mortalities associated with ageing. In treated HIV infection, the risk of these morbidities and mortalities is linked to immune activation, inflammation and coagulation indices. And in persons with treated HIV infection, failure to restore circulating CD4 T cell numbers is associated with a greater risk of morbidities and mortalities as well as to heightened levels of inflammation and coagulation. The drivers of immune activation, inflammation and coagulation in treated HIV infection are incompletely defined and could be related to sustained low levels of viral replication in tissues, to translocation of microbial products across a damaged gut mucosa, to replication of co-pathogens such as cytomegalovirus, to increased levels of inflammatory lipids, or to homeostatic responses to lymphocytopenia that may drive expansion of CD8 T cell numbers. We present here models that link inflammation and coagulation to morbid outcomes as well as to the pathogenesis of CD4 T cell restoration failure and CD8 T cell expansion.

No MeSH data available.