• Title/Summary/Keyword: Antiretroviral therapy

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Antiretroviral Therapy 2000

  • Samuel, Rafik;Suh, Byungse
    • Archives of Pharmacal Research
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    • v.23 no.5
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    • pp.425-437
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    • 2000
  • As we enter the new millennium, there have been dramatic improvements in the care of patients with HIV infection. These have prolonged life and decreased morbidity and mortality. There are fourteen currently available antiretrovirals approved in the United States for the treatment of this infection. The medications, including their pharmacokinetic properties, side effects, and dosing are reviewed. In addition, the current approach to the use of these medicines is discussed.

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Ten years of experience in the prevention of mother-to-child human immunodeficiency virus transmission in a university teaching hospital

  • Park, Jung-Weon;Yang, Tae-Whan;Kim, Yun-Kyung;Choi, Byung-Min;Kim, Hai-Joong;Park, Dae-Won
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.117-124
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    • 2014
  • Purpose: Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment. Methods: This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed. Results: Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of $325{\mu}L$ ($92-729{\mu}L$). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%). Conclusion: This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.

Adherence to antiretroviral therapy and associated factors among HIV-positive adolescents in Sub-Saharan Africa: a systematic review

  • Gebre Gelana Gudisa;Sangeun Jun
    • Journal of Korean Biological Nursing Science
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    • v.25 no.4
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    • pp.266-275
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    • 2023
  • Purpose: Although long-term viral suppression and antiretroviral therapy (ART) success depend on sustained adherence, adolescents' adherence rates are suboptimal. Optimal adherence is influenced by various factors. Since Sub-Saharan Africa is home to over 80% of adolescents living with human immunodeficiency virus (HIV) and considering their unique characteristics and susceptibility to poor adherence, it is crucial to provide updated knowledge on adherence rates and their determinants among this population. This review aims to present up-to-date data on adherence rates and associated factors among HIV-positive adolescents in Sub-Saharan Africa. Methods: A systematic review was conducted following the PRISMA guidelines. The PubMed and Scopus databases were used to identify documents corresponding to the study's objectives. Eleven studies were included in this review after being selected from among all studies that were found online from 2017 to 2023. Results: The reported adherence rates ranged from 55% to 86%. In total, 32 factors were found to be related to adherence among HIV-positive adolescents in Sub-Saharan Africa. These included 12 adherence-facilitating factors and 20 adherence-inhibiting factors. The most often mentioned factors affecting adherence were advanced World Health Organization clinical stage (i.e., stage IV), ART dose and regimens, a lack of support, and violence victimization. Conclusion: Our findings can help healthcare providers collaborate with HIV-positive adolescents to improve ART adherence and ensure the best possible health outcomes.

Highly Active Antiretroviral Therapy Alters Sperm Parameters and Testicular Antioxidant Status in Diet-Induced Obese Rats

  • Oyeyipo, Ibukun P.;Skosana, Bongekile T.;Everson, Frans P.;Strijdom, Hans;du Plessis, Stefan S.
    • Toxicological Research
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    • v.34 no.1
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    • pp.41-48
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    • 2018
  • The efficacy of highly active antiretroviral therapy (HAART) has led to an increase demand for therapeutic use, thereby necessitating investigation into drug toxicity. This study was designed to investigate the in vivo effects of HAART on sperm parameters and testicular oxidative stress in lean and obese rats. Wistar rats (males, n = 40, weighing 180~200 g) were assigned randomly into 4 groups and treated accordingly for 16 weeks as follows: Control (C): lean group fed with standard rat chow; Diet induced obesity (DIO): obese animals fed a high caloric diet; C + ART: lean animals treated with HAART; DIO + ART: obese animals treated with HAART. An antiretroviral drug combination of Tenofovir, Emtricitabine and Efavirenz at a dose of 17, 26 and 50 mg/kg/day was administered for the latter 6 weeks via jelly cube feeding. At the end of the experimental period, sperm analysis was performed on sperm collected from the caudal epididymis, while the testis was homogenized for antioxidant enzyme and lipid peroxidation assays. Results showed that HAART significantly decreased sperm motility (p < 0.05) in both lean and obese animals, and viability (p < 0.05) in the DIO group. Testicular glutathione, catalase and superoxide dismutase were significantly decreased (p < 0.05), while Thiobarbituric acid reactive substances (TBARS) levels were significantly increased (p < 0.05) when the DIO+ART group was compared to Control group. Thus, the decreased sperm qualities associated with HAART might be as a result of increased testicular oxidative stress prominent in obese animals.

Frequent Genetic Defects in the HIV-1 5'LTR/gag Gene in Hemophiliacs Treated with Korean Red Ginseng: Decreased Detection of Genetic Defects by Highly Active Antiretroviral Therapy

  • Cho, Young-Keol;Jung, You-Sun;Sung, Heung-Sup;Joo, Chul-Hyun
    • Journal of Ginseng Research
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    • v.35 no.4
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    • pp.413-420
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    • 2011
  • We investigated whether Korean red ginseng (KRG) and highly active antiretroviral therapy (HAART) affect the frequency of gross deletion in 5'LTR/gag in 20 hemophiliacs. This study is a prospective study in 20 hemophiliacs who were infected with Korean subclade B of HIV-1 from two cash-paid plasma donors in 1990. Over a 13-year period, we obtained 436 amplicons of 5'LTR/gag genes by nested polymerase chain reaction using 147 peripheral blood mononuclear cells. Of the 436 amplicons, 92 (21.1%) showed gross deletion in 5'LTR/gag. Despite of a 2.3-fold higher monthly dose of KRG intake, the frequency of gross deletion in 5'LTR/gag (16.4%) was significantly decreased during HAART compared with 28.1% prior to HAART (p<0.01). Gross deletion in 5'LTR/gag was 10% more detected on KRG-therapy than prior to KRG-therapy (p<0.05). In addition, we also obtained 28 amplicons containing premature stop codon or isoleucine at initiation codon of 254 amplicons sequenced on KRG intake (7.5%) or HAART (13.6%) compared with 0% before KRG intake. These findings indicate that high frequency of gross deletion in 5'LTR/gag and genetic defects prior to HAART are significantly associated with KRG intake and the detection of gross deletion in 5'LTR/gag is decreased by HAART.

Factors Associated with Renal Dysfunction, Including Highly Active Antiretroviral Therapy in Korean HIV-Infected Patients (HIV 감염 환자에서 고활성 항레트로바이러스 요법을 포함한 신기능 장애 위험인자 연구)

  • Yeo, Jee-Young;Shin, Hyoung-Shik;Chin, Bum-Sik;Lee, Yu-Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.95-102
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    • 2012
  • HIV 치료를 위한 강력한 항바이러스 약물요법이 널리 사용됨에 따라 HIV에 감염된 상태에서 신장질환 발생 위험성을 지닌 채 오랜 기간 생존하는 환자들이 증가하고 있다. 본 연구는 국립중앙의료원 감염병 센터를 내원한 만18세 이상의 HIV 감염 환자를 대상으로 HIV 감염 환자에게 신기능 장애를 유발하는 위험인자를 평가하고자 환자군 대조군 연구를 후향적으로 실시하였다. 2006년 1월부터 2011년 3월까지 5년 3개월 동안 신기능이 저하된 모든 HIV 감염 환자를 환자군으로 하며, 정상 신기능을 가진 HIV 감염 환자들 중 대조군을 무작위로 선정하여 환자군과 대조군을 1:2의 비율로 하였다. 환자군과 대조군을 비교해 만성신질환을 유발하는 위험인자를 평가하기 위한 분석변수로 성별, 연령, CD4+ 세포수, 혈중 바이러스 수, HAART 56일 이상 여부, 당뇨병과 C형 간염을 선정하였다. 또한 추가적으로 개별 antiretroviral 약물들 사용과 신기능이 얼마나 관련되어 있는지 알아보기 위해 각각의 약물과 eGFR의 상관관계를 분석하였다. 환자군은 CD4+ 세포수가 < $200{\times}10^6$ cells/l 인 군이 7.7배(OR: 7.7; 95% CI, 1.8-32.9) 단백뇨가 있는 환자의 경우 7.8배(OR: 7.8; 95% CI, 1.6-37.8) 더 유의하게 만성신질환 발생위험이 높았다. 개별 antiretroviral 약물들과 eGFR의 상관관계를 분석한 결과, lamivudine 이 eGFR 과 약한 음적 상관관계를 보이는 것으로 나타났으며(r = -.211, p < .05), 다른 약물들의 경우 통계적으로 유의한 값을 보이지 않았다. 이번 환자군-대조군 연구는 HIV 감염 환자들이 만성 신질환으로 발전하는데 여러 인자들의 역할에 대해 평가하고자 하였다. 여러 변수들을 평가해 본 결과, 만성 신질환 환자들의 경우 CD4+ 세포수가 < $200{\times}10^6$ cells/l 이거나 단백뇨를 동반한 경우가 통계적으로 유의하게 많았다.

Metabolic Complications Associated with HIV and Highly Active Antiretroviral Therapy : Overview & A Clinical Case Report (HIV와 HAART 요법과 관련된 대사합병증: 개요 및 임상증례보고)

  • Choi, Eun Joo;Graham, Kathleen K.
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.274-282
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    • 2012
  • 현재 HIV(human immunodeficiency virus) 감염에 대하여 보다 많은 효과적인 약물치료법이 가능하다. Highly active antiretroviral therapy (HAART)로 언급되는 이 치료법은 항 HIV치료제의 다양한 병용법으로 구성된다. 그러나, 최근에 이렇게 치료된 환자들에게 중요한 독성들(toxicities)로서 빈번하게 상당한 지질이상과 혈중당의 항상성 조절장애와 연관된 몸의 지방 분포 비정상으로서 나타나는, 광범위한 대사성 합병증(metabolic complications)이 출현해왔다. 이러한 합병증의 관리는 표준적인 치료 중재(interventions)와 연관하여 지질과 당 대사와 관련된 항 HIV치료제의 특성 있는 효과를 이해하면서, 항 HIV 약물들을 조절하는 것을 포함한다. 본 증례는 항HIV 약물요법과정에서 나타난 상당한 지질 이상, 매우 높은 LDL 수치와 높은 TG수치에 따르는 후속 약물요법을 보여주며, 개별화된 항 HIV 약물요법을 수행하면서, 대사성 합병증에 관련된 수치의 검사와 주기적인 약물치료과정의 모니터링을 권하여 HIV에 감염된 환자들의 효과적인 치료를 향상시키기 위한 것이다.

Antiretroviral Therapy 2006: Pharmacology, Applications, and Special Situations

  • Samuel, Rafik;Bettiker, Robert;Suh, Byung-Se
    • Archives of Pharmacal Research
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    • v.29 no.6
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    • pp.431-458
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    • 2006
  • As we approach the completion of the first 25 years of the human immunodeficiency virus(HIV) epidemic, there have been dramatic improvements in the care of patients with HIV infection. These have prolonged life and decreased morbidity. There are twenty currently available antiretrovirals approved in the United States for the treatment of this infection. The medications, including their pharmacokinetic properties, side effects, and dosing are reviewed. In addition, the current approach to the use of these medicines is discussed. We have included a section addressing common comorbid conditions including hepatitis B and C along with tuberculosis.

Recent Data Search for Acupuncture and Moxibustion Therapy on Acquired Immune Deficiency Syndrome(AIDS) (AIDS 침구(鍼灸) 치료(治療)에 대한 최근 정보 검색)

  • Song, Ho-Sueb;Lim, Jeong-Eun;Kwon, Soon-Jung;Lee, Seong-No;Hwang, Hyeon-Seo;Kim, Kee-Hyun
    • Journal of Acupuncture Research
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    • v.18 no.3
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    • pp.154-170
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    • 2001
  • Objective : To broaden understanding about acupuncture and moxibustion therapy on AIDS and to promote base studies and clinical trials Materials and Methods : Analysis was given to more than 30 literatures including acupuncture and moxibustion therapy on AIDS-related sites explored by internet search engine named NAVER from Nov., 2000 to Feb. 20th, 2001 Results : 1. Acupuncture and moxibustion played great role as a complementary therapy in enabling AIDS patients to keep their antiretroviral therapy by enhancing immune system, ameliorating AIDS-related symptoms and side effect of antiretroviral drug 2. Acupuncture and moxibustion therapy had a broad spectrum indication from systemic or local signs of AIDS patients to signs of antiretroviral drug-related side effect 3. Contraindication of acupuncture and moxibustion therapy against AIDS patients include abstraction and moxibustion on the skin lesion, because of their easy exposure to inflammation 4. AIDS patients were regarded as the state of KI-HE(氣虛), EUM-HE(陰虛), YEOL-DOK(熱毒) in general 5. BO-KI(補氣), BO-HYUL(補血), BO-EUM(補陰), CHEONG-YEOL-HAE-DOK(淸熱解毒) were shown as a principle of acupuncture and moxibustion therapy for AIDS patients 6. Principle of selecting acupoints for AIDS patients had characteristics of enhancing immune system, detoxicating detrimental agents and relieving each AIDS related symptom appropriately 7. Acupuncture on 合谷(HAPKOK, LI4), 內關(NAE-GWAN, P6), 足三里(CHOK-SAMNI, S36) were applied to the early stage of AIDS in order to enhance immune system. Acupuncture on 血海(HYOLHAE, SP10), 三陰交(SAMUMGYO, SP6), (KOHWANG, B43) were applied to the intermediate stage of AIDS so as to enhance immune system and eliminate YEOL-DOK(熱毒) in blood. Moxibustion on 湧泉(YONGCHON, K1), 足三里(CHOK-SAMNI, S36) were applied to the late stage owing to enhance immune system more. Conclusion : The efficacy of acupuncture and moxibustion therapy on AIDS has been acknowledged to the world, moreover, it is proved to be significant as a complementary therapy on AIDS patients. Thus, more control group studies of the efficacy of acupuncture and moxibustion therapy on AIDS and clinical trials are considered to be necessary.

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