The treatment of human immunodeficiency virus is under constant development. This report reviews recent advances in antiretroviral agents.
Anti-Retroviral Agents* ; HIV

The study was conducted on 32 HIV positive patients (24 males and 8 females, over 15 years old, with CD4 T-cell counts <350 cell/mm3) who were treated with antiretrovirus therapy (Videx and Zerit) at Dong Da Hospital from Nov 2002 to Oct 2003. The results showed that ARV therapy is effective. The weight, Kanofsky scores, and T CD4 counts of patients were increased significantly after 6 months of treatment. Side effects included fatigue, headache, nausea, but only on first week. Enzyme amylase was increased slightly after 6 months of treatment
Anti-HIV Agents ; Anti-Retroviral Agents ; HIV ; Therapeutics ; Pharmaceutical Preparations ; Retroviridae

Anti-Retroviral Agents ; Congresses as Topic ; HIV Infections ; drug therapy ; prevention & control ; Human Rights ; Humans ; Public Health

Anti-Retroviral Agents ; therapeutic use ; HIV Infections ; drug therapy ; Health Services Accessibility ; Humans

Acquired Immunodeficiency Syndrome ; drug therapy ; Anti-Retroviral Agents ; therapeutic use ; HIV Infections ; drug therapy ; Humans

OBJECTIVE: To determine the prevalence of otorhinolaryngologic (ENT) manifestations in people living with Human Immunodeficiency Virus (HIV) infection seen in our institutions and to determine the association of these manifestations with age, sex, CD4 count and antiretroviral treatment.

METHODS:
Study Design: Cross-sectional study

Setting: Two Tertiary Government Hospitals

Subjects: Adult patients (>19 years old) confirmed to be HIV- infected  were seen at Jose R. Reyes Memorial Medical Center and San Lazaro Hospital from February to July 2014. A data sheet regarding ENT manifestations was filled upon examination. Age, sex, CD4 count and antiretroviral treatment data were recorded. Independent samples t-test was used to determine age association with manifestations. Fischer's exact test was used to determine association of sex and manifestations. Chi-square test of independence was used to determine association of CD4 count and antiretroviral treatment with manifestations. Association was considered statistically significant if p< 0.05.

RESULTS: Three hundred one (301) patients participated with 287 males (95.3%) and 14 females (4.7%). The mean age was 31.7 ± 8. One hundred ninety seven (197 or 65.4%) had ENT manifestations. The most common areas of manifestations came from the oral cavity-oropharyngeal area (n=104, 37%), nasal cavity-nasopharyngeal area (n=73, 26%) and ear (n=43, 15%). The most frequent manifestations were cervical lymphadenopathy, aphthous stomatitis and acute rhinitis. There was no significant difference in the age (p=0.31) and sex (p=0.15) of patients with and without manifestations. However, there was a direct association of manifestations with low CD4 count (p<0.001) and inverse association with antiretroviral treatment (p=0.036).

CONCLUSION: Our findings emphasize the importance of screening for ENT manifestations, regular CD4 monitoring and enrollment to antiretroviral therapy in persons with HIV. Baseline otorhinolaryngologic examination upon HIV diagnosis and prior to initiating treatment should be followed by regular surveillance. Conversely, physicians should also be aware that patients with ENT manifestation may have HIV infection.

Human ; Male ; Female ; Adult ; HIV ; Otorhinolaryngologic Diseases ; CD4 Lymphocyte Count ; Anti-Retroviral Agents ; Stomatitis ; Rhinitis

BACKGROUNDThis study was aim to explore the characteristics of phenotypic resistance of resistant strains of HIV type-1 (HIV-1) subtype B and to compare the concordance between the phenotypic resistance and genotypic resistance.

METHODSThe genotypic resistance assay for the HIV-1 clinical isolates was performed. One isolate without resistance mutation was chosen as a drug-sensitive reference strain and seven subtype B isolates with resistance mutations were phenotypically tested. Fifty percent inhibitory concentrations (IC50) between resistant and sensitive viruses were compared. The resistance extent was determined by the folds of the increased IC50. The concordance between the phenotypic resistance and genotypic resistance was also analyzed.

RESULTSIC50 of resistant isolates were 0.0006 - 0.1300 micromol/L for zidovudine (AZT), 0.0016 - 0.0390 micromol/L for lamivudine (3TC), 0.0104 - 0.4234 micromol/L for nevirapine (NVP), and 0.0163 - 0.1142 micromol/L for indinavir (IDV), respectively. Genotypic and phenotypic resistance assays indicated that the resistant strains were intermediately and highly resistant to nucleotide analog reverse transcriptase inhibitors and non-nucleotide analog reverse transcriptase inhibitors. The phenotypic assay was consistent with the genotypic assay. For measuring the potential resistance, the genotypic assay was more sensitive than the phenotypic. In evaluating the resistance to protease inhibitors, these two assays were discrepant.

CONCLUSIONSBoth the phenotypic and genotypic assays indicate that the resistant viruses exist in HIV-infected patients in China who have received treatment. Phenotypic and genotypic assays have high concordance, and the genotypic assay could replace the phenotypic assay to predict the HIV-1 resistance.

Anti-Retroviral Agents ; pharmacology ; China ; Drug Resistance, Viral ; genetics ; HIV-1 ; drug effects ; genetics ; Humans ; Mutation ; Phenotype

OBJECTIVETo analyze the key indicators of China Comprehensive AIDS Response Program (China CARES) and the effects of this program during 2008 and 2011.

METHODSData were obtained from National AIDS Comprehensive Prevention and Control Information System. The general population HIV test rate and spouse of people living with HIV or AIDS (PLWHA) HIV test rate were chosen as the indicators for HIV testing expansion; anti-retroviral therapy (ART) coverage and PLWHA CD4 test rate during the past 6 months as the indicators for treatment expansion; femal sex worker (FSW) intervention coverage and injection drug users (IDU) intervention coverage as the Indicators for behavior intervention expansion. The Key working quality indicators of 309 program sites were calculated and the results were compared.

RESULTSDuring 2008 and 2011, for China CARES, the Median of general population HIV test rate were 1.8%, 2.5%, 3.2% and 5.5%, the Median of spouse of PLWHA HIV test rate were 80.9%, 85.7%, 91.8% and 100.0%, the Median of ART coverage were 60.0%, 66.7%, 76.1% and 92.0%, the Median of PLWHA CD4 test rate during the past 6 months were 27.7%, 45.4%, 58.6% and 75.3%, the Median of FSW intervention coverage were 43.8%, 67.8%, 73.3% and 90.9%, the Median of IDU intervention coverage were 18.2%, 24.0%, 34.0% and 72.4%. The indicators of China CARES increased steadily from 2008 to 2011 in HIV testing expansion, treatment expansion and behavior intervention expansion; Compared to 2008, the percentage of the China CARES which had great progress of the 6 indicators were 98.4% (304/309), 98.3% (286/291), 94.0% (281/299), 93.5% (288/308), 91.8% (279/304) and 90.0% (223/247). in 2008, 3 indicators which were ART coverage, PLWHA CD4 test rate during the past 6 months and FSW intervention coverage were lower than national average (6.9%, 17.9% and 30.9%), the general population HIV test rate, spouse of PLWHA HIV test rate and IDU intervention coverage were higher than national average (3.4%, 64.3% and 22.8%), with the China CARES project going on, in 2011, key indicators which were general population HIV test rate, spouse of PLWHA HIV test rate, ART coverage, PLWHA CD4 test rate during the past 6 months, FSW intervention coverage and IDU intervention coverage were all higher than national average (6.5%, 80.6%, 81.9% and 55.9%).the proportions of China CARES sites whose 6 indicators were higher than national average in 2008 were 32.7% (101/309), 60.6% (149/246), 37.4% (99/265), 61.1% (181/296), 64.0% (174/270) and 45.3% (73/161), and the proportions increase annually to 2011 were 44.0% (136/309), 89.3% (260/291), 76.6% (229/299), 77.9% (240/308), 91.4% (278/304) and 64.8% (160/247).

CONCLUSIONAn obvious achievements have been made in the areas of HIV/AIDS prevention and control among China CARES sites during 2008 and 2011 than the national average.

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; prevention & control ; Anti-Retroviral Agents ; therapeutic use ; China ; epidemiology ; Humans ; Quality Indicators, Health Care

OBJECTIVETo examine the proportion and reasons of drop-out from antiretroviral therapy (ART) among 8 367 adult HIV-infected individuals in Dehong prefecture, Yunnan province.

METHODSAll adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART.

RESULTSThe proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4% (1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as: living area, gender, age, marital status, HIV transmission route, baseline CD4⁺ T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model, drop-out from ART was significantly correlated with residential area, marital status, HIV transmission route, baseline CD4⁺ T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city, Lianghe county or Yingjiang County, being married or living with partner, HIV infection through sexual contact, with baseline CD4⁺ T cell counts ≤ 200 cells/mm³, and ART included in the initial treatment regimen etc., were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART, 704 (58.6%) were lost to follow-up, 303 (25.2%) did not adhere to treatment, 74 (6.2%) moved out the region, 64 (5.3%) were Burmese that had returned to Burma, 29 (2.4%) stopped the treatment according to doctors' advice, 18 (1.5%) were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied, according to the situation of patients.

CONCLUSIONThe proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Adult ; Anti-Retroviral Agents ; therapeutic use ; China ; HIV Infections ; drug therapy ; Humans ; Patient Dropouts ; statistics & numerical data

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus (HIV) as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressing social and psychological factors involved in the care of individuals continue to be important considerations.
Anti-Retroviral Agents ; therapeutic use ; Antiretroviral Therapy, Highly Active ; HIV ; pathogenicity ; HIV Infections ; drug therapy ; prevention & control ; transmission ; Humans