Abstract:
OBJECTIVES:To evaluate whether fuzzy operators can be usefully applied to the interpretation of genotypic HIV-1 drug resistance by experts, and to improve the prediction of salvage therapy outcome by adapting interpretation rules of genotypic resistance on the basis of their association with virological response data. METHODS:We used a clinical dataset of 231 patients failing highly active antiretroviral therapy (HAART) and starting salvage therapy with baseline resistance genotyping and virological outcomes after 3 and 6 months. A set of rules predicting genotypic resistance was initially derived from an expert (ADL). Rules were implemented using a fuzzy logic approach and the virological outcomes dataset used for the training phase. The resulting algorithm was validated using a separate set of 184 selected patients by correlating the resulting predicted activity with observed virological response at 3 months. For comparison, the expert systems from the drug resistance group of the Agence Nationale de Recherches sur le SIDA (ANRS-AC11) and the algorithm from the Stanford's HIV drug resistance database (Stanford HIVdb) were evaluated on the same set. RESULTS:The starting algorithm had a correlation with virological outcomes of R2=0.06 (P=0.0001). After the training phase the correlation with virological outcomes increased to R2=0.19 (P<0.000001). In the validation set of patients, the activity of the salvage regimen predicted by the fuzzy algorithm was the only variable independently predictive of the 3-month viral load change even after adjusting by the activity predicted by the two expert systems and baseline viral load (for each 10% salvage regimen's activity increase, mean HIV RNA change from baseline: -0.27 log10 copies/ml; 95% CI -0.39, -0.15). CONCLUSION:Using fuzzy operators in a virological outcomes training database to implement a rules-based algorithm for genotypic resistance interpretation, significant improvements of outcomes prediction were obtained. The resulting algorithm showed an independent predictive capability of virological outcomes over that of two rules-based interpretation algorithms made by experts. Although the system was trained and validated on a limited number of cases, the approach deserves further evaluation.
journal_name
Antivir Therjournal_title
Antiviral therapyauthors
De Luca A,Vendittelli M,Baldini F,Di Giambenedetto S,Trotta MP,Cingolani A,Bacarelli A,Gori C,Perno CF,Antinori A,Ulivi Gsubject
Has Abstractpub_date
2004-08-01 00:00:00pages
583-93issue
4eissn
1359-6535issn
2040-2058journal_volume
9pub_type
杂志文章,多中心研究abstract::The balance of virus production and clearance for untreated patients with chronic hepatitis C virus (HCV) results in a decline of viraemia when initiating active antiviral treatment. During the first phase of interferon-alpha therapy, after a delay of about 8-9 h, the kinetics of the viral load is characterized by a r...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract::Compounds that can block the CXCR4 chemokine receptor are a promising new class of antiretroviral agents. In these experiments we studied the effect of a modified form of the native stromal cell-derived factor-1 (SDF-1), Met-SDF-1beta. The in vitro susceptibility of two different CXCR4-tropic HIV-1 strains was determi...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The H275Y neuraminidase mutation conferring oseltamivir resistance has been reported in several pandemic A/H1N1 (pH1N1) isolates. We sought to evaluate transmission of this mutant virus through the direct contact and the airborne (aerosol and droplet) routes in the ferret model. METHODS:Groups of four ferre...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP1794
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Porcine reproductive and respiratory syndrome virus (PRRSV) causes significant economic loss in the swine industry. Currently, there is no effective way to prevent PRRSV infection. Sodium tanshinone IIA sulfonate (STS), a natural compound derived from Salvia miltiorrhiza, was shown to possess anti-PRRSV acti...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2694
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Antibodies to liver-kidney microsome type 1 (anti-LKM-1), which are a marker of autoimmune hepatitis, are found in a minority of patients with chronic hepatitis C virus (HCV) infection. Whether interferon/ribavirin therapy is safe and effective in these patients is unclear. AIM:To describe the prevalence, c...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Serum HBV DNA level is crucial in the management of chronic hepatitis B (CHB); however, the assay is expensive and cannot be used widely. Therefore, we explored the possibility of hepatitis B surface antigen (HBsAg) quantification as a surrogate marker for HBV DNA level in CHB patients. METHODS:A total of 2...
journal_title:Antiviral therapy
pub_type: 杂志文章,随机对照试验
doi:10.3851/IMP1696
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To assess the tolerability, virological, immunological and clinical effects of nevirapine in the setting of a compassionate use programme in pretreated HIV-infected individuals. DESIGN:Retrospective observational cohort-study in 13 HIV-outpatient clinics in The Netherlands. METHODS: MAIN OUTCOME MEASURES:p...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract::With the advent of the human immunodeficiency virus (HIV) protease inhibitors and the non-nucleoside reverse transcriptase inhibitors, the importance of drug-drug interactions with antiretroviral agents is becoming increasingly recognized. Every clinician involved in the care of HIV-infected persons should have a broa...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
abstract::Oseltamivir phosphate is an FDA-approved treatment for influenza that has been available for prescription use in the USA since 1999. The present report describes findings from a post-marketing safety study of skin reactions associated with oseltamivir use. All patients in the claims-derived Ingenix Research Database w...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Insulin resistance (IR) was one of the first reported complications in HIV-positive patients who were receiving antiretroviral therapy (ART). However, the metabolic effects of newer fixed-dose ART combinations are unclear. METHODS:This Phase I prospective randomized open-label study evaluated the effects on...
journal_title:Antiviral therapy
pub_type: 杂志文章,随机对照试验
doi:10.3851/IMP3049
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Proton magnetic resonance spectroscopy (1H-MRS) and neuropsychological tests may be useful for monitoring the effectiveness of highly active antiretroviral therapy (HAART) in HIV-associated brain injury. We aimed to evaluate whether brain abnormalities will improve 3 months after HAART. METHOD:Thirty-three ...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Current stopping rules during pegylated interferon (peg-IFN)/ribavirin (RBV) treatment rely on week 12 HCV RNA response, but earlier identification of non-responders offers clinical and economic advantages. AIMS AND METHODS:To evaluate, among 129 HCV-genotype-1-infected, treatment-naive patients receiving p...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::The use of nucleoside reverse transcriptase inhibitors (NRTIs) for the treatment of HIV infection is clearly linked to the development of subcutaneous fat atrophy. Until recently, however, in vitro studies of adipocytes have shown no or only modest and inconsistent effects of these agents on adipocyte biology. This is...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Sexually transmitted acute hepatitis C among HIV-positive homosexual men has been noted as an emerging epidemic. METHODS:Forty-seven patients with mainly sexually acquired, acute hepatitis C were enrolled in this prospective, multicentre trial, and 36 of these patients were treated within the acute phase of...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:The tuberculosis (TB) mortality rate of registered TB patients in Malawi is 23%, and 59% of the deaths occur in the first 2 months of treatment. HIV-related complications appear to be an important cause. Starting antiretroviral therapy early during tuberculosis treatment may improve outcome but problems ofte...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:A complete virological response is closely related to the long-term outcome of patients with chronic hepatitis B and prevention of emerging HBV mutations. We aimed to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) monotherapy compared to entecavir-adefovir dipivoxil (ETV-ADV) combination therap...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3851/IMP3169
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus genotype 1B responds poorly to treatment with interferon, in contrast to the more interferon-sensitive genotypes 2 and 3. Studies on combination therapy regimens with PEG-interferon and ribavirin report sustained response rates that generally do not exceed 50%, in contrast to sustained resp...
journal_title:Antiviral therapy
pub_type: 杂志文章,meta分析
doi:
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Protease inhibitors (PI) have relatively low penetration into the genital tract, raising concerns about the potential for genital HIV RNA shedding in patients taking PI-based regimens, particularly PI monotherapy (PI-mono). METHODS:We measured HIV RNA and PI drug concentrations in samples of semen, cervico-...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP3340
更新日期:2020-01-01 00:00:00
abstract::MicroRNAs regulate gene expression by binding to the 3'-untranslated region (UTR) of target messenger RNAs (mRNAs). The importance of microRNAs has been shown for several liver diseases, for example, viral hepatitis. MicroRNA-122 is highly abundant in the liver and is involved in the regulation of lipid metabolism. Mi...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP2766
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Monocytes transmigrating to the brain play a central role in HIV neuropathology. We hypothesized that the continued existence of neurocognitive impairment (NCI) despite potent antiretroviral (ARV) therapy is mediated by the inability of such therapy to control this monocyte/macrophage reservoir. METHODS:Cro...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2411
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Single-drug class regimens with nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) are generally not recommended as initial therapy because they are inferior compared with therapy with two NRTIs plus efavirenz. However, triple-NRTI combinations can be useful in specific circumstances such as in t...
journal_title:Antiviral therapy
pub_type: 杂志文章,meta分析,评审
doi:10.3851/IMP2726
更新日期:2014-01-01 00:00:00
abstract::In order to study the inhibitory effect of various reverse transcriptase inhibitors (RTIs) on cell-free HIV, we adapted a recently described in vitro system, based on co-cultures of dendritic cells and resting CD4 T cells, modelling early target cells during sexual transmission. The compounds tested included the secon...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:The tendency for haemorrhagic stroke in patients with chronic HCV infection has emerged recently but the finding may be confounded by comorbidities. Proving the causality between HCV infection and haemorrhagic stroke is mandatory. Our study was designed to investigate the incidence of intracranial haemorrhag...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP3172
更新日期:2018-01-01 00:00:00
abstract::There are many potential reasons for increased liver-related mortality in HIV-hepatitis B virus (HBV) coinfection compared with either infection alone. HIV infects multiple cells in the liver and might potentially alter the life cycle of HBV, although evidence to date is limited. Unique mutations in HBV have been defi...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Little is known about non-adherence to HBV therapy. This study aimed to investigate the relationship between self-reported missed days of antiviral therapy and HBV virological breakthrough and factors associated with virological breakthrough. METHODS:A cross-sectional survey of 211 HBV patients receiving or...
journal_title:Antiviral therapy
pub_type: 杂志文章,多中心研究
doi:10.3851/IMP3087
更新日期:2017-01-01 00:00:00
abstract::Although zidovudine (ZDV) is effective in HIV-1-infected patients, the duration of its efficacy may be short when treatment is started in advanced HIV disease. This pilot prospective case-control study was designed to evaluate the combination of ZDV plus didanosine [ddI] compared with ZDV monotherapy as an initial the...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Human papillomavirus (HPV) infections are a major human health problem; they are the cause of recurrent benign warts and of several cancers of the anogenital tract and head and neck region. Although there are two prophylactic HPV vaccines that could, if used universally, prevent as many as two-thirds of HPV-induced ca...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP2612
更新日期:2013-01-01 00:00:00
abstract::The prevention of mother-to-child transmission of HIV-1 during breastfeeding is a major concern in resource-poor settings where alternatives to breast milk may be unaffordable, unsafe and limited by social stigma. The use of triple-drug antiretroviral regimens initiated during pregnancy and continued throughout breast...
journal_title:Antiviral therapy
pub_type: 评论,杂志文章
doi:10.3851/IMP2314
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Despite successful suppression of HIV-1 with HAART, some patients do not have robust immunological recovery. Chronic inflammation from persistent immune activation could contribute to this poor response, resulting in HIV-1 disease progression and the development of some non-HIV-1 comorbidities. METHODS:We c...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2350
更新日期:2012-01-01 00:00:00
abstract::Chronic infection with HBV or HCV can lead to the development of hepatocellular carcinoma (HCC). The major risk factors for HBV-related HCC are persistent presence of hepatitis B e antigen (HBeAg) and/or high serum HBV DNA levels, and cirrhosis. The major risk factor for HCV-related HCC is cirrhosis. One randomized do...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP1895
更新日期:2011-01-01 00:00:00