Abstract:
OBJECTIVE:In patients with a chronic asymptomatic HIV-1 infection and >200 CD4+ T-cells/microl, the optimal timing of highly active antiretroviral therapy (HAART) initiation is unclear. It involves a trade-off between a potentially reduced risk of mortality, when started earlier in the course of infection, and an earlier exposure to pill burden and potential toxicities. We investigated patients' preferences for immediate HAART initiation relative to delaying HAART for 1 year. METHODS:Consecutive patients were asked for their preference during an interview. A hypothetical difference in 3-year mortality risk between both options was systematically varied between 0% and 10% to determine the threshold at which preference would switch to HAART initiation. RESULTS:About 30% of patients preferred HAART initiation even if the mortality risk would be equal for both options. Almost 25% always preferred delaying HAART even if this would result in a 10% greater mortality risk. Most treatment guidelines recommend delaying HAART >350 CD4+ T-cells/microl. However, at a risk difference between starting and delaying HAART that corresponds with this CD4+ T-cell count, about 50% would prefer to start HAART immediately. Most guidelines recommend starting HAART below 200 CD4+ T-cells/microl. However, at a risk difference between both options corresponding with this CD4+ T-cell count, about 40% preferred delaying HAART. CONCLUSIONS:We found large variation in patients' preferences. Some patients were more inclined to initiate HAART earlier than the recommended guidelines, whereas others were more inclined to delay HAART. These findings emphasize the need for shared decision-making when deciding on the most optimal timing of HAART initiation in chronic asymptomatic HIV-1 infection.
journal_name
Antivir Therjournal_title
Antiviral therapyauthors
Locadia M,van Grieken RA,Prins JM,de Vries HJ,Sprangers MA,Nieuwkerk PTsubject
Has Abstractpub_date
2006-01-01 00:00:00pages
335-41issue
3eissn
1359-6535issn
2040-2058journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Patients infected with hepatitis C virus (HCV) who respond to treatment with interferon-alpha plus ribavirin exhibit biphasic or triphasic viral load decreases. While the rapid first phase is indicative of the effectiveness of therapy in blocking viral production (epsilon), the slope of the final phase (lamb...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To evaluate, retrospectively, biochemical, serological and histological responses in chronic hepatitis B (CHB)-infected children who received combination therapy and continued with prolonged treatment with lamivudine (3TC). PATIENTS AND METHODS:CHB infection was defined as the presence of hepatitis B surface...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章
doi:
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:There is a paucity of data on the long-term efficacy of combination lamivudine and adefovir therapy in patients with lamivudine-resistant chronic hepatitis B. METHODS:We determined the cumulative virological, serological and biochemical outcomes of 165 lamivudine-resistant chronic hepatitis B patients on la...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2335
更新日期:2012-01-01 00:00:00
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:BACKGROUND/AIMS:The role of antibody in hepatitis C virus (HCV) infection remains unclear although many reports attest to its role in viral clearance. Here we describe epitopes that are recognized by antibody present in the serum of infected patients and show that such epitopes can induce neutralizing antibodies. METH...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Eczema vaccinatum is the most common severe pathology associated with smallpox vaccination (vaccinia virus), occurring at high rates among individuals with a previous history of atopic dermatitis (atopic eczema). METHODS:Monoclonal antibodies capable of neutralizing vaccinia virus, anti-H3 and anti-B5, were...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP1717
更新日期:2011-01-01 00:00:00
abstract::We assessed the prevalence and clinical impact of insertions within the HIV-1 p6Gag proline-rich (PTAP) region on initial antiretroviral therapy response in 461 HIV-infected, drug-naive individuals initiating therapy in British Columbia, Canada between June 1996 and August 1998. HIV p6Gag insertions were detected by n...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2003-04-01 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
abstract::Zidovudine treatment of human immunodeficiency virus (HIV) infection induces drug-resistant viral strains harbouring specific amino acid substitutions in the reverse transcriptase (RT). To investigate whether this phenomenon could be observed in the case of human T lymphotropic virus type I (HTLV-I) infection, we anal...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:A genome-wide association study revealed an association between variants of the inosine triphosphatase (ITPA) gene and ribavirin (RBV)-induced anaemia. The aim of this study was to replicate this finding in an independent Japanese cohort and to define a method to allow pretreatment prediction of anaemia in c...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP1796
更新日期:2011-01-01 00:00:00
abstract::Ribavirin is a guanosine analogue that has little antiviral activity when used alone, but considerably enhances the efficacy of conventional and pegylated interferon in the treatment of hepatitis C virus (HCV). The precise mode of action of ribavirin is not fully understood; however, it is crucial for the achievement ...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:
更新日期:2008-01-01 00:00:00
abstract::HBV is a hepatotropic and non-cytopathic virus that causes more than one million deaths annually from liver cirrhosis and hepatocellular carcinoma. As the virus itself is non-cytopathic, it is widely accepted that both viral control and liver pathology are mediated by the host immune system. Until recently, the focus ...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP1620
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:US guidelines recommend genotyping for persons newly diagnosed with HIV infection to identify transmitted drug resistance mutations associated with decreased susceptibility to nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors. To date, testin...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2780
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:In HIV-infected patients, therapeutic drug monitoring (TDM) of antiretroviral drugs is recommended in special populations and in specific situations to optimize therapy. Currently, TDM is performed via measurement of drug plasma concentrations; however, dried blood spots (DBS) may offer a patient friendly an...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2501
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To identify predictors of the virological response to antiretroviral therapy in patients in whom initial therapy has failed. METHODS:The Narval trial was designed to compare phenotyping, genotyping and standard of care for the choice of antiretroviral therapy in patients in whom a protease inhibitor (PI)-con...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:We examined whether waist circumference (WC) and self-reported abdominal size changes can estimate visceral adipose tissue (VAT) changes for those initiating antiretroviral therapy (ART). METHODS:Prospectively collected data from ACTG A5257 and its metabolic substudy, A5260s, were used for this analysis. AR...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP3148
更新日期:2017-01-01 00:00:00
abstract::The study was carried out to evaluate the therapeutic effects of zanamivir, a highly selective, potent and specific inhibitor of influenza A and B virus neuraminidases, in adult patients with acute influenza-like illness. Patients who presented within 36 h of the onset of influenza-like symptoms were randomly assigned...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To assess potential pharmacokinetic (PK) interactions between atazanavir (ATV, 300 mg, once daily) and lopinavir (LPV, 400 mg, twice daily), both boosted by ritonavir (RTV, 100 mg). DESIGN:Two-parallel groups, addition of LPV in patients receiving ATV (n=6), and addition of ATV in patients receiving LPV (n=...
journal_title:Antiviral therapy
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::Neurological manifestations of HCV infection appear to be under-recognized in clinical practice despite the majority of HCV-infected patients experiencing symptoms such as fatigue, depression and cognitive dysfunction. There is also growing evidence for a link between HCV infection and an increased risk of Parkinson's...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP3245
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The multidrug resistance proteins (MRPs) form a subfamily within the ATP binding cassette transporters that confer resistance to a variety of structurally unrelated compounds. MRP4 has been reported to transport antiretroviral drugs out of cells in an active process. Although the main therapeutic effects of ...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP1468
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Across sub-Saharan Africa, men who have sex with men (MSM) and transgender women (TGW) have disproportionately poor HIV treatment outcomes. Stigma and criminalization create barriers to health-care engagement and adherence to antiretroviral therapy (ART), potentially promoting the development of HIV drug res...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP3342
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The increased risk for cardiovascular disease (CVD) in HIV is well established. Despite high prevalence of viral hepatitis coinfection with HIV, there are few studies on the risk of CVD amongst antiretroviral therapy (ART)-treated coinfected patients. METHODS:Ontario HIV Treatment Network Cohort Study parti...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2724
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:We examined the prevalence of ritonavir-boosted darunavir (DRV) resistance-associated mutations (RAMs) in HIV-infected children in the UK to determine the drug's potential clinical utility as a first-line or second-line protease inhibitor (PI). METHODS:The prevalence of DRV RAMs, identified from IAS 2010 an...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:10.3851/IMP2015
更新日期:2012-01-01 00:00:00
abstract::This article describes the development of a novel sequential sampling method for the surveillance of transmitted HIV drug resistance by cross-sectional survey. Two commonly used sequential sampling methods are described and their applicability to the problem of classifying the prevalence of transmitted HIV drug resist...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Clinical utilization of genotype resistance testing is evolving. We examined the extent to which HIV care providers requesting genotype resistance tests used the information appropriately and the impact of inappropriate utilization. METHODS:Data from a prospective cohort of HIV-infected patients (the HIV Ou...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::HCV-related liver disease is an important contributor to morbidity and mortality in the HIV-infected population. Successful treatment of HIV-HCV-coinfected patients is followed by favourable clinical outcomes. While the combination of pegylated interferon and ribavirin remains the mainstay in the treatment of non-1 HC...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:10.3851/IMP2601
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To characterize 1-year virological response to antiretroviral therapy and its determinants by sex. METHODS:This is a population-based analysis of antiretroviral therapy naive HIV-positive adult men and women. Factors associated with sex and with plasma HIV RNA viral load suppression to below 500 copies/ml w...
journal_title:Antiviral therapy
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:We sought to determine whether markers of systemic inflammation are associated with the presence of moderate/severe obstructive sleep apnea (OSA) and whether this association differs based on HIV and HIV treatment status. METHODS:HIV-uninfected men (HIV-; n=60), HIV-infected men receiving HAART (HIV+/HAART;...
journal_title:Antiviral therapy
pub_type: 杂志文章,多中心研究
doi:10.3851/IMP2745
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Succinylated human serum albumin (Suc-HAS) is a negatively charged neo-glycoprotein that binds to the positively charged V3-loop of HIV-1 gp120, acting as HIV-1-fusion inhibitor in vitro (IC50: 0.5-5.0 microg/ml). Suc-HSA was safe in rats and monkeys, and showed antiretroviral effect in a human-to-mouse mode...
journal_title:Antiviral therapy
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2007-01-01 00:00:00
abstract::HIV drug resistance testing is becoming an integral part of antiretroviral drug development and of patient management. The parameters that characterize the performance of both phenotypic and genotypic assays and the validation of this performance are essential to their proper use for these applications. Several princi...
journal_title:Antiviral therapy
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-01 00:00:00