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Updated HHS Adult and Adolescent Antiretroviral Treatment Guidelines Released

The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents announces the release of the updated Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Key updates to the guidelines include additions and changes to the following guideline sections: What to Start: Significant changes to the list of Recommended, Alternative, and Other regimens for treatment-naive patients prompted by recent findings from clinical trials and cohort studies, as well as experience in clinical practice. Addition of a new table to assist clinicians in selecting an initial ARV regimen based on specific clinical scenarios and ARV-related considerations. Management of the Treatment-Experienced Patient: Expanded information on the management of patients failing first and second ART regimens, and new information about isolated CNS virologic failure and new onset neurologic symptoms. A new section to highlight information on poor CD4 cell recovery and persistent inflammation and the increased risk of morbidity. Drug Interactions: A new table outlining the mechanisms of interaction of ARV drugs. Updates to all drug-drug interaction tables, particularly to those related to ritonavir- or cobicistat-boosted ARV drugs. In addition, the Acute/Early HIV Infection, HIV-2 Infection, and HIV/Hepatitis C Virus (HCV) Coinfection sections have been updated to reflect the most recent information relevant to each section. For a complete preview...

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Conclusions: Machine-learning techniques could be useful in exploring patterns of care. Among Medicare disabled HCV patients, the receipt of more QC indicators was associated with higher treatment rates. Future research is needed to assess determinants of differential QC receipt.
Source: Medical Care - Category: Health Management Tags: Online Articles: Applied Methods Source Type: research
Conclusion: PCSK9 polymorphism may affect HIV pathogenesis, particularly in HIV/HCV coinfected women. A likely mechanism for this effect is PCSK9-mediated regulation of cholesterol metabolism. Replication in independent cohorts is needed to clarify the generalizability of the observed associations.
Source: AIDS - Category: Infectious Diseases Tags: Clinical Science Source Type: research
Conclusion: The increased rate of all-cause and liver-related mortality among hepatitis-coinfected individuals in this HIV-positive cohort highlights the need for primary prevention and access to effective hepatitis treatment for HIV-positive individuals.
Source: AIDS - Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research
CONCLUSION: While treatment uptake has increased with the availability of second-generation DAAs, marginalized populations, already engaged in care, are still failing to access treatment. Targeted strategies to address barriers are needed to avoid further health inequities and to maximize the public health impact of DAAs. PMID: 29116684 [PubMed - in process]
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
AIDS Research and Human Retroviruses , Vol. 0, No. 0.
Source: AIDS Research and Human Retroviruses - Category: Infectious Diseases Authors: Source Type: research
ConclusionsIn this SOF‐experienced NS5A inhibitor‐naïve population, which included participants with cirrhosis or HCV/HIV co‐infection, high SVR12 rates were achieved.This article is protected by copyright. All rights reserved.
Source: Liver International - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
AbstractFood insecurity (FI) is associated with depressive symptoms among HIV mono-infected people. Our objective was to examine to what extent this association holds among HIV –hepatitis C virus (HCV) co-infected people. We used data from a prospective cohort study of HIV–HCV co-infected people in Canada. FI was measured using the ten-item adult scale of Health Canada’s Household Food Security Survey Module and was classified into three categories: food secure, mode rate FI, and severe FI. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10) and was cla...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research
The National Institute on Drug Abuse has awarded $5 million to researchers at UCLA to develop a resource and data center for millions of pieces of research, lab samples, statistics and other data aimed at boosting research into the effects of substance abuse on HIV/AIDS.The five-year grant, called Collaborating Consortium of Cohorts Producing NIDA Opportunities, will connect groups of investigators with National Institute on Drug Abuse-funded research and data ranging from state-of-the-art bioinformatics to laboratory specimens, said Pamina Gorbach, professor of epidemiology at the UCLA Fielding School of Public Health and...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Conclusions Our study suggests that HCVcAg testing in serum is an excellent alternative to HCV polymerase chain reaction in Africa. Although HCVcAg detection and quantification in DBS has a reduced sensitivity, its specificity and accuracy are good and it could therefore be used for scaling up HCV testing and care in resource-limited African settings. PMID: 28953324 [PubMed - in process]
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
Abstract BACKGROUND: Clinicians are incorporating patient-reported outcomes in the management of HIV-infected persons co-infected with hepatitis C virus (HCV), but there are no validated inventories to monitor symptoms of patients during HCV therapy. DESIGN: Five-year retrospective cohort analysis of persons living with HIV (PLWH) treated for HCV. METHODS: The HCV symptom-inventory (HCV-SI) was administered before, during, and after HCV treatment. Discriminant validity was assessed, separately, in mixed model linear regression of HCV-SI T-scores on treatment regimens (pegylated-interferon and ribavirin; ...
Source: AIDS Research and Therapy - Category: Infectious Diseases Authors: Tags: AIDS Res Ther Source Type: research
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