This study demonstrated the impact of first-line treatment regimens on bone. Greater increases in bone turnover and decreases in BMD were observed in subjects treated with tenofovir-emtricitabine than were observed in subjects treated with abacavir-lamivudine.

Immune activation in human immunodeficiency virus (HIV) infection is driven by microbial translocation and in HIV patients is one of the contributors to faster progression of liver disease along with increased cell apoptosis. The aim of the study was to compare microbial translocation and apoptosis markers in HIV monoinfected and HIV/hepatitis C virus (HCV) coinfected patients, depending on HIV immune status and antiretroviral treatment (ART). We analysed data for 78 HIV monoinfected and 105 HIV/HCV coinfected patients from the Rīga East University Hospital. Lipopolysaccharide (LPS), endotoxin core antibodies (EndoCAb), cytokeratin 18 (CK18) and cyto-chrome c (Cyt-c) levels were measured. No significant difference in LPS, EndoCAb, Cyt-c levels between HIV and HIV/HCV patients was found. The CK18 level was higher in the HIV/HCV group. Correlation between CD4+ cell count and EndoCAb antibodies was found in HCV positive patients. There was a significant effect of ART on markers for EndoCAb IgA and EndoCAb IgM antibodies in the HIV monoinfected group. Correlation between CD4+ cell count and EndoCAb antibodies and LPS was found in HIV/HCV patients on ART. Coinfection with HCV can lead to more pronounced response in EndoCAb antibody production and higher levels of cell apoptosis markers, despite similar LPS levels. ART has a positive effect on immune activation.

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Purpose of the study The aim of this study was to describe trends in the management of pregnancies in HIV‐infected women and their outcomes, over a 4‐year period in Latvia on an Infectology Center of Latvia (LIC) basis. Methods The study of HIV‐infected women in Latvia giving birth to one or more children between 1 Jan 2008 and 31 Dec 2011. Results We identified 199 HIV‐infected women with 210 pregnancies. Mean age was 27 years, median baseline pregnancy CD4 count was 452 cells/mm3, the baseline pregnancy plasma viral load (VL) was 53,066 copies/ml. Knowledge of HIV status before pregnancy was 60.5%, but 32.5% HIV‐positive diagnosis was confirmed during pregnancy and 7.1% after delivery. One pregnant woman's HIV disease progressed to AIDS and death. Women on antiretroviral therapy (ART) were 82.3%. Maternal monotherapy with the zidovudine (ZDV) rate was 10.4%, dual therapy with nucleoside reverse‐transcriptase inhibitor (NRTI) ‐ 2.3%, triple therapy with the protease‐inhibitor (PI) plus NRTI ‐ 87.3%. Median VL at delivery was 1349. A greater proportion of cases 91.5% had a VL <1000 copies/ml, from them 47.4% <40 copies/ml. Vaginal deliveries range was 20.8% of pregnancies and elective cesarean delivery 68.6%. Preterm delivery occurred in 12.1%. Overall mother‐to‐child transmission (MTCT) of HIV rate was 4.3%. Among the 35.5% of mothers initiating ART at 14 weeks’ gestation, MTCT was 1.4%, compared with 1.5% and 3.1% for those initiating ART at <14 weeks (n=67, 31.9%) and >24 weeks (n=32, 15.2%). Among 17.6% women, who did not receive prophylactic ART, MTCT rate was 16.2%. 7 of 9 women giving birth to an HIV‐positive child were diagnosed with HIV before pregnancy, 1 of 9 during pregnancy, 1 of 9 after delivery. From women giving birth to an HIV‐positive child 6 did not receive prophylactic ART, 1 started ART at week 14, 2 after week 14. Conclusions Women's low education, recurrent pregnancies, intravenous drug use, vaginal deliveries, not receiving and late initiation of prophylactic ART was independently (p<0.05) associated with an increased risk of MTCT. Strategies are needed to facilitate earlier identification of HIV‐ infected women (also HIV status identification twice during pregnancy). Management of pregnancies in HIV‐infected women according to the LIC guidelines, i.e. ART from week 14, intravenous ZDV during labour, elective cesarean delivery, neonatal ZDV during 6 weeks and no breastfeeding is effective to reduce risk for MTCT.

Introduction: Pegilated interferon alpha-2a 40KD (Pegasys  ) is registered in European Union, and is indicated for the treatment of HBeAg positive or HBeAg negative chronic hepatitis B in adult patients with compensated liver disease, evidence of viral replication and increased ALT. The aim of this study was to evaluate efficacy and safety of Pegasys  for Pegasys  treatment naive patients with HBeAg positive and HBeAg negative chronic hepatitis B. Materials and methods:Multicenter trial design (8 centers in the Baltic States), prospective, non-randomized, open label study. In total, 39 patients with chronic active hepatitis B were enrolled in the study. Study drug -Pegasys  180 mcg, once per week. After completion of the treatment, patients were followed up for additional 24 weeks. Neutrophils, platelets, ALT, HBV DNA, HBeAg, HBsAg, HBeAb, and HBsAb were controlled.Results: For efficacy assessment, 36 patients were analyzed. Safety analysis was performed for 39 patients. No serious adverse events and laboratory abnormalities were observed for 37 patients. Adverse events were self limited without drug ordination after stopping the study medication. Conclusions:Peg-interferon α-2a 40 KD-Pegasys  therapy for chronic hepatitis B patients is efficient and demonstrates good tolerability, minimal number of self limited side effects-only neutropenia, thrombocytopenia.