Antiretroviral Activity and Safety of Once-Daily Etravirine in Treatment-Naive HIV-Infected Adults: 48-Week Results

Floris-Moore, Michelle; Mollan, Katie R.; Wilkin, Aimee M.; Johnson, Marc A.; Kashuba, Angela D. M.; Wohl, David A.; Patterson, Kristine B.; Francis, Owen; Catherine, Kronk,; Eron, Joseph J.

doi:10.3851/imp2982

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…Etravirine (ETR) recently appeared to be clinically safe but was found to be neurotoxic in vitro [39,146]. However, Efavirenz (EFV) and nevirapine (NVP), which are FDA approved and used in NNRTI regimen [124], have been found to exert neurotoxicity [39,137,147].…”

Section: Neurotoxicity Of Antiretroviral Drugsmentioning

confidence: 99%

Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

Sánchez

Kaul

2017

Brain Sciences

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Multiple mechanisms appear to contribute to neuronal stress and injury underlying HIV-associated neurocognitive disorders (HAND), which occur despite the successful introduction of combination antiretroviral therapy (cART). Evidence is accumulating that components of cART can itself be neurotoxic upon long-term exposure. In addition, abuse of psychostimulants, such as methamphetamine (METH), seems to compromise antiretroviral therapy and aggravate HAND. However, the combined effect of virus and recreational and therapeutic drugs on the brain is still incompletely understood. However, several lines of evidence suggest a shared critical role of oxidative stress, compromised neuronal energy homeostasis and autophagy in promotion and prevention of neuronal dysfunction associated with HIV-1 infection, cART and psychostimulant use. In this review, we present a synopsis of recent work related to neuronal stress and injury induced by HIV infection, antiretrovirals (ARVs) and the highly addictive psychostimulant METH.

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Section: Neurotoxicity Of Antiretroviral Drugsmentioning

confidence: 99%

Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

Sánchez

Kaul

2017

Brain Sciences

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“…For five studies, PLWH were directly involved in intervention delivery (Enriquez et al, 2015;Gwadz et al, 2015;Simoni et al, 2007;Simoni et al, 2009;Williams et al, 2006). For the remaining two studies, research teams included community representatives and relevant bilingual workers guiding the research conduct (Floris- Moore et al, 2016;van Servellen et al, 2005).…”

Section: Appointing Staffmentioning

confidence: 99%

Do interventions to improve adherence to antiretroviral therapy recognise diversity? A systematic review

et al. 2020

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People living with HIV (PLWH) are often culturally and linguistically diverse populations; these differences are associated with differing barriers to antiretroviral therapy (ART) adherence. Cultural competence measures the extent to which trial design recognises this diversity. This systematic review aimed to determine whether adherence trial participants represent the diversity of PLWH.Randomised Controlled Trials in Organisation for Economic Co-operation and Development countries to improve ART adherence were eligible. We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews. For all included trials, we searched for their development, testing and evaluation studies. We compared trial participant characteristics with nationally reported PLWH data. We appraised trial cultural competence against ten criteria; scoring each criterion as 0, 1 or 2 indicating cultural blindness, pre-competence or competence respectively.For 80 included trials, a further 13 studies presenting development/testing/evaluation data for the included trials were identified. Only one of the 80 included studies reported trial participants representative of the country's population of PLWH. The median (IQ) cultural competence score was 2.5 (1.0, 4.0) out of 20. HIV adherence trial participants are not reflective of the population with HIV, which may be due to limited adoption of culturally competent research methods.

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Beneficial and Adverse Effects of cART Affect Neurocognitive Function in HIV-1 Infection: Balancing Viral Suppression against Neuronal Stress and Injury

Yuan

Kaul

2019

J Neuroimmune Pharmacol

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HIV-associated neurocognitive disorders (HAND) persist despite the successful introduction of combination antiretroviral therapy (cART). While insufficient concentration of certain antiretrovirals (ARV) may lead to incomplete viral suppression in the brain, many ARVs are found to cause neuropsychiatric adverse effects, indicating their penetration into the central nervous system (CNS). Several lines of evidence suggest shared critical roles of oxidative and endoplasmic reticulum stress, compromised neuronal energy homeostasis, and autophagy in the promotion of neuronal dysfunction associated with both HIV-1 infection and long-term cART or ARV use. As the lifespans of HIV patients are increased, unique challenges have surfaced. Longer lives convey prolonged exposure of the CNS to viral toxins, neurotoxic ARVs, polypharmacy with prescribed or illicit drug use, and age-related diseases. All of these factors can contribute to increased risks for the development of neuropsychiatric conditions and cognitive impairment, which can significantly impact patient well-being, cART adherence, and overall health outcome. Strategies to increase the penetration of cART into the brain to lower viral toxicity may detrimentally increase ARV neurotoxicity and neuropsychiatric adverse effects. As clinicians attempt to control peripheral viremia in an aging population of HIV-infected patients, they must navigate an increasingly complex myriad of comorbidities, pharmacogenetics, drug-drug interactions, and psychiatric and cognitive dysfunction. Here we review in comparison to the neuropathological effects of HIV-1 the available information on neuropsychiatric adverse effects and neurotoxicity of clinically used ARV and cART. It appears altogether that future cART aiming at controlling HIV-1 in the CNS and preventing HAND will require an intricate balancing act of suppressing viral replication while minimizing neurotoxicity, impairment of neurocognition, and neuropsychiatric adverse effects.

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Antiretroviral Activity and Safety of Once-Daily Etravirine in Treatment-Naive HIV-Infected Adults: 48-Week Results

Cited by 6 publications

References 26 publications

Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

Do interventions to improve adherence to antiretroviral therapy recognise diversity? A systematic review

Beneficial and Adverse Effects of cART Affect Neurocognitive Function in HIV-1 Infection: Balancing Viral Suppression against Neuronal Stress and Injury

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