Highly Active Antiretroviral Therapy Decreases Mortality and Morbidity in Patients with Advanced HIV Disease

Murphy, Edward L.; Collier, Ann C.; Kalish, Leslie A.; Assmann, Susan F.; Para, Michael F.; Flanigan, Timothy P.; Kumar, Princy; Mintz, Letty; Wallach, Frances; Nemo, George J.

doi:10.7326/0003-4819-135-1-200107030-00005

Cited by 515 publications

(338 citation statements)

References 30 publications

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“…The following changes have been made; The introduction of Anti-Retroviral Therapy (ART) in 1997 altered the course and nature of patients infected with HIV by increasing the duration of asymptomatic infection and increasing life expectancy [2,3]. ART is a combination of medication given to those affected with the disease.…”

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confidence: 99%

Fracture management in HIV positive individuals: a systematic review

Wijesekera

Graham

Lalloo

et al. 2016

International Orthopaedics (SICOT)

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Purpose: Human immunodeficiency virus (HIV) infection could potentially play an important role in the management of fractures as they have been shown to affect fracture healing and the post-operative risk of implant sepsis.Methods: A systematic review of the relevant literature was performed on PubMed and Scopus databases. Twenty-six studies were identified, critiqued and analysed accordingly. No randomised controlled trials were identified.Results: HIV positivity was not shown to influence an individual's risk of early wound infection in operatively managed closed fractures. Thank you for your kind comments on our unique systematic review. We have responded to the reviewers and made the changes suggested. Authors' response Many thanks for your comments. The suggested references however interesting, does not seem to cater to this population of interest. The suggested first article focusses on myocardial complications in those undergoing arthroplasty. The second suggested article main emphasis is on spinal trauma and does not refer to the HIV population. Thus we have decided not to go forth inserting these references and no further actions were taken. We do think that these articles are useful and may be included in a future study.Reviewer #2: This is a nice review paper suggesting the well-known fact that there is a place in HIV patients to surgical fixation of fractures.However the authors should: 1) Explain in the "Introduction" and in the "Discussion" the meaning of ART and the new development in this mode of treatment and describe the change in morbidity and mortality in HIV patients" in the last few years and the relation of this change to their findings Authors' response Many thanks for your comments. We agree that a further explanation on ART should be included to the reader. This was included in the "Introduction." Clarification on the morbidity and mortality reduction since the introduction of ART in HIV infected patients was also included. Regarding discussing the new developments in ART, this is a whole topic in itself and beyond the scope of this review. However, we are currently finalising a similar systematic review focusing on the effect of ART on bone metabolism and fracture healing which we will submit for consideration for publication in your journal soon. Authors' action Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationThe following changes have been made; The introduction of Anti-Retroviral Therapy (ART) in 1997 altered the course and nature of patients infected with HIV by increasing the duration of asymptomatic infection and increasing life expectancy [2,3]. ART is a combination of medication given to those affected with the disease. This suppresses the viral load and improves the patient immunological status [4]. A 50% reduction in morbidity and mortality has been reported in those with a CD4 T-cell count of >500cells/mm3 and have been started on ART promptly [5,6]. However, despite near normal life expectancy, there is little evidence to...

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Section: Powered By Editorial Manager® and Produxion Manager® From Armentioning

confidence: 99%

Fracture management in HIV positive individuals: a systematic review

Wijesekera

Graham

Lalloo

et al. 2016

International Orthopaedics (SICOT)

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“…Los beneficios de la terapia antiviral pueden verse comprometidos cuando aparecen ciertos factores, como defectos de la inmunidad del huésped, alta capacidad del virus para desarrollar resistencia a los fármacos (13,(17)(18)(19)(20)(21), y pobre cumplimiento del tratamiento. A esto se suma el alto costo y el bajo acceso a los medicamentos en los países en vía de desarrollo, así como la alta toxicidad de los mismos (22,23).…”

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Patrones de prescripción de antirretrovirales en 997 pacientes colombianos

Machado

Alzate

2008

biomedica

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Introducción. El tratamiento antirretroviral de la infección por virus de inmunodeficiencia humana ha mejorado la supervivencia y la calidad de vida de los pacientes desde el advenimiento de la terapia combinada en 1996. Objetivos. Conocer el manejo farmacológico de la infección por VIH/sida. Materiales y métodos. Estudio descriptivo observacional con selección de pacientes con infección por VIH/sida, de ambos sexos, de todas las edades, en tratamiento, al menos, durante tres meses (julio a septiembre de 2006) localizados en diferentes ciudades colombianas y afiliados al Sistema General de Seguridad Social en Salud. Se diseñó una base de datos con registros sobre el consumo de medicamentos antirretrovirales, recolectados por la empresa que dispensa dichos fármacos a los pacientes de las entidades promotoras de salud. Resultados. Se estudiaron 997 pacientes con edad promedio de 37,7±13,2 años, 82,6% de hombres. Todos los pacientes recibían terapia con tres o más antirretrovirales; el orden de prescripción de medicamentos fue: inhibidores de nucleósidos de transcriptasa inversa (96,4%), inhibidores de transcriptasa inversa no nucleósidos (54,9%), inhibidores de proteasa (39,8%) y otros (0,4%), todos a dosis adecuadas. Las combinaciones más empleadas fueron: lamivudina-zidovudina-efavirenz (35%), lamivudina-zidovudina con lopinavir/ritonavir (8,4%), abacavir con lamivudina-zidovudina (5,5%), lamivudina-zidovudina con nevirapina (5,2 %) y otras 65 asociaciones diferentes (45,9%). Conclusiones. Todos los antirretrovirales se están utilizando a las dosis establecidas internacionalmente y predominan patrones de prescripción racionales para iniciar la terapia. Sin embargo, el encontrar 69 asociaciones diferentes de antirretrovirales lleva a considerar que no hay adecuados criterios para la implementación de los esquemas después del inicio del tratamiento, guiados según los datos científicos y quienes los prescriben adoptan múltiples opciones por fuera de lo recomendado a nivel mundial.Palabras clave: síndrome de inmunodeficiencia adquirida/terapia, terapia antirretroviral altamente activa, prescripción de medicamentos, Colombia. Patterns of antiretroviral drug prescripcion in 997 Colombian patientsIntroduction. Antiretroviral therapy for treatment of human immunodeficiency virus type 1 (HIV-1) infection has improved steadily since the advent of combination therapy in 1996. Objective. The pharmacological therapies of the infection by HIV/AIDS were documented in order to determine if effective treatment regimes were prescribed. Materials and methods. Pharmacological therapies of the human immunodeficiency virus infection were compared in 997 patients affiliated with the health security system, of both sexes and all ages. All had been in treatment for more than three months (July-September 2006) and were distributed in 15 Colombian cities. The data were retrieved from medication consumption files which were maintained by the institutions that had distributed medications to the selected patients. Results. The average age of...

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“…In this survey, 37.5% of the respondents reported accepting patients with a history of opportunistic infections, 25% include them only when they had particular types of infection (esophageal candidiasis) which occurred in a more distant past. However, HAART increased the survival even in patients with a history of opportunistic infections (20,24) . Thus, at present this history does not seem to be a good predictor of survival, as long as the patient is stable, considering the CD4 count and the viral load.…”

Section: Discussionmentioning

confidence: 98%

Liver transplantation in HIV-positive patients: the position of the Brazilian groups

Brandão

Mariante-Neto

2005

Arq. Gastroenterol.

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-Background -Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. Aim -To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. Methods -A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation.

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Highly Active Antiretroviral Therapy Decreases Mortality and Morbidity in Patients with Advanced HIV Disease

Abstract: The data support an independent reduction in mortality and opportunistic events attributable to HAART, even in patients with very advanced HIV disease. However, patients with CMV infection or disease may not have a reduction in new CMV events due to HAART.

Cited by 515 publications

References 30 publications

Fracture management in HIV positive individuals: a systematic review

Fracture management in HIV positive individuals: a systematic review

Patrones de prescripción de antirretrovirales en 997 pacientes colombianos

Liver transplantation in HIV-positive patients: the position of the Brazilian groups

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