Impact of highly active antiretroviral therapy on organ‐specific manifestations of HIV‐1 infection

Torre, Donato; Speranza, Filippo; Martegani, Roberto

doi:10.1111/j.1468-1293.2005.00268.x

Cited by 44 publications

(31 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Neste estudo, os inibidores de proteases foram usados em 57,3% dos esquemas de tratamento. Apesar disso, até o momento ainda não se obteve redução signifi cativa dos casos de câncer de colo uterino desde a introdução da HAART em 1996 [26][27][28][29] . Outro ponto que precisa ser mencionado é que a resposta imunológica é muito complexa, e não deve ser avaliada apenas pela contagem de linfócitos T CD4+, já que se observa diminuição dos macrófagos, neutrófi los, células natural killer e até da expressão do interferon gama neste grupo de pacientes 30 .…”

Section: Descrição Da Lesãounclassified

Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Zimmermmann¹,

Melo²,

Castro³

et al. 2006

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

RESUMOObjetivo: avaliar a associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical em pacientes HIV positivas. Métodos: estudo transversal no qual foram incluídas 87 pacientes infectadas pelo HIV, confi rmado por testes sorológicos prévios. Todas eram portadoras do HPV cervical, diagnosticado por meio da reação em cadeia da polimerase. Foram realizados anamnese, exame físico e colposcopia de todas em pacientes. A biópsia do colo uterino foi realizada quando indicada pelo exame colposcópico. Os resultados histopatológicos foram classifi cados com neoplasia intra-epitelial de baixo grau (NIC I) ou de alto grau (NIC II e II). A associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão foi verifi cada por meio da comparação de médias utilizando a análise da variância (ANOVA). Resultados: entre as 60 pacientes biopsiadas foram encontrados 24 casos (40,0%) com NIC I, oito (13,3%) NIC II, três (5%) NIC III, 14 (23,3%) pacientes somente com cervicite crônica e 11 (18,3%) apresentando efeito citopático produzido pelo HPV, mas sem perda da polaridade celular. Isso equivale a 35 mulheres com lesão intra-epitelial de baixo grau (NIC I + HPV) (58,3%) e 11 (18,3%) com lesão intra-epitelial de alto grau (NIC II + NIC III). A associação entre a média da contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial cervical não foi signifi cativa (p=0,901). Conclusões: não houve associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial do colo uterino, diagnosticada pelo exame histopatológico. PALAVRAS-CHAVE:Neoplasia intra-epitelial cervical/patologia; Sondas DNA HPV; Neoplasias do colo do útero; Infecções por HIV; AIDS ABSTRACT Purpose: to evaluate association between CD4+ cell count and cervical intraepithelial lesion severity in HIV-infected women. Methods: cross-sectional study of 87 HIV-infected patients which were confi rmed by previous serologic examinations. All had cervical HPV diagnosed by polymerase chain reaction (PCR). All patients underwent anamnesis, physical examinations and colposcopy. Cervix biopsy was performed when indicated by colposcopical examination. Histopathological results followed Richart's classifi cation, adapted by Wright, and CD4+ cell count and cervical intraepithelial lesion severity association was analysed by comparison of means using analysis using analysis of variance (ANOVA).Results: among 60 biopsied women 24 were found (40.0%) with CIN I, eight (13.3%) with CIN II, three (5%) with CIN III, 14 (23.3%) with chronic cervicitis and 11 with cytopathic effect of HPV, without cell polarity loss. This corresponds to 35 (58.3%) women with intraepithelial lesion of low grade (CIN I + HPV) and 11 (18.3%) with intraepithelial lesion of high grade (CIN II + CIN III). There was no signifi cant association between CD4+ cell count mean and cervical intraepithelial lesion severity (p=0.901).Conclusions: there was no association between CD4+ cell count and cervical intraepithelial lesion severity diagnosed by hi...

show abstract

Section: Descrição Da Lesãounclassified

Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Zimmermmann¹,

Melo²,

Castro³

et al. 2006

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

show abstract

“…It is interesting that lower baseline serum creatinine was associated with a small but significant rise Table 2 Associations between time-weighted change from baseline to last follow up for anion-gap, calculated creatinine clearance and serum creatinine in the tenofovir (TDF)-highly active antiretroviral therapy (HAART), non-TDF-HAART and ceased-TDF-HAART groups in time-weighted change in CCrCl. This may be attributable to overall improvements in renal function associated with antiretroviral therapy [22].…”

Section: Laboratory Parametersmentioning

confidence: 99%

Minor changes in calculated creatinine clearance and anion‐gap are associated with tenofovir disoproxil fumarate‐containing highly active antiretroviral therapy

et al. 2006

View full text Add to dashboard Cite

BackgroundTenofovir disoproxil fumarate (Tenofovir DF, TDF), the first nucleotide reverse transcriptase inhibitor approved for the treatment of HIV disease, has been associated with renal dysfunction in isolated cases. The aim of this study was to assess changes in renal parameters in individuals receiving TDFand non-TDF-containing highly active antiretroviral therapy (HAART). MethodsAll individuals on HAART attending our clinic were included in the analysis. Time-weighted changes in serum creatinine, calculated creatinine clearance (CCrCl) and anion-gap were assessed for individuals on TDF-and non-TDF HAART. ResultsOf 948 individuals on HAART, 290 (31%) and 618 (65%) were on TDF-and non-TDF HAART, with 40 (4%) having ceased TDF HAART. Baseline values for serum creatinine, CCrCl and anion-gap were similar for those on TDF-and non-TDF HAART. In a multivariate analysis, statistically significant differences were observed in time-weighted change from baseline in anion-gap and CCrCl between individuals on TDF-and non-TDF HAART [mean difference in change between groups: anion-gap 0.78 mmol/L (standard error, 0.19) and CCrCl À 6.80 (standard error 2.2); P 5 0.005 and P 5 0.032, respectively] after adjusting for baseline anion-gap and CCrCl, respectively. Two cases of TDF-associated renal failure were observed. ConclusionOvert renal failure with TDF HAART is rare. However, subtle but statistically significant changes in anion-gap and CCrCl were observed which were associated with TDF HAART. These parameters may be of use in monitoring individuals on HAART. Cidofovir and adefovir, compounds structurally related to TDF, have been associated with an increased risk of acute renal insufficiency. In particular, a dose-and timedependent development of a Fanconi-like syndrome has been reported [5,6]. In pivotal studies assessing the safety and efficacy of TDF, renal safety profiles were found to be similar in individuals receiving and in those not receiving TDF-containing highly active antiretroviral therapy (HAART) [2][3][4]. In addition, a recent large cohort has described no significant evidence of renal dysfunction with the use of TDF in clinical practice [7]. However, there are mounting numbers of anecdotal reports describing Fanconi's syndrome and renal insufficiency induced by TDF therapy [8][9][10][11][12][13][14][15][16][17][18]. Predisposing factors for the development of acute renal failure with the use of TDF remain obscure.Several groups reporting no significant evidence of renal dysfunction with the use of TDF have relied on serum creatinine as a marker of renal function [7]. A recent report utilizing glomerular filtration rate (GFR) calculated on the basis of a 24-h urine collection has observed a lower GFR associated with TDF treatment [19].The aim of this study was to investigate changes in anion-gap and calculated creatinine clearance (CCrCl) in a large cohort of HIV-1-infected individuals receiving TDFand non-TDF-containing HAART. Methods Study designAll individuals currently on HAART attending the Departmen...

show abstract

“…US epidemiologic data show that the incidence of end-stage renal disease linked to HIV has dropped substantially since the advent of HAART [39]. Concerns are now centered on ARV-mediated nephrotoxicity, especially proximal renal tubular dysfunction induced by treatment with TDF.…”

Section: Haart-related Nephrotoxicitymentioning

confidence: 97%

Progress and challenges in antiretroviral therapy for HIV-infected children

Rosenberg

Abadi²,

Dobroszycki³

et al. 2006

Curr Infect Dis Rep

View full text Add to dashboard Cite

Impact of highly active antiretroviral therapy on organ‐specific manifestations of HIV‐1 infection

Cited by 44 publications

References 103 publications

Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Minor changes in calculated creatinine clearance and anion‐gap are associated with tenofovir disoproxil fumarate‐containing highly active antiretroviral therapy

Progress and challenges in antiretroviral therapy for HIV-infected children

Contact Info

Product

Resources

About