1.
Experience of SARS-CoV-2 infection in two kidney transplant recipients living with HIV-1 infection.
Chowdary, P, Shetty, S, Booth, J, Khurram, MA, Yaqoob, M, Mohamed, IH
Transplant infectious disease : an official journal of the Transplantation Society. 2021;(2):e13500
Abstract
There is still no consensus on the optimal management of COVID-19 within the general population due to the emerging evidence base. High-risk groups, including kidney transplant recipients living with HIV present unique additional challenges. Here we discuss two kidney transplant recipients living with HIV with SARS-CoV-2 infection and their clinical course, and review the existing literature for this subset of challenging patients.
2.
Maintenance of Viral Suppression after Optimization Therapy from Etravirine Plus Raltegravir to Rilpivirine Plus Dolutegravir in HIV-1-Infected Patients.
Riccardi, N, Del Puente, F, Taramasso, L, Di Biagio, A
Journal of the International Association of Providers of AIDS Care. 2019;:2325958218821657
Abstract
Non-nucleoside reverse-transcriptase inhibitor plus integrase strand transfer inhibitor-based dual therapies are an attractive simplification, nucleoside reverse transcriptase inhibitor-sparing strategy for experienced human immunodeficiency virus-infected patients. Thus, we performed a 24-week real-life observational study to assess efficacy and safety of switching from raltegravir plus etravirine to dolutegravir plus rilpivirine in 7 previously heavily treated patients. This simplification strategy reduced pill burden and preserved viral suppression in treatment-experienced patients with no major mutations to rilpivirine at historical genotyping.
3.
A multimodal, evidence-based approach to achieve lipid targets in the treatment of antiretroviral-associated dyslipidemia: case report and review of the literature.
Bain, AM, White, EA, Rutherford, WS, Rahman, AP, Busti, AJ
Pharmacotherapy. 2008;(7):932-8
Abstract
Metabolic abnormalities associated with the treatment of human immunodeficiency virus (HIV) infection are well-recognized problems that increase cardiovascular risk. As a result of the complexity of treating both HIV- and antiretroviral-related comorbidities, strategies that improve adverse drug events while maintaining viral control are in critical need. Although guidelines have somewhat helped in the general approach and in first-line strategies for managing dyslipidemia in patients receiving antiretrovirals, a paucity of data exist to guide clinicians in treating patients whose conditions are refractory to first-line options or who are at substantial risk for cardiovascular events. Further complicating the choice of lipid-lowering strategy is the lack of randomized controlled data from the HIV-affected population and a concern about clinically significant drug-drug interactions. We describe an HIV-infected patient with efavirenz-associated dyslipidemia at very high cardiovascular risk who had not achieved his primary or secondary lipid goals despite 2 years of treatment in a lipid specialty clinic. Lipid control was accomplished in 10 weeks with a targeted, stepwise approach of switching efavirenz to nevirapine, followed by rosuvastatin 20 mg/day, which was sustained for at least 10 months. Of most importance, this outcome was achieved without any clinically significant alteration in virologic or immunologic control. This case report highlights the potential for a pharmacist-guided, multistep approach that addresses HIV-related dyslipidemia and incorporates the pharmacokinetic literature to guide lipid-lowering therapy and promote the attainment of goals based on current standards of care.
4.
[Role of pharmacists in medical team on HIV infection].
Ido, K
Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan. 2006;(6):409-14
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Abstract
Medical staff, including physicians, nurses, pharmacists, nutritionists, laboratory medical technologists, social workers, and case managers, should act as a team to support patients with human immunodeficiency virus (HIV) infection. The therapeutic purpose of a potent cocktail of anti-HIV drugs is to maintain undetectable plasma levels of HIV over the long term. To achieve this, it is necessary to maintain treatment compliance. However, noncompliance frequently occurs because of a poor understanding of HIV therapy or difficulty in taking anti-HIV drugs. Thus pharmacists should contribute as HIV medical team members by providing medication counseling to ensure treatment compliance or delivering drug information to achieve successful HIV therapy. We describe the roles of pharmacists on HIV medical teams at Ehime University Hospital in examples of nutritional disorder or pregnant women with HIV.
5.
A team approach to the treatment of AIDS wasting.
Abbaticola, MM
The Journal of the Association of Nurses in AIDS Care : JANAC. 2000;(1):45-56
Abstract
Despite the aggressive use of antiretroviral agents, AIDS wasting (AW) affects many persons infected with HIV. AW is characterized by a disproportionate loss of metabolically active tissue, specifically body cell mass--tissue involved with glucose oxidation, protein synthesis, and immune system function. AW correlates with poor quality of life and clinical outcomes. This condition requires a multidisciplinary team approach for effective management. Optimal maintenance of lean body mass and reversal of AW involves a combination of appropriate antiretroviral use, opportunistic infection prophylaxis, optimal nutrition, exercise, body composition monitoring, anabolic agents including growth hormone (rhGH[m]) and testosterone supplementation, mental health support, economic aid, and legal assistance. The team approach to treatment of AW requires the coordinated activity of nurses, dietitians, physicians, pharmacists, social workers, case managers, reimbursement personnel, caregiver(s), physical therapists, and the patient. This article, based on clinical experience treating AW, explains how the condition is managed using a multidisciplinary team approach.