Intermittent interleukin (IL)-2 administration to human immunodeficiency virus (HIV)-1 infected patients is well documented and generally used, but there is limited information about the changes of ...acute-phase protein (APP) levels in response to this treatment. Fifteen patients undergoing highly active anti-retroviral therapy (HAART) treatment, with undetectable viral load, but low CD4⁺ cell count (<300/μl), have been treated with 3·6 M IU Proleukine® administered twice daily by subcutaneous injection over 5 days. C-reactive protein (CRP), d-dimer, C3, C9, C1-inh and alpha-2HS glycoprotein levels were measured immediately before IL-2 administration, as well as on day 5 and 2-3 weeks thereafter. After IL-2 administration, both mean d-dimer and CRP levels increased significantly (P < 0·001), but returned (P < 0·001) to baseline within the subsequent 2-3 weeks. Alpha-2HS glycoprotein decreased immediately after IL-2 administration. No significant differences were detected in the levels of C3, C9 and C1-inh. A significant, positive correlation (r = 0·5178, P = 0·0008) was ascertained between the changes of CRP level, measured immediately before as well as 5 days after IL-2 administration, and changes in CD4 T cell counts measured 2-3 weeks before and after treatment, respectively. IL-2 administration induces rapid elevation of two major APPs (CRP, d-dimer). The positive correlation observed between the changes of CRP levels and CD4⁺ cell counts after IL-2 administration may indicate that the abrupt, but transitory overproduction of CRP might contribute to the CD4⁺ cell count-increasing effect of the drug and/ or may be associated with serious side effects.
A hepatitis C (HCV) cure is associated with changes in lipids and inflammatory biomarkers, but its impact on clinical endpoints among treated human immunodeficiency virus (HIV)/HCV coinfected persons ...is unclear.
People living with HIV from EuroSIDA with a known HCV status after January 2001 were classified into strata based on time-updated HCV RNA measurements and HCV treatment, as either HCV antibody-negative; spontaneously resolved HCV; chronic, untreated HCV; cured HCV (HCV RNA-negative); or HCV treatment failures (HCV RNA-positive). Poisson regression was used to compare incidence rates between HCV groups for end-stage liver disease (ESLD; including hepatocellular carcinoma HCC), non-acquired immunodeficiency virus defining malignancy (NADM; excluding HCC), and cardiovascular disease (CVD).
There were 16 618 persons included (median follow-up 8.3 years, interquartile range 3.1-13.7). There were 887 CVD, 902 NADM, and 436 ESLD events; crude incidence rates/1000 person-years follow-up were 6.4 (95% confidence interval CI 6.0-6.9) for CVD, 6.5 (95% CI 6.1-6.9) for NADM, and 3.1 (95% CI 2.8-3.4) for ESLD. After adjustment, there were no differences in incidence rates of NADM or CVD across the 5 groups. HCV-negative individuals (adjusted incidence rate ratio aIRR 0.22, 95% CI 0.14-0.34) and those with spontaneous clearance (aIRR 0.61, 95% CI 0.36-1.02) had reduced rates of ESLD compared to cured individuals. Persons with chronic, untreated HCV infections (aIRR 1.47, 95% CI 1.02-2.13) or treatment failure (aIRR 1.80, 95% CI 1.22-2.66) had significantly raised rates of ESLD, compared to those who were cured.
Incidences of NADM or CVD were independent of HCV group, whereas those cured had substantially lower incidences of ESLD, underlining the importance of successful HCV treatment for reducing ESLD.
Open reading frame (ORF) 26 of human herpesvirus-8 (HHV-8) from peripheral blood samples of 15 Hungarian HIV-positive patients with or without Kaposi's sarcoma (KS) were amplified and sequenced. Four ...variants of HHV-8 were identified according to ORF 26 genotyping. Most of the samples were shown to be subtype A3, however, subtypes A, B3/C2/C2', and C3 (ORF 26 region) were also identified. The ORF 26 subtypes A and C3 of HHV-8 were only recovered from patients with KS while A3 was dominant in KS negative cases. The amplification of the hypervariable ORF K1 gene was successful only from 2 of the same 15 patients. Sequence analysis of the amplified ORF K1/VR1 regions identified subtype A3 from 2 patients with AIDS-associated KS. A novel ORF K1/VR1 variant belonging to subgroup A' was detected in a different sample in one of them. Amplification of the ORF K15, another representative locus for HHV-8 genotyping, was not successful from any of the peripheral blood samples. Unsuccessful amplification of the terminal K1 and K15 ORFs from peripheral blood samples suggests that KS biopsy specimens are needed for complete genotyping of HHV-8 strains from Hungary.
BACKGROUND: The HEARTS (HIV Epidemiology and AntiRetroviral Treatment Study) is a non-interventional retrospective claims database study of patients receiving healthcare services for their HIV ...infection between 2005 and 2015 in Hungary (n=1772), who were identified from the National Health Insurance Fund Administration databases based on multiple criteria including International Classification of Diseases and International Classification of Procedures in Medicine codes, and medication purchase data. The first results about the epidemiology of HIV patients was published earlier. During the entire period, a total of 1,496 (84.4%) of the prevalent patients received antiretroviral (ARV) treatment. OBJECTIVES: In this part of the study, our aim was to investigate the changes of ARV drug dispensing over time at active substance and drug class level, to determine the therapeutic adherence of patients and to examine the persistence of active substances as third agents of combination therapies, especially darunavir (DRV). METHODS: The method of the ARV drug utilization analysis is based on days of treatment estimation RESULTS: Between 2005 and 2015 the most commonly dispended protease inhibitors (PI) were ritonavir (alone or as pharmacokinetic booster) (35%) and DRV (28%), whilst the patients most often used lamivudine (62%), tenofovir (56%) and zidovidin+lamivudine (41%) as their dual nucleoside reverse transcriptase inhibitor (NRTI) backbone.The adherence of the treated prevalent population was fair (≥80%) as defined by the PDC (proportion of days covered) ratio. Considering the third agent consumption of the adherent patient population, amongst Pi's persistence of DRV was the highest. Assuming 60-day gaps, the 1-year and 5-year persistence was 87% and 51%, respectively, and the median was 1851 days. CONCLUSIONS: Due to the development of ARV therapies and understanding their mechanism of action and keeping in mind the perspective of patients, we conclude that the tolerability and simplification of treatment administration could be major aspects of treatment success in real-world settings.
Reported here are three cases of pulmonary Mycobacterium xenopi infection that occurred in AIDS patients in Hungary shortly after starting highly active antiretroviral therapy. In this country, ...Mycobacterium xenopi is the most common nontuberculous mycobacterial species causing pulmonary mycobacterial infections. Cases of pulmonary Mycobacterium xenopi disease have been described in patients infected with the human immunodeficiency virus infection and in patients with other immunodeficiencies; however, only limited information is currently available concerning the connection between nontuberculous Mycobacterium infection and AIDS in Hungary. This report thus adds useful information regarding the diagnosis, clinical course, and treatment regimens of Mycobacterium xenopi infections in AIDS patients.
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