Vincent Soriano

..The present study represents an update of the current knowledge about HBV/HIV coinfection and an intent to provide practical advise about how to give the best care to HIV-infected persons with chronic hepatitis B...

..There is little information about the influence of antiretroviral drugs on the antiviral activity of pegylated interferon (PEG-IFN) plus ribavirin (RBV) against hepatitis C virus (HCV)...

..The relatively low efficacy of current anti-HCV medications and their low tolerability clearly indicated the need for new drugs with more potent and direct antiviral activity against HCV...

..At this time, most experts agree that early introduction of anti-HBV active HAART is the best strategy for the treatment of chronic hepatitis B in HIV patients, and Truvada must be part of the triple regimen...

..It is unclear whether this applies to HIV/HCV-co-infected patients...

..Thus, HBV/HIV-coinfected patients might benefit from an earlier introduction of HAART...

..The efficacy is greatly influenced by the number of baseline protease resistance mutations; 5 mutations is the best threshold to predict the chances of VR to any PI/r-based regimen...

..In contrast, Latin Americans with high-risk sexual practices may be a particularly vulnerable collective to acquire blood-borne viruses in the receptor country...

..9). Total bilirubin, a nonexpensive, simple, and widely available parameter, might be used as a surrogate of virological response to ATV-based regimens, especially in areas with limited resources where HIV-RNA testing is not available...

..Differences between PEG-IFN-alpha molecules could be more pronounced in HIV-coinfected individuals, in whom response to HCV treatment is impaired...

..If proved, this strategy could be particularly attractive for the subset of patients with greater cardiovascular risk...

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..Raltegravir has demonstrated good antiviral activity and safety profile in twice-daily (bid) dosing. However, its long terminal elimination half-life might allow once-daily (qd) administration...

..Most antiretrovirals are metabolized in the liver, and lower dosing could be advisable in patients with severe liver insufficiency...

..In summary, single mutations at the HR1 env region result in significant loss of susceptibility to ENF. Despite virologic failure, these patients may maintain elevated CD4+ counts through a reduction in their overall immune activation...

..Patients with complete viral suppression under ATV/r 300/100 mg qd may benefit from switching to ATV 400 mg qd guided by TDM, which may make it possible to minimize adverse events without compromising antiviral efficacy in most cases...

..Thus, it is still uncertain whether multifunctional CD8 responses are the cause or consequence of low plasma viremia...

..Coinfection with distinct HCV genotypes is unlikely in former IDUs coinfected with HIV and does not explain the lower efficacy of HCV therapy in this population...

..Plasma levels of atazanavir were significantly higher in patients with genotype CC than in those with CT or TT, and bilirubin levels correlated with atazanavir concentrations...

..Therefore, extending therapy (for 12 months in HCV genotypes 2/3 and perhaps for 18 months in HCV genotypes 1/4) might be warranted in HIV/HCV-coinfected patients showing EVR...

..The inclusion of additional sequences in the VircoNET database, mainly those derived from heavily treatment-experienced patients and/or from patients failing the most recently approved drugs might improve its performance...

..A substantial proportion of patients under atazanavir-therapy experienced significant hyperbilirubinemia and jaundice following initiation of hepatitis-C therapy...

..However, the occurrence of liver complications (including hepatocellular carcinoma) and/or HCV relapses in coinfected patients when followed for long periods of time after HCV therapy is not well known...

..5 microg/ml (4.5 [1.3 to 15.5]), baseline serum HCV RNA (2.5 [1.2 to 5.1]), and HCV genotype 1 or 4 (13.3 [2.6 to 66.7]). Monitoring of RBV C(trough) may permit early adjustment of RBV dosage to avoid HCV relapse...

..It may evolve causing severe liver complications, with variceal bleeding and portal thrombosis being particularly frequent...

..The presence of TAMs precluded the selection of K65R in patients treated with TDF. Resistance pathways for TDF and thymidine analogues seem to be divergent and could be the basis to explore a synergism between these drugs...

..As in HIV infection, virus replication could drive or be contained by T-cell immunity. We have examined the effect of HIV coinfection and of suppression of HCV replication with therapy on HCV-specific T-cell responses...

..In summary, HIV genotyping but not drug levels might be helpful to predict which patients would benefit from a rescue intervention based on APV/RTV 600/100 twice daily...

..Given the overlap between envelope and polymerase in the hepatitis B virus (HBV) genome, changes in antigenic sites of the HBV surface antigen may occur as a result of selection of drug-resistance mutations...

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..More advanced immunodeficiency and the coexistence of parasitic diseases and infections with a large diversity of HIV-1 non-B and recombinant variants are expected...

..In summary, while inferences of HIV-1 coreceptor usage using genotypic tools seem to be reliable for clade B viruses, their performances are poor for non-B subtypes, in which they particularly fail to detect X4 variants...

..Given that therapy is poorly tolerated and rates of response are lower in patients coinfected with HCV and human immunodeficiency virus (HIV), the recognition of predictors of response is a high priority in this population...

..Tipranavir (TPV) and darunavir (DRV) are potent against protease inhibitor (PI)-resistant viruses. Efficacy of these compounds when confronting distinct HIV subtypes is not known...

..Information on the impact of therapy with pegylated interferon (pegIFN) plus ribavirin on mtDNA is scarce and conflicting results have been reported...

..The use of RBV 1000-1200 mg/day plus pegIFN is relatively safe and provides SVR in nearly half of coinfected patients, twice as high in HCV-2/3 than HCV-1/4...

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..Kidney abnormalities are the main concern using the drug. As glomerular function is infrequently affected in patients treated with TDF, herein, we report the results of an extensive examination of tubular function...

..The bidirectional interferences between hepatitis C virus and HIV have clinical consequences and complicate the management of coinfected individuals...

..ProI47A should thus be considered the primary lopinavir resistance mutation...

..Information available on the prevalence and distribution of distinct HBV variants in HIV-positive patients is scarce...

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..Nef-specific CD8+ responses might contribute to a better virological control of HIV replication following treatment interruptions in HIV-infected individuals and might be boosted by the immunomodulatory effect of HU...

..Higher transaminase levels were recognized in patients with higher degree of fibrosis...

..The GIQ predicts accurately the virological response in patients receiving ATV. Hyperbilirubinemia is associated with higher ATV plasma levels...

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..Infected individuals are generally Spanish natives with a prior history of intravenous drug use and are coinfected with HIV-1 and/or HCV...

..So far, it is unclear to what extent immune activation may influence the evolution of CD4 T-cell counts in patients on HAART...

..CONCLUSION: More flexible criteria would considerably increase the number of patients to be treated with IFN-based therapy. The majority of patients ready to initiate HCV therapy have a poor therapeutic profile...

..This is the first description of CRF02_AG/CRF06_ cpx recombinants in Spain. The results highlight the tremendous heterogeneity of HIV-1 recombinant strains currently in circulation...

..001), despite elevated and stable rates of tenofovir use. A reduction in the rate of coadministration of didanosine (from 41.6% of patients in 2004 to 0.8% of patients in 2006; P < .001) largely explained this observation...

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..Little is known about the extent and predictors of polymorphisms potentially influencing the susceptibility to HIV integrase inhibitors (INIs)...

..Extensive intraerythrocyte accumulation of RBV following boosted production of red blood cells by EPO could explain these findings...

..HCV genotype 4 is spreading among European intravenous drug users, who are frequently coinfected with HIV. Information about treatment response in this subset of patients is scarce and conflicting results have been reported...

..Thus, activation of CD8(+) T cells does not seem to be associated with the extent of CD4(+) T cell recovery beyond the first year of successful HAART...

..At any time, nevertheless, the GIQ provided the most accurate prediction of the VR...

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..It may allow the early recognition of HBV viraemic individuals who may benefit from either initiating or switching antiviral therapy. In any situation, the use of anti-HBV therapies more potent than lamivudine alone is warranted...

..None of them admitted prior exposure to antiretroviral drugs. Thus, HIV/HBV-coinfected patients might benefit from baseline drug resistance testing for both HIV and HBV to optimize the selection of anti-HBV active antiviral therapy...

..This article forms part of a special issue of Antiviral Research marking the 25th anniversary of antiretroviral drug discovery and development, Vol 85, issue 1, 2010...

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..Hopefully, this success will translate into a halt of liver-related complications and death in the co-infected population...

..8 vs. 13.8 g/ml, p = 0.017). Thus, therapeutic drug monitoring might be helpful in ensuring a viral response in this subset of patients...

..Two novel changes, K101H and E399D, significantly diminished etravirine susceptibility. Thus, the original etravirine resistance-associated mutation list should be updated and weighted for a suitable genotypic resistance interpretation...

..Therefore, individuals infected with HIV-1 group O might benefit from raltegravir and/or etravirine therapy...

..48 for TPV C(trough). HIV-infected patients who initiate a salvage regimen based on TPV may benefit from baseline drug resistance testing and TPV plasma concentration determination, as vIQ is the best predictor of a virological response...

..e. NNRTI and 3TC)...

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..The management of HIV/HCV-coinfected individuals needs to consider the high risk of mitochondria-associated toxicities in this population, which may significantly influence treatment decisions and therapeutic modalities...

..J. Med. Virol. 77:23-28, 2005. (c) 2005 Wiley-Liss, Inc...

..Thus, keeping on treatment HIV-infected individuals failing virologically and harboring drug-resistant viruses may ameliorate their immunological deterioration until new drugs became available...

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..The expected poor prognosis of patients harboring MNR viruses may often be overcome using rescue interventions based on potent ritonavir-boosted PI combinations...

..Therefore, facilitating the arrival of compounds belonging to new drug classes should be considered a priority...

..Toxicity and drug resistance seem to occur rarely when this combination is used, which allows good adherence and spares other future treatment options...

..In respect to nonnucleoside reverse transcriptase inhibitors (NNRTIs), resistance often results from single mutations (K103N is the most frequently found) located at or near the drug pocket binding...

..In contrast, agents that target gp41-dependent fusion select for HIV variants with mutations in the gp41 envelope gene...

..This information has important pathogenic implications and may influence therapeutic decisions...

..All these aspects explain why the response to antiretroviral therapy might vary in subjects infected with different HIV-1 clades...

..In vitro, rtA194T conferred a reduced susceptibility to TDF in the presence of LAM-associated mutations...

..Genotyping at the time of initiation of salvage therapy with Kaletra might help to predict which individuals will experience a greater benefit...

..Drug-resistance testing is thus not required before beginning antiretroviral therapy...

..Thus, either HIV infection itself or treatment with stavudine-containing regimens might induce mtDNA depletion and related metabolic disturbances as hyperlactatemia...

..Herein, we examine the incidence of cirrhosis, using TE assessment, in HIV-infected individuals with chronic hepatitis B or C receiving highly active antiretroviral therapy (HAART)...