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ABSTRACT: The aim of highly active antiretroviral therapy (HAART) for patients chronically infected with the human immunodeficiency virus type I is to achieve maximal and durable viral suppression. Maintaining the blood plasma HIV-I-RNA concentration (pVL) <50 copies/ml is currently considered appropriate for this goal. With the current treatment options, the percentage of previously untreated patients who achieve a pVL <50 copies/ml after one year of initial HAART is about 70%. Characteristics of the host, virus, drugs and the treatment team have been associated with the virological response to initial HAART. Adjusting the initial HAART regimen and patient management to a risk profile based on these factors is possibly helpful in improving the virological response to HAART. Adherence to a potent and well-tolerated HAART regimen is likely to be the most relevant factor for virological success. The additive value of the other factors needs to be clarified.
The Netherlands Journal of Medicine 01/2005; 62(11):424-40. · 2.07 Impact Factor
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ABSTRACT: Semen samples from a donor who seroconverted for human immunodeficiency virus type 1 (HIV-1) during the period that he was donating at our clinic were stored before and after infection. Semen analysis was done on all of these samples before cryopreservation. Retrospectively, both qualitative and quantitative HIV-1 testing was performed on the cryopreserved semen samples to determine the time of primary HIV-1 infection. After HIV-1 infection, semen volume, sperm motility and the percentage of spermatozoa with normal morphology were reduced compared with the same parameters before HIV-1 infection. HIV-1 RNA was intermittently detectable in semen. HIV-1 infection led to a reduction in semen volume, sperm motility and normal sperm morphology in this donor. However, the clinical significance of these findings is unclear. A longitudinal cohort study on the effects of HIV-1 infection on semen quality is necessary to confirm these findings.
Human Reproduction 01/2005; 19(12):2845-8. · 4.47 Impact Factor
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ABSTRACT: Three patients with a cellular immunodeficiency were treated with rifabutin, clarithromycin and ethambutol for a disseminated infection with Mycobacterium avium-intracellulare complex (MAC). The patients developed uveitis, sometimes in combination with a transient rash, arthralgia, arthritis, jaundice and pseudojaundice. It seems likely that these reactions were caused by rifabutin, alone or together with other drugs such as clarithromycin. These adverse reactions probably depend on the dose, metabolism and excretion of the drug. Inhibition of cytochrome P450 seems to be an important mechanism.
The Netherlands Journal of Medicine 07/1996; 48(6):211-5. · 2.07 Impact Factor
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S H Lowe,
A M J Wensing,
E A M Hassink,
R W ten Kate,
C Richter,
G Schreij,
P P Koopmans,
J R Juttmann,
I van der Tweel,
J M A Lange,
J C C Borleffs
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ABSTRACT: To improve the dosing frequency and pill burden of antiretroviral therapy, we compared two once-daily dosed regimens to a twice-daily dosed regimen.
HIV-1-infected, antiretroviral drug-naïve adults were randomized to either twice-daily nelfinavir and stavudine and once-daily didanosine (regimen A) or simplified once-daily dosed antiretroviral regimens consisting of nevirapine, didanosine, and lamivudine (regimen B) or saquinavir, ritonavir, didanosine, and lamivudine (regimen C).
At 48 weeks of therapy, the proportion of patients with a blood plasma HIV-1 RNA concentration (pVL) <50 copies/mL by intention-to treat analysis was 42.3%, 50.0%, and 56.5% for regimens A (n = 26), B (n = 22), and C (n = 23), respectively. The time to a pVL <50 copies/mL for the first time was significantly shorter in regimen C, and there was significantly more progression to CDC events in regimen B. These differences are possibly due to differences in baseline characteristics. Adverse events were lowest for regimen C; more signs associated with mitochondrial toxicity occurred in regimen A. Increase in CD4 count was comparable between arms.
No statistically significant difference in efficacy was found between the two investigated once-daily dosed treatment regimens (B and C) and the reference (A). Regimen C possibly had a better virological response and less toxicity than regimens A and B.
HIV Clinical Trials 6(5):235-45. · 1.64 Impact Factor
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S.H. Lowe,
A.M.J. Wensing,
E Hassink,
R W ten Kate,
C Richter,
G Schreij,
P P Koopmans,
J R Juttmann,
I. van der Tweel,
J.M.A. Lange,
J.C.C. Borleffs
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S.H. Lowe,
A.M.J. Wensing,
E.A. Hassink,
R W ten Kate,
C. Richer,
G Schreij,
P P Koopmans,
J R Juttmann,
I. van der Tweel,
Joep M A Lange,
J.C.C. Borleffs
