862 research outputs found

    Optimizing HIV therapy. A consensus project on differences between cytidine analogues and regime compactness

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    The identification of the most effective HAART regimens in different clinical settings is still an issue. The aim of the study was to analyze how the compactness of HAART regimens is perceived and if differences between lamivudine (3TC) and emtricitabine (FTC) do exist according to a panel of Italian HIV/AIDS clinicians, using the Delphi method

    Correlates of spinal deforming index (SDI) in HIV-positive patients naive and on treatment

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    Methods HIV-infected subjects naive or on stable HAART were included. Vertebral deformities were identified using SDI (according to semiquantitative method by Genant), calculated by summing the deformity grades of all vertebrae (T4 to L4); pathological deformities are defined as follow: grade 1 between 20–25%, grade 2 between 26–40%, and grade 3 > >40%. According to WHO criteria, osteopenia and osteoporosis were diagnosed in patients having spine BMD calculated as -1 << T-score << -2.5 and T-score ≀≀2.5, respectively. The correlation between SDI and spine BMD was evaluated by univariate and multivariate linear regression. [Other variables considered: gender, age, current CD4 count, CD4 nadir, BMI, lipid parameters, alcohol intake, smoking habit, physical activity, family history for bone fracture, months of ARV exposure, and co-infection with hepatitis viruses; only the variables with p <<0.2 in univariate analyses were included in the final model.

    Reasons why HIV-positive women do not want to have a child: the questionnaire-based DIDI study

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    Given that the majority of HIV‐positive women are of reproductive age, it is necessary to understand the interaction between HIV and family planning, especially as antiretroviral medications allow to live longer, healthier lives. Aim of this analysis form the DIDI study was to assess prevalence of motherhood desire in current years and to identify variables associated pregnancy decision‐making in HIV‐infected women. DIDI is an Italian, 16‐center, questionnaire‐based survey performed in 585 HIV‐positive women between Nov. 2010 and Feb. 2011. The items covered in the self‐administered questionnaire included: socio‐demographic characteristics, sexual and gynecological health, motherhood desire, strategies adopted to become pregnant, reasons for not wanting a child, partnership, HIV disclosure, physical and mental health, ART adherence, drug use. For the present analysis only women aged<45 years and engaged in a partnership were included. Absence of motherhood desire was defined by a negative answer at the question whether the women at present would like to have a child. 178 women were included: mean age 39 (IQR, 33–42), HIV transmission heterosexual 75%, IVDU 11%, heterosexual/IVDU 2.5%, not known 7.5%; mean CD4 and HIV‐RNA were 552/mmc (+252) and 3.85 c/ml (+4.7), respectively. Absence of motherhood desire was found in 61% of women; 50% of women declared that HIV negatively affected motherhood desire, and 22% declared a decrease in desire after start of ART. The probability of vertical transmission was estimated higher than 50% by 19% of women, even when adopting all preventive measures. Not wanting a child was associated with: fear of vertical transmission (p<0.001), fear of not being able to raise the child (p<0.001), decline in motherhood desire after HIV (p=0.007), unstable partnership (p=0.02). At multivariable analysis, variables found to be significantly associated with negative pregnancy decision‐making were: fear of vertical transmission (AOR 3.75; 95%CI 1.18–11.89), economic restrictions (AOR 0.28; 95% CI 0.10–0.76 In conclusion, absent motherhood desire in HIV‐positive women with child‐bearing potential is frequent and essential information on vertical HIV transmission is lacking. HIV‐positive women of childbearing age may benefit from counseling interventions sensitive to factors that influence infected women's pregnancy decisions

    Predictors of severe hyperbiliruniaemia in HIV-infected patients treated with atazanavir (ATV)

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    Methods HIV-infected subjects on ATV/ritonavir containing stable HAART regimen were included. ATV plasma concentrations were measured 24 hours after the last dose by HPLC with UV detector. Polymorphism at the uridin-glocoronosyl-transferase 1A1 (UGT1A1) was examined in DNA extracted from blood mononuclear cells, to identify subjects with Gilbert's syndrome. The correlation between bilirubin plasma levels, ATV concentration and polymorphism of UGT1A1 (defined as the presence than at least one TA7 allele) were evaluated by multivariate linear regression (other covariates included: gender, age, CD4 count, months of ATV exposure). Predictors of severe hyperbilirubinemia (>2.5 ÎŒmol/l; grade 3) were evaluated by multivariate logistic regression (polymorphism at UGT1A1, Cmin, BMI, age included as covariates)
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