Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Random mating and reproductive compatibility among Argentinean and southern Brazilian populations of Anastrepha fraterculus

As a prerequisite for area-wide application of the sterile insect technique in an area encompassing northern Argentina and southern Brazil, prezygotic and postzygotic reproductive compatibility among three geographically distant populations in the area was tested. In field cages, sexually mature adults of each population were found to be sexually compatible, mating duration was not affected by fly origin and there was no clear evidence of spatial partition of mating location. In the laboratory, homotypic and heterotypic crosses for all possible combinations displayed similar levels of fertility and yielded F1 adults without distortion of the sex ratio. Finally, F1 hybrid and parental adults produced equally viable F2 eggs. Put together, our results and those from earlier studies suggest that a large area, ranging from Buenos Aires to the surroundings of São Paulo, could be managed using a single A. fraterculus mass-reared strain. At the northern margin of this area, two A. fraterculus morphotypes appear to coexist in sympatry. We delineate future research to further delimit the distribution of the aff1 morphotype (Argentina-southern Brazil) and to gain insight into evolutionary patterns producing divergence and radiation of tropical fruit fly species.Fil: Rull, J.. Instituto de Ecología; MéxicoFil: Abraham, Solana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia. Cátedra Terapéutica Vegetal; ArgentinaFil: Kovaleski, A.. Estação Experimental de Vacaria. Embrapa Uva e Vinho; Brasil. International Atomic Energy Agency; AustriaFil: Segura, Diego Fernando. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Grupo Vinculado Instituto de Genética "Ewald A. Favret" al Iabimo | Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular. Grupo Vinculado Instituto de Genética "Ewald A. Favret" al Iabimo; ArgentinaFil: Islam, A.. International Atomic Energy Agency; AustriaFil: Wornoayporn, V.. International Atomic Energy Agency; AustriaFil: Dammalage, T.. International Atomic Energy Agency; AustriaFil: Tomas, U. Santo. International Atomic Energy Agency; AustriaFil: Vera, María Teresa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia. Cátedra Terapéutica Vegetal; Argentin