Baseline characteristics of severe pneumocystis pneumonia patients according to the duration of corticosteroid therapy.

<p>^†median (interquartile range)</p><p>HIV: human immunodeficiency virus, CMV: cytomegarlovirus, PaO₂: partial pressure of oxygen in arterial blood, A-aDO₂: alveolar-arterial oxygen difference, LDH: lactate dehydrogenase, CRP: C-reactive protein, PCP: pneumocystis pneumonia.</p><p>Baseline characteristics of severe pneumocystis pneumonia patients according to the duration of corticosteroid therapy.</p

Patient enrollment process.

<p>Patient enrollment process.</p

Baseline characteristics of the study patient.

<p>^†median (interquartile range)</p><p>^¶The value for βD glucan is missing for one patient</p><p>HIV: human immunodeficiency virus, CMV: cytomegarlovirus, PaO₂: partial pressure of oxygen in arterial blood, A-aDO₂: alveolar-arterial oxygen difference, LDH: lactate dehydrogenase, CRP: C-reactive protein, PCP: pneumocystis pneumonia, cART: combination antiretroviral therapy.</p><p>Baseline characteristics of the study patient.</p

Additional file 1: of Invasive pneumococcal disease among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution

Distribution of the 10 prefectures participating in the enhanced surveillance. They are marked with numbers on a Japanese map: 1: Hokkaido; 2: Miyagi; 3: Yamagata; 4: Niigata; 5: Mie; 6: Nara; 7: Kochi; 8: Fukuoka; 9: Kagoshima; and 10: Okinawa prefecture. (PPTX 156 kb

Additional file 2: of Invasive pneumococcal disease among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution

Distribution of the serotypes of causative pneumococcal isolates from patients with invasive pneumococcal diseases by age and immunocompromised status in four groups (n = 281); Group 1 (15-39y, nonimmunocompromised) n = 10 (A), Group 2 (40-64y, nonimmunocompromised) n = 48 (B), Group 3 (> = 65y, nonimmunocompromised) n = 116 (C), Group 4 (> = 15y immunocompromised) n = 107 (D). (PPTX 74 kb

Switching Tenofovir/Emtricitabine plus Lopinavir/r to Raltegravir plus Darunavir/r in Patients with Suppressed Viral Load Did Not Result in Improvement of Renal Function but Could Sustain Viral Suppression: A Randomized Multicenter Trial

<div><p>Background</p><p>Whether tenofovir nephrotoxicity is reversible after its withdrawal is unknown. Furthermore, there are no data on the viral efficacy of raltegravir (RAL) plus ritonavir-boosted Darunavir (DRV/r) in patients with suppressed viral load.</p> <p>Methods</p><p>This multicenter, randomized trial compared renal function and viral efficacy in patients with suppressed viral load treated with RAL+DRV/r and ritonavir-boosted lopinavir (LPV/r) plus tenofovir/emtricitabine (TVD), who had been previously on LPV/r+TVD. The primary endpoint was the proportion of patients with >10% improvement in estimated glomerular filtration rate (eGFR) at 48 weeks calculated with Cockcroft-Gault equation.</p> <p>Results</p><p>58 randomized and treatment-exposed patients were analyzed (28 on RAL+DRV/r and 30 on LPV/r+TVD). Greater than 10% improvement in eGFR was noted in 6 (25%) out of 24 with RAL+DRV/r and 3 (11%) of 28 with LPV/r+TVD, and the difference was not statistically significant (p=0.272, 95% CI -0.067 to 0.354). Sensitivity analyses using three other equations for eGFR showed the same results. Urinary β2 microglobulin, a sensitive marker of tenofovir tubulopathy, significantly improved with RAL+DRV/r than with LPV/r+TVD (-271 versus -64 µg/gCr, p=0.026). Per protocol analysis showed that the HIV-RNA was <50 copies/mL at week 48 in all patients of both arms (24 in RAL+DRV and 29 in LPV/r+TVD).</p> <p>Conclusions</p><p>Switching LPV/r+TVD to RAL+DRV/r did not significantly increase the proportion of patients who showed >10% improvement in renal function among those with relatively preserved eGFR. However, the switch improved urinary β2 microglobulin, suggesting that discontinuation of TDF might be beneficial in the long-term. RAL+DRV/r showed favorable viral efficacy in patients with suppressed viral load.</p> <p>Trial Registration</p><p><a href="http://clinicaltrials.gov" target="_blank">ClinicalTrials.gov</a> NCT01294761 <a href="http://clinicaltrials.gov/ct2/show/nct01294761?term=spare&rank=2" target="_blank"><u>http://clinicaltrials.gov/ct2/show/NCT01294761?term=SPARE&rank=2</u></a>, Umin Clinical Trials Registry UMIN000005116 <a href="http://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=r000006083&language=j" target="_blank"><u>http://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000006083&language=J</u></a>)</p> </div

Median changes in markers of renal tubular function between baseline and 48 weeks.

<p>(A) Urinary β2 microglobulin, (B) Urinary albumin, (C) Percent tubular resorption of phosphate, (D) Urinary N-acetyl-β-D-glucosaminidase. RAL, raltegravir; DRV/r, ritonavir-boosted darunavir; LPV/r, ritonavir-boosted lopinavir; TVD, fixed dose of tenofovir/emtricitabine.</p

Proportion of patients with HIV RNA <50 copies/ml at 24 and 48 weeks.

<p>(A) Per protocol analysis. (B) Intention-to-treat analysis. VL, viral load; RAL, raltegravir; DRV/r, ritonavir-boosted darunavir; LPV/r, ritonavir-boosted lopinavir; TVD, fixed dose of tenofovir/emtricitabine.</p