Tenofovir DF ( TDF) has infrequently been associated with renal toxicity. Cobicistat (COBI), like ritonavir, can increase creatinine (Cr) without affecting glomerular filtration by inhibiting renal tubular creatinine secretion. We examined the renal safety of recently approved single tablet regimen STRIBILD [STB] (elvitegravir [EVG]/COBI/emtricitabine [FTC]/TDF). Pooled renal safety data through Week 48 were analysed from three STB studies (104,102, and 103) and Two COBI studies (105 and 114).
In the pooled STB studies, the median exposures to STB (n=749), ATR (n=375), and ATV/r+TVD (n=355) were 48, 59, and 48 weeks. The median (IQR) changes in Cr (mmol/L) at Week 48 in the three groups were 11.49 (5.30 to 19.44), 0.88 (-5.30 to 7.95), and 7.07 (0.88 to 15.02). The rates of renal AEs leading to study drug discontinuation (renal AE DC) were STB 1.1% (8/749), ATR 0 %, and ATV/r+TVD 0.3 % (1/355). One patient in STB reported a serious renal AE not leading to study drug discontinuation. In the pooled COBI studies, the median exposures to ATV/co+TVD (n=394) and ATV/r+TVD (n=377) were 48 weeks. The median (IQR) changes in Cr (mmol/L) at Week 48 in the two groups were 11.49 (4.42 to 19.44) and 7.95 (0.88 to 15.02). The rates of renal AE DC were ATV/co+TVD 1.5 % (6/394), ATV/r+TVD 1.6 % (6/377); two and three renal AE DCs from each group were serious AEs.
As expected, small increases in Cr were seen with the use of STB or COBI. The rates of renal event leading to study drug discontinuation with TDF-containing COBI-boosted EVG or ATV regimen were low at 1.2% (14/1143).
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
In recent years there has been a widespread uptake of smartphones with internet access and location services and the development of mobile ‘apps’ for gay men to meet each other. We reviewed data collected in the Sydney and Melbourne Gay Community Periodic Surveys (GCPS) to identify which men were relying on mobile and internet methods to meet each other and whether these methods were associated with different risk practices.