Antiviral therapy
-
In haematopoietic stem cell transplant (HSCT) recipients, cytomegalovirus (CMV) infection contributes significantly to morbidity and mortality in both the early and late post-transplant period. Ganciclovir (GCV) is the treatment of choice for CMV, but requires intravenous administration, a fact that complicates its long-term use. Oral valganciclovir (VGCV) and intravenous GCV were recently shown to have similar efficacy for pre-emptive CMV treatment in solid organ transplant recipients, but relatively limited data are available in HSCT recipients. The objectives of this study were to compare the efficacy of VGCV versus intravenous GCV or foscarnet (FOS) for pre-emptive therapy of active CMV infection in allogeneic HSCT and to determine the incidence of adverse effects and relapses. ⋯ In allogeneic HSCT recipients, VGCV seemed effective and safe in the pre-emptive therapy of active CMV infection.
-
Plans are outlined for a new database for hepatitis antiviral drug resistance mutations that will be closely linked to existing sequence databases. The new database will contain an infrastructure to store all available information on drug resistance mutations for the virus and a mutation can be searched by itself or in conjunction with the sequence information. ⋯ The resistance mutation database would be annotated by authorized users, recruited from among clinicians and researchers familiar with each virus. The new database would provide a central location to find known drug resistance mutations for HBV and HCV; the ability to search the sequence database for each (combination of) mutations, retrieve alignments of relevant sections, and analyse mutation context and other background information; and rapid inclusion of newly found mutations without the need to wait for a publication.
-
According to recent World Health Organization data, approximately 170-200 million people worldwide are infected with hepatitis C virus (HCV). At present, illicit drug users (IDUs) constitute the largest group of individuals infected with HCV in industrial countries. ⋯ The aim of our review is to focus on tertiary prevention of HCV infection among IDUs. We review strategies to prevent HCV infection and disease progression, attitude to antiviral treatment, access to specific HCV therapy and data of efficacy and safety of antiviral treatment among IDUs.
-
Pegylated interferon (PEG-IFN) alpha2a and alpha2b differ in their pharmacokinetic properties, which might have an effect on their antiviral effects against hepatitis C virus (HCV). Differences between PEG-IFN-alpha molecules could be more pronounced in HIV-coinfected individuals, in whom response to HCV treatment is impaired. ⋯ The antiviral effect against HCV seems to be greater for PEG-IFN-alpha2a than -alpha2b in the HIV setting. A shorter half-life of PEG-IFN-alpha2b could explain this finding.
-
Multicenter Study
Living with HIV, antiretroviral treatment experience and tobacco smoking: results from a multisite cross-sectional study.
To assess the prevalence of and factors associated with tobacco smoking and dependence in HIV patients. ⋯ Very few HIV smokers seem to be good candidates for a standard tobacco cessation program. Tobacco reduction or cessation strategies should be adapted to this population.