摘要:

Objective:To evaluate the pharmacokinetics, efficacy and tolerability of a low-dose boosted indinavir (IDV)/ritonavir (RTV) regimen [100 mg RTV/400 mg IDV twice daily (bid)] in patients previously receiving a standard IDV regimen [800 mg three times a day (tid)].Methods:In a prospective, open-label, cross-over trial, patients with plasma HIV RNA < 200 copies/ml receiving an IDV-containing regimen (800 mg tid) were switched to an RTV/IDV (100/400 mg bid)-containing regimen. Minimal and maximal IDV plasma concentrations (Cminand Cmax) were determined before the switch (day 0), at week 2 and week 4 after the switch. The CD4 cell count and plasma HIV RNA were determined at day 0, week 2 and week 4, then every 8 weeks. The primary end-point was the percentage of patients with plasma HIV RNA below 200 copies/ml at week 48.Results:Twenty patients were enrolled. At baseline, on IDV 800 mg tid, median IDV Cminwas 194 ng/ml and median IDV Cmaxwas 8449 ng/ml. On RTV/IDV (100/400 mg), median IDV Cminincreased to 536 ng/ml at week 2 and 475 ng/ml at week 4, while Cmaxdecreased to 2983 ng/ml at week 2 and 2997 ng/ml at week 4 (P< 0.001). The median area under the IDV plasma concentration-time curve measured in seven patients was 25 126 ng.h/ml, and the IDV half-life (t1/2) was 4.4 h. All patients had plasma HIV RNA remaining < 200 copies/ml at week 48. Tolerability of RTV/IDV was excellent.Conclusion:RTV/IDV (100/400 mg bid) yields significantly higher IDV plasma Cminand lower IDV Cmaxvalues relative to the standard IDV regimen, thereby improving both tolerability and efficacy.

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To identify risk factors for Kaposi's sarcoma (KS) among men seropositive for both human herpesvirus 8 (HHV-8) and HIV.Design:Cross-sectional study of 91 HHV-8 seropositive, HIV seropositive men who have sex with men (57 with KS), and 70 controls at lower risk for KS.Methods:Patients received clinical evaluations. Blood, oral fluids, semen, rectal brush, rectal swab, and urine were collected, and tests for HHV-8 were performed.Results:Men with KS were more likely to have HHV-8 DNA in peripheral blood mononuclear cells (PBMC) than men without KS [35.1 versus 5.9%, odds ratio (OR), 8.6, 95% confidence interval (CI), 1.9–39.9]. The prevalence of HHV-8 DNA in oral fluids was similar for the two groups (37.0 versus 32.4%; OR, 1.2; 95% CI, 0.5–3.0). HHV-8 DNA was rarely detected in specimens of other types from these men, or in any specimens from the 70 controls. Among men with KS, HHV-8 DNA in PBMC was associated with new KS lesions (OR, 4.5; 95% CI, 1.4–14.5), and HHV-8 DNA in oral fluids was associated with oropharyngeal KS lesions (OR, 3.1; 95% CI, 1.0–10.1). Men with high HHV-8 antibody titers were more likely to have KS (OR, 9.6; 95% CI, 1.2–78.2), but were less likely to have new KS lesions (OR, 0.2; 95% CI, 0.0–1.1) or HHV-8 DNA in PBMC (OR, 0.2; 95% CI, 0.0–1.6) or oral fluids (OR, undefined;P= 0.001).Conclusions:In HHV-8- and HIV-seropositive men, HHV-8 DNA is associated with KS. Among men without KS, HHV-8 DNA is most commonly found in oral fluids. High HHV-8 antibody titers may protect against circulating HHV-8 and new KS lesions.

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To assess changes in sexual behaviours among male factory workers in Ethiopia.Design:Open cohort studies in two factories near Addis Ababa.Data and methods:At intake and biannual follow-up visits, data were collected on sexual behaviours including casual sex, sex with commercial sex workers (CSW), condom use, and history of sexually transmitted diseases (STDs) as indicated by genital discharge and genital ulcer. Health education, HIV testing, and counselling were offered to all participants.Results:Between February 1997 and December 1999, 1124 males were enrolled in the two cohort studies. At intake, the prevalence of casual sex in the past year, sex with CSWs, condom use with the last casual partner, history of genital discharge in the past 5 years, and history of genital ulcer in the past 5 years were 9.7, 43.4, 38.8 (Akaki site only), 10.6 and 2.1%, respectively. At the Wonji site, the intake prevalence of casual sex, sex with CSW, and history of genital discharge decreased significantly by calendar year between 1997 and 1999. At both sites combined, between the first and the fourth follow-up visits, there was a decline in the proportion of males reporting recent casual sex (from 17.5 to 3.5%,P< 0.001), sex with CSWs (from 11.2 to 0.75%,P< 0.001), and genital discharge (from 2.1 to 0.6%,P= 0.004).Conclusion:There was a decline over time in risky sexual behaviours reported by cohort participants. Part of this decline occurred independently of cohort interventions.

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Background:Hormonal contraceptives have been associated with increased risk of HIV acquisition.Methods:The association between hormonal contraception use and HIV acquisition was assessed in a rural community-based cohort in Rakai District, Uganda. A group of 5117 sexually active HIV-negative women were surveyed at 10 month intervals between 1994 and 1999. Information on demographic and sociobehavioral characteristics, use of hormonal contraception (pill and injectable methods), condoms and the number of sexual partners was obtained by home-based interview. HIV incidence rate ratios (IRR) and 95% confidence intervals (CI) associated with hormonal contraception were estimated by multivariate Poisson regression after adjustment for age, condom use, number of sexual partners, marital status, education and history of genital ulcer disease.Results:At one or more interviews, 16.6% of women reported use of hormonal contraceptives and 23.0% reported condom use. HIV incidence was 2.3/100 person-years in hormonal contraceptive users compared with 1.5/100 person-years in non-hormonal contraceptive users (unadjusted IRR, 1.56; 95% CI, 1.00–2.33). After multivariate adjustment, the IRR associated with hormonal contraceptives was reduced to 0.94 (95% CI, 0.53–1.64). The adjusted IRR was 1.12 (95% CI, 0.48–2.56) with oral contraceptive use and 0.84 (95%CI, 0.41–1.72) with injectable methods.Conclusion:Use of hormonal contraception is not associated with HIV acquisition after adjustment for behavioral confounding.

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objectives:To investigate the association between the three human retroviruses, HIV-1, HIV-2 and HTLV-I.Design:Community-based follow-up studies of retrovirus infections in two cohorts.Methods:A total of 2057 individuals aged 35 years and over were eligible for inclusion. Participants were interviewed and had a blood sample drawn. Samples were analysed for HIV-1, HIV-2 and HTLV infections. Uni- and multivariate analyses that included behavioural and socio-economic factors were performed using logistic regression and Poisson regression models.Results:A total of 1686 individuals participated with a blood sample in the HIV prevalence analyses and 1581 individuals participated in the HTLV-I prevalence analyses. The overall prevalence was 2.1% for HIV-1, 13.5% for HIV-2 and 7.1% for HTLV-I. Comparing the < 45 year age group with 45+ year age groups, the female : male (F : M) prevalence ratio increased with age for all three retroviruses. Dual infections were more common in women than in men. Assuming independent distribution of the viruses, the observed prevalence of dual infections in women was significantly higher than expected, while the prevalence was not increased in men. The prevalence of dual infections increased with age in women, the odds ratio (OR) being 3.4 [95% confidence interval (CI), 1.0–11.3] for any combination of dual infection, while the prevalence decreased with age in men (OR, 0.3; 95% CI, 0.1–2.0) (test of interaction,P= 0.033). Control for behavioural factors did not modify these patterns.Conclusions:The pattern of increased prevalence among older women could have public health implications; women of older age groups should be regarded as a potential vulnerable group and included in HIV/AIDS prevention programmes.

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2003

数据来源: OVID