In patients failing to respond to adefovir monotherapy or an adefovir-containing regimen for chronic hepatitis B virus, a combination of tenofovir and emtricitabine resulted in undetectable hepatitis B viral DNA levels without any renal toxicity. Tenofovir, in combination with emtricitabine, may be an alternative treatment for those with detectable hepatitis B viral DNA on adefovir.

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Introduction: Diuretics are used in patients with hypertension, edema and congestive heart failure. It functions by increasing water secretion into the urine causing a reduction in blood volume and pressure although most diuretics in the market have side effects in contrast to herbal medication with less toxicity. Leaves of Sterculia foetida (Kalumpang) has been used as diuretics in folkloric practices in the Philippines. Aim: This study was conducted to evaluate the diuretic activity of the methanolic extract of Kalumpang in male albino Sprague Dawley rats. Methods: Five groups were utilized in the study, negative control, positive control with drug furosemide and experimental group with extract of Kalumpang prepared in low to high concentrations 150, 250 and 350mg/kg. Urinary volume, pH, specific gravity and urinary electrolytes were measured in 5 hour. Data examined using one-way analysis of variance (ANOVA) and t-test, diuretic property of the extract was measured by modified Lipschitz method. Results: The result indicated that S. foetida in low concentration (150mg/kg) has a moderately positive diuretic index capacity of 1.17, and lipschitz value of 0.66 with an increase in potassium secretion and low sodium ions in the urine. Percentage increase in urine volume was measured hourly and was noted at 1 st (12.75%) and 2 nd hour (337.5%). Phytochemical analysis revealed presence of metabolites-alkaloids, flavonoids, sterols, tannins and triterpenes. Conclusion: The finding of this study provided scientific credential for the folkloric use of Stercula foetida L (Kalumpang) plant extract using quantitative analysis in the diuretic property.

The life expectancy of HIV seropositive persons is approaching the life expectancy of those who are uninfected with HIV. Hepatitis C virus (HCV) infection has emerged as a worldwide epidemic. Given the similar transmission route between HCV and HIV, there has been an explosion in the number of individuals infected with both viruses. Because of the successful introduction of antiretroviral therapy, patients are more susceptible to new opportunistic infections such as HCV. HCV leads to a more rapid progression to end-stage liver disease in patients with HIV, and the morbidity and mortality related to HCV in co-infected patients is on the rise. Therefore, it has become imperative to treat both HIV and HCV in co-infected patients. The primary goal of HCV therapy is permanent eradication of the virus. Secondary goals include reduction in hepatic fibrosis progression, development of decompensated cirrhosis, and hepatocellular carcinoma. Early studies using standard interferon-alfa for the treatment of HCV in co-infected individuals were discouraging, as poor outcomes, high discontinuation rates, and severe adverse events were observed. The current standard of care for treatment of HCV is pegylated-interferon and ribavirin. New studies have recently demonstrated a higher sustained virologic response rate and a better adverse event profile than previously reported in co-infected patients. As a result, we recommend considering all co-infected patients for HCV therapy while watching closely for unique treatment-related toxicities. The treatment of HCV in co-infected patients should be a high priority for all providers.

Objective: Evaluate the effectiveness and safety of simplification of tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV) in selected treatment-experienced HIV-1-infected patients who have been virologically suppressed for>3 months on their current regimen. Methods: We selected patients who started the simplified regimen between December 1st 2008 and March 31st 2012. Exclusion criteria: prior therapeutic failure, presence of resistance mutations to any component of TDF/FTC/EFV and patients previously observed in other centers. Efficacy and safety assessments were performed at baseline, 4 weeks after switch and then every 12–24 weeks. Statistical analysis was performed with SPSS version 20.0. Results: 384 patients were evaluated; 302 (79%) male; mean age 47 (SD=10) years; median CD4 cells count was 504 cells/mm3 (367–710). Baseline median glomerular filtration rate (eGFR; Cockcroft-Gault equation) was 100 mL/min (86–116) and median ALT was 33 U/L (21–47). Median total cholesterol (TC) was 205 mg/dL (176-236), high-density lipoproteins (HDL) 45 mg/dL (38–54); low-density lipoproteins (LDL) 130 mg/dL (108–151); triglycerides (TG) 125 mg/dL (84–176). Prior NNRTI-based regimen in 327 (85%) patients (TDF/FTC and EFV in 76%); protease inhibitor in 52 (14%) and integrase inhibitor in 5 (1%). Discontinuation of treatment occurred in 49 patients (13%) after a mean time of 1.1 years (SD=1.1) of follow-up: nervous system symptoms (n=11), decreased eGFR (n=5), virological failure (n=5), pregnancy (n=5), gastrointestinal symptoms (n=3), rash (n=1), other reasons (n=2); 12 patients dropped out the treatment and 5 died. Occurrence of blips (transient increase in VL ≤200 copies/mL) was documented in 98 (26%) patients; in 70, VL decreased to <20 copies/mL after the blips and in 28 VL is not yet available. 317 patients (83%) achieved≥48 weeks of follow-up after simplification. Compared with baseline, significantly higher levels of CD4 cells count, HDL and eGFR were found and lower levels of TC, LDL and TG. Conclusion: Simplification to TDF/FTC/EFV was shown to be an efficient and safe option in virologically suppressed patients and without a previous virological failure