Taking HAART in HIVAN: Will protease inhibitor sparing regimens alter renal outcome?

Foster, Mary H.

doi:10.1111/j.1523-1755.2004.00527.x

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Infact, renal involvement in HIV-infected patients can occur in the setting of undetectable viral load. 23 Low hemoglobin, bicarbonate, and high urea and potassium levels were all significantly associated with renal impairment. This is similar to what is obtained in any form of renal derangement, irrespective of the cause.…”

Section: Discussionmentioning

confidence: 96%

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Baseline Renal Function among Antiretroviral Therapy-Naive, HIV-Infected Patients in Southeast Nigeria

Onodugo

Chukwuka

Onyedum

et al. 2013

J Int Assoc Provid AIDS Care

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Background:Renal insufficiency has been shown to be a significant, independent risk factor for mortality among HIV-infected patients. Unfortunately, little is known about the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment. This study aims to find the prevalence of abnormal renal function among antiretroviral therapy (ART)-naive, HIV-infected patients in the South Eastern geopolitical zone of Nigeria.Method:This is a cross-sectional hospital-based study, involving 300 ART-naive HIV-positive patients, seen over a 1-year period, aged from 18 years and older, presenting to the clinic for the first time.Results:A total of 300 patients were included in the study, 104 (34.7%) males and 196 (65.3%) females. The prevalence of significant renal disease was 24.3% (73 of 300), while 38.3% (115 of 300) had mild renal impairment. Using logistic regression, age, CD4 count, urea, creatinine, and hemoglobin were significantly associated with renal impairment.Conclusion:The authors observed a high prevalence of significant renal impairment among HIV-infected patients at the time of ART initiation.

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Section: Discussionmentioning

confidence: 96%

“…Infact, renal involvement in HIV-infected patients can occur in the setting of undetectable viral load. 23…”

Section: Discussionmentioning

confidence: 99%

Baseline Renal Function among Antiretroviral Therapy-Naive, HIV-Infected Patients in Southeast Nigeria

Onodugo

Chukwuka

Onyedum

et al. 2013

J Int Assoc Provid AIDS Care

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“…Saquinar protects mesangial cells from apoptosis but fails to protect against NO triggered cell death. This is despite the fact that signals for ROS and NO are known to overlap and produce antagonistic as well as synergistic effects [83]. Recently, it is now thought that ROS may actually be acting as signalling molecules mobilized in response to various stimuli.…”

Section: Pathways Of Generation Of Ros By Hiv and Haartmentioning

confidence: 99%

The Male Genital Tract in the Era of Highly Active Antiretroviral Therapy (HAART): Implication for Antioxidant Therapy

Azu¹

2012

J AIDS Clinic Res

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With nearly two decades following the introduction of Highly Active Antiretroviral Therapy (HAART) in the management of HIV/AIDS, tremendous success has been recorded in the control of HIV replication and overall wellbeing and longevity of afflicted patients. But this success has not been complete as HAART strategy still suffers from a myriad of issues, chiefly deleterious side effects owing to oxidative stress-induced cellular injuries. Pointless to say that this has impeded progress made so far and has left researchers in the continued search for options. With changing trends in fertility concerns of many patients infected with HIV, a gradual but persistent trust towards procreative tendencies of these patients who are still within the reproductive age axis becomes a compelling issue for experts. Numerous research points to the beneficial effects of antioxidant augmentation in HAART especially relevant in the midst of escalated cost of antiretroviral drugs in resource-deprived settings. A continued attempt to elucidate pathophysiological mechanisms involved in HAART-associated oxidative stress-mediated reproductive injuries remains critically important to improving the treatment strategies for this epidemic condition. Therefore, an overview of our current knowledge on HAART induced changes via oxidant-antioxidant pathway becomes pertinent as we unravel the body of knowledge that may be necessary to guide future directions particularly in reproduction. J o ur nal o f A ID S & Cli n ic a l R es earc h

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“…55 The recent popularity of protease inhibitorsparing regimens has led some researchers to wonder if these regimens will be detrimental to renal survival in patients with HIVAN. 66 Only one case report describes a response to a nonnucleoside reverse transcriptase inhibitor-based regimen. 18 In this case, a 46-year-old African-American man experienced rapid reversal of biopsy-proven HIVAN within 4 weeks of starting combination therapy with lamivudine, zidovudine, and nevirapine.…”

Section: Antiretroviral Therapymentioning

confidence: 99%

Pharmacotherapy for Human Immunodeficiency Virus—Associated Nephropathy

2005

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Approximately 10% of adult patients with human immunodeficiency virus (HIV) infection have HIV-associated nephropathy (HIVAN). This condition, a leading cause of renal failure, is characterized by damage to specific areas of the renal filtration system. It manifests with increased serum creatinine levels, overt proteinuria, and in some patients, end-stage renal disease (ESRD). The mortality rate for HIVAN-related ESRD is high-30% within the first year of onset. Most instances of HIVAN occur in patients of African descent. Although advances in defining the pathology have been made, the optimal treatment strategy remains unclear. Potential benefits of potent combination antiretroviral therapy, angiotensin-converting enzyme (ACE) inhibitors, and corticosteroids have been reported in small clinical trials and case reports. Cyclosporine is another option, but clinical experience with this agent in managing HIVAN is limited. Few conclusions can be drawn from the limited body of available evidence. Antiretroviral therapy, ACE inhibitors, and corticosteroids are possibly associated with reversal of serum creatinine level increases and proteinuria, but studies are necessary to further define the role of these agents in therapy. Close monitoring is advised when treating any patient with HIVAN.

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Taking HAART in HIVAN: Will protease inhibitor sparing regimens alter renal outcome?

Cited by 5 publications

References 9 publications

Baseline Renal Function among Antiretroviral Therapy-Naive, HIV-Infected Patients in Southeast Nigeria

Baseline Renal Function among Antiretroviral Therapy-Naive, HIV-Infected Patients in Southeast Nigeria

The Male Genital Tract in the Era of Highly Active Antiretroviral Therapy (HAART): Implication for Antioxidant Therapy

Pharmacotherapy for Human Immunodeficiency Virus—Associated Nephropathy

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