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Antiretroviral Therapy, Highly Active

Antiretroviral Therapy, Highly Active is a potent combination of three or more antiretroviral drugs used to treat HIV infection and AIDS.
This highly effective treatment regimen, also known as HAART, can suppress viral replication and improve immune function, leading to significant reductions in HIV-related morbidity and mortality.
The descriptin combines multiple classes of antiretroviral agents, such as nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors, to target the virus at different stages of its life cycle.
Experincing optimal treatment outcomes with HAART requires adherence to the prescribed regimen and careful monitoring by healthcare providers.

Most cited protocols related to «Antiretroviral Therapy, Highly Active»

1
Preventing HIV Transmission in Botswana
Between July 2006 and May 2008, we enrolled pregnant women with HIV-1 infection in the Mma Bana Study (meaning “mother of the baby” in Setswana) in southern Botswana. Women with CD4+ cell counts of 200 or more were randomly assigned (in permuted blocks stratified according to clinical site) to receive either 300 mg of abacavir, 300 mg of zidovudine, and 150 mg of lamivudine coformulated as Trizivir (GlaxoSmith-Kline) twice daily (the NRTI group) or 400 mg of lopinavir and 100 mg of ritonavir coformulated as Kaletra (Abbott) with 300 mg of zidovudine and 150 mg of lamivudine coformulated as Combivir (GlaxoSmithKline) twice daily (the protease-inhibitor group). Women with CD4+ cell counts of less than 200 cells per cubic millimeter or with an acquired immunodeficiency syndrome (AIDS)–defining illness received standard-of-care treatment for Botswana: 200 mg of nevirapine, 300 mg of zidovudine, and 150 mg of lamivudine twice daily (after a 2-week lead-in period of oncedaily nevirapine at a dose of 200 mg) (the observational group). Women in the randomized groups began to receive HAART between 26 and 34 weeks’ gestation and continued it through weaning or 6 months post partum (whichever occurred first), and women in the observational group began to receive HAART between 18 and 34 weeks’ gestation and continued treatment indefinitely. We report results for the primary end points at 6 months post partum.
Infants received single-dose nevirapine (6 mg) at birth and received zidovudine (4 mg per kilogram of body weight twice daily) from birth through 4 weeks. Women were counseled to exclusively breast-feed and to complete weaning 3 days before the 6-month study visit. Infants were provided free formula and foods from the time of weaning (whenever it occurred) through 12 months.
Study drugs were provided by GlaxoSmith-Kline (Trizivir and Combivir) and Abbott Pharmaceuticals (Kaletra), but these companies had no other role in the design of the study, the accrual or analysis of the data, the preparation of the manuscript, or the decision to submit the manuscript for publication. The Botswana government provided nevirapine, Combivir, additional medications, and some laboratory testing. The Health Research Development Committee of Botswana and the Human Subjects Committee of the Harvard School of Public Health approved the study protocol and amendments. An independent data and safety monitoring board reviewed safety and efficacy data approximately every 6 months. The full study protocol including the statistical-analysis plan, is available with the full text of this article at NEJM.org. All authors vouch for the completeness and veracity of the reported data and analyses and attest that the study as reported conforms with the protocol.
Shapiro R.L., Hughes M.D., Ogwu A., Kitch D., Lockman S., Moffat C., Makhema J., Moyo S., Thior I., McIntosh K., van Widenfelt E., Leidner J., Powis K., Asmelash A., Tumbare E., Zwerski S., Sharma U., Handelsman E., Mburu K., Jayeoba O., Moko E., Souda S., Lubega E., Akhtar M., Wester C., Tuomola R., Snowden W., Martinez-Tristani M., Mazhani L, & Essex M. (2010). Antiretroviral Regimens in Pregnancy and Breast-Feeding in Botswana. The New England journal of medicine, 362(24), 2282-2294.
Publication 2010
abacavir Acquired Immunodeficiency Syndrome Antiretroviral Therapy, Highly Active Body Weight CD4+ Cell Counts Cells Childbirth Clinical Trials Data Monitoring Committees Combivir Cuboid Bone Food HIV-1 Homo sapiens Infant Infection Kaletra Lamivudine Lopinavir Mothers Nevirapine Pharmaceutical Preparations Pregnancy Pregnant Women Protease Inhibitors Ritonavir Trizivir Woman Zidovudine
2
Prospective Observational Study of U.S. Military HIV Patients
The U.S. Military HIV Natural History Study (NHS) is a prospective multicenter observational study of HIV-infected active duty military personnel and other beneficiaries (spouses, dependents, and retired military personnel) from the Army, Navy/Marines and Air Force. All participants provided written informed consent. The cohort characteristics have been previously described [17 (link)]. Patients were included in this analysis if they were enrolled in the NHS and initiated HAART at any time from 1996 until December 31, 2007 with data collected through July 1, 2008. The NHS has been approved by the Institutional Review Board of each participating center.
Marconi V.C., Grandits G.A., Weintrob A.C., Chun H., Landrum M.L., Ganesan A., Okulicz J.F., Crum-Cianflone N., O'Connell R.J., Lifson A., Wortmann G.W, & Agan B.K. (2010). Outcomes of highly active antiretroviral therapy in the context of universal access to healthcare: the U.S. Military HIV Natural History Study. AIDS Research and Therapy, 7, 14.
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Publication 2010
Antiretroviral Therapy, Highly Active Ethics Committees, Research Marines Military Personnel Patients
3
Developing a Medication Adherence Questionnaire
The questionnaire design process began by collecting as many instruments and items as we could that had attempted to measure self-reported medication adherence. We first conducted a literature review using combinations of the following search terms: HIV, highly active antiretroviral therapy, medication adherence, self-report, questionnaires, survey methodology. In addition we reviewed references of review articles and directly contacted a number of investigators. There were dozens of such questions that varied in their reference period, how they were worded, what respondents were supposed to report about, and the response tasks respondents were supposed to use to provide answers (a detailed list of the items we considered is available from the first author upon request). We focused our initial attention on the question wording and response tasks that seemed to be used most often and had the strongest face validity.
Wilson I.B., Fowler FJ J.r., Cosenza C.A., Michaud J., Bentkover J., Rana A., Kogelman L, & Rogers W.H. (2013). Cognitive and Field Testing of a New Set of Medication Adherence Self-Report Items for HIV Care. AIDS and Behavior, 18(12), 2349-2358.
Publication 2014
Antiretroviral Therapy, Highly Active Attention
4
Hair-Based Antiretroviral Quantification
Efavirenz, lopinavir and ritonavir reference compounds, and internal standards (IS), ritonavir-d6 and celecoxib, were obtained from Toronto Research Chemicals (Toronto, Canada). Proteinase K was purchased from Sigma™. Acetonitrile, methanol and other solvents or reagents were HPLC grade or analytical grade. Human hair samples were obtained from patients on lopinavir/ritonavir or efavirenz–based HAART in the Women’s Interagency HIV Study (WIHS). Blank human hair samples were obtained from healthy volunteers to serve as negative controls.
Huang Y., Gandhi M., Greenblatt R.M., Gee W., Lin E.T, & Messenkoff N. (2008). Sensitive analysis of anti-HIV drugs, efavirenz, lopinavir and ritonavir, in human hair by liquid chromatography coupled with tandem mass spectrometry. Rapid communications in mass spectrometry : RCM, 22(21), 3401-3409.
Publication 2008
acetonitrile Antiretroviral Therapy, Highly Active Celecoxib efavirenz Endopeptidase K Hair Healthy Volunteers High-Performance Liquid Chromatographies Homo sapiens Lopinavir lopinavir-ritonavir drug combination Methanol Patients Ritonavir Solvents Woman
5
Long-term HIV Care Databases in Baltimore and Rio de Janeiro
The Johns Hopkins AIDS Service provides care for a large proportion of HIV-infected patients in Baltimore. An observational, longitudinal, clinical database has been maintained on patients receiving primary HIV care since 1990. In this longitudinal database, data are updated regularly using clinic and inpatient clinical documentation (from the Johns Hopkins AIDS Service and elsewhere), laboratory testing results, and pharmacy records. Prescription of antiretroviral therapy (drug, dates of use, and dose) is documented by the medical provider and support staff in the clinical records. Trained abstractors record all this information onto standardized forms for processing. Data on mortality came from the medical records, Maryland State vital statistics records, the National Death Index, and the national Social Security Death Index. Details of the methodology have been previously described [12 (link)].
The IPEC/FIOCRUZ AIDS Clinic has provided care to HIV-infected patients in Rio de Janeiro since 1986. An observational, longitudinal, clinical database has been maintained on patients receiving primary HIV care in the clinic since 1998. The data collection process was patterned after the process established at the Johns Hopkins AIDS Service. Data are updated regularly using clinic and inpatient clinical documentation, laboratory testing results, and pharmacy records. Since 1996, the Brazilian Ministry of Health initiated a program of providing HAART free of charge to all HIV-infected individuals. Locally produced antiretroviral drugs have been widely used in Brazil since then. Brazil now holds a unique position as a developing country with more than 200 000 patients receiving HAART. Prescription of antiretroviral therapy at IPEC–FIOCRUZ (drug, dates of use, and dose) is documented by the medical provider and support staff in the clinical records. Trained abstractors record all this information onto standardized forms for processing. Data on mortality came from the medical records and national death statistics. Details of the methodology have been previously described [13 ].
Grinsztejn B., Veloso V.G., Friedman R.K., Moreira R.I., Luz P.M., Campos D.P., Pilotto J.H., Cardoso S.W., Keruly J.C, & Moore R.D. (2009). Early mortality and cause of deaths in patients using HAART in Brazil and the United States. AIDS (London, England), 23(16), 2107-2114.
Publication 2009
Acquired Immunodeficiency Syndrome Antiretroviral Therapy, Highly Active Inpatient Patients Pharmaceutical Preparations Primary Health Care Therapeutics

Most recents protocols related to «Antiretroviral Therapy, Highly Active»

1
Pharmaceutical Services for HIV Patients
All HIV-positive patients who were older than 18 years, receiving highly active antiretroviral therapy, and were provided pharmaceutical services in the ART pharmacy of the facility and who were willing to give consent and completed the interview process were included in this study. While patients who did not meet these criteria were excluded.
Ahmad D.M., Abonyi E.E., Chukwudi Ugwuonah J., Okon P.E., Aliyu S., Uzairue, BMLS, MSc L.I, & Lucero-Prisno D.E. (2023). HIV Patients’ Satisfaction with Pharmaceutical Care at a Nigerian Tertiary Healthcare Facility During the Covid-19 Pandemic. Journal of the International Association of Providers of AIDS Care, 22, 23259582231159093.
Publication 2023
Antiretroviral Therapy, Highly Active HIV Seropositivity Patients Pharmaceutical Services
2
Comprehensive Clinical Data Profiling for HIV/AIDS
Data on the demographics and clinical characteristics of participants, including the following covariates, were extracted from the CDPCIS. In brief, information on age, sex, weight, height, marital status, education level, race, infection pathway, history of sexual behavior, whether coupled with sexually transmitted diseases (STDs), initial HAART prescription, disease stage (HIV or AIDS), WHO clinical stage, and other variables was collected strictly following the standard operating procedure of this study in a face-to-face interview or physical examination at enrollment. The body mass index (BMI) was calculated using the following equation: BMI = weight (kg)/height (m)/height (m). In addition, HIV/AIDS-associated laboratory testing, including CD4+ T lymphocytopenia (CD4), CD8+ T lymphocytopenia (CD8), serum hemoglobin, platelet (PLT), white blood cell (WBC), alanine aminotransferase (ALT), aspartate transaminase (AST), serum creatinine, total bilirubin (TBIL), and fasting plasma glucose (FPG), were carefully determined by experienced professional technicians from Huzhou CDC or local AIDS-designated treatment hospitals per standard clinical procedures and documented in the electronic medical records at CDPCIS.
Jin M., Wang Y., Li J., Wu Z., Liu X., Wang H., Chen Y., Wang Z., Tong Z., Li X., Ren F., Zhu X., Yang Z, & Mao G. (2023). Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China. Frontiers in Medicine, 10, 1055115.
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Publication 2023
Acquired Immunodeficiency Syndrome Antiretroviral Therapy, Highly Active Aspartate Transaminase Bilirubin Blood Platelets Creatinine D-Alanine Transaminase Face Glucose Hemoglobin Hospital Administration Index, Body Mass Infection Leukocytes Lymphopenia Physical Examination Plasma Serum Sexually Transmitted Diseases T-Lymphocytopenia, Idiopathic CD4-Positive
3
Survival Analysis of PLWHA in China
The data used in the present study were extracted from 1,694 PLWHA from the China Disease Prevention and Control Information System (CDPCIS) during 17 years of follow-up in the Huzhou area, China. Detailed information on participant enrollment, HAART, and follow-up can be found in a previous study (17 (link)). The inclusion criteria were as follows: over 18 years of age; living in the Huzhou area containing temporary residents; diagnosed or identified from 1 January 2005 to 30 June 2022; having completed baseline (pre HAART) laboratory serum testing; and being visited at least once. Survival time was determined as the duration from receiving HAART to death or 30 June 2022. PLWHA who received HAART before entering the cohort, those with missing baseline hemoglobin records, or those with illogical survival times were excluded from the final data analysis.
Among the 1,694 PLWHA enrolled in this study (Figure 1), 169 were excluded based on the inclusion criteria. Of the remaining 1,525 participants, 96 were dead and 1,429 were alive.
Jin M., Wang Y., Li J., Wu Z., Liu X., Wang H., Chen Y., Wang Z., Tong Z., Li X., Ren F., Zhu X., Yang Z, & Mao G. (2023). Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China. Frontiers in Medicine, 10, 1055115.
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Publication 2023
Antiretroviral Therapy, Highly Active Hemoglobin Serum
4
Acute Respiratory Failure in AIDS Patients
Consecutive AIDS patients with ARF admitted to the ICU or the Center for Infectious Diseases, Beijing Ditan Hospital, from April 2019 to March 2022, were screened daily. All enrolled patients in this study were inpatients infected with HIV and were considered to have AIDS as defined by the Centers for Disease Control and Prevention classification system for HIV infection [19 (link)]. A newly diagnosed HIV infection was diagnosed within two months before ICU admission and had not received HAART. If patients at the Center for Infectious Diseases met the inclusion criteria, they would transfer to the ICU. ARF was defined as the onset of respiratory symptoms within 72 h before enrollment, a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/ FiO2) ≤ 300 mmHg or PaO2 ≤ 60 mmHg with partial pressure on air with arterial carbon dioxide (PaCO2) ≤ 50 mmHg and symptoms of respiratory distress (tachypnea > 25/min, labored breathing, and dyspnea at rest). In addition to ARF, the inclusion criteria were being between 18 to 70 and being willing to accept endotracheal intubation if needed.
Exclusion criteria were impending cardiopulmonary arrest, a disorder of consciousness, absence of airway protective gag reflex, upper airway obstruction, pregnancy or breastfeeding, other organ failures apart from ARF, consent withdrawal, used immunosuppressant, and enrolment in other research protocols. ARF caused by pneumothorax or massive pleural effusion, acute exacerbation of chronic lung disease, cardiogenic pulmonary edema, and central nervous system lesions were also excluded.
Hao J., Liu J., Pu L., Li C., Zhang M., Tan J., Wang H., Yin N., Sun Y., Liu Y., Guo H, & Li A. (2023). High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation in AIDS Patients with Acute Respiratory Failure: A Randomized Controlled Trial. Journal of Clinical Medicine, 12(4), 1679.
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Publication 2023
Acquired Immunodeficiency Syndrome Acute Disease Airway Obstruction Antiretroviral Therapy, Highly Active Arteries Carbon dioxide Cardiopulmonary Arrest Central Nervous System Communicable Diseases Consciousness Disorders HIV Infections Immunosuppressive Agents Inpatient Intubation, Intratracheal Lung Oxygen Partial Pressure Patients Pleural Effusion Pneumothorax Pregnancy Pulmonary Edema Signs and Symptoms, Respiratory
5
Cervical Screening in Women with HIV
We performed a multicentric, retrospective cohort study that involved two Italian centers: IRCCS Fondazione Policlinico San Matteo, Pavia, and Luigi Sacco Hospital, ASST-Fatebenefratelli-Sacco, University of Milan, Milan. All WLWH who attended the colposcopic services of the two institutions from 1999 to 2019 were retrospectively identified by searching the clinical databases.
Those patients who presented at entry with a normal Pap smear and a negative HR-HPV test and who had at least one year of follow-up were selected for the analysis. Exclusion criteria were: age 21 years or older, ongoing pregnancy, treatment for CIN or total hysterectomy before enrollment. Institutional Review Board (IRB) approval by our institution was obtained (RC805036 IRCCS Fondazione Policlinico San Matteo, Pavia, Italy).
Anamnestic items about sociodemographic and clinical features were compiled after structured interviews during enrollment and the follow-up. All patients were evaluated every 6–12 months according to an established protocol, including a Pap smear, HPV test, and colposcopy with targeted biopsies if necessary. Abnormalities in cervical cytology were classified according to the most recent Bethesda system terminology [14 (link)]. Cytology examinations performed before the introduction of the Bethesda system terminology were revised by the pathologists of each institution involved in the study. The colposcopic examinations were recorded, taking into consideration the 2011 revised colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) [15 (link)]. Cervical samples for the HPV test were obtained immediately before colposcopy, and scrapes were taken with a cervix brush, suspended in Thin Prep Preserve Cyt Solution (Cytic Corporation, Marlborough, MA, USA), and stored at 4 C. HPV type-specific sequences were detected by the line probe assay INNO-LiPA HPV genotyping assay version V2 up to 2009 and version EXTRA subsequently (Fujirebio Europe, Gent, Belgium), according to the manufacturer’s instructions. The International Agency for Research on Cancer (IARC) classified HPV types into the following categories: high-risk HPV with proven carcinogenicity (16, 18, 31, 33, 45, 52, 58, 26, 35, 39, 51, 53, 56, 59, 66, 68, 73, 82) and low-risk HPVs (6, 11, 40, 43, 44, 54, 69, 70, 74) [16 (link)]. We considered persistent infection the detection of HPV DNA for at least 2 years.
The colposcopic examination was performed by two experienced gynecologists (BG and AA) certified by the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV). Targeted cervical biopsies were obtained in all cases where a cervical lesion was suspected and in all cases of high-grade squamous cervical lesions (HSIL), irrespective of the colposcopic impression. Endocervical curettage was performed, according to the clinician’s judgment, when the extent of the lesion or the squamocolumnar junction was not entirely visible (transformation zone type 3). Histopathologic results were reported according to Lower Anogenital Squamous Terminology (LAST) as LSIL (CIN1), HSIL (CIN2), HSIL (CIN3), or HSIL (CIN2/3) [17 (link)]. The use and type of antiretroviral therapy were recorded on the basis of the medications listed in the patients’ charts. HAART was defined as the co-administration of two nucleoside reverse-transcriptase inhibitors and at least one of the following: a protease inhibitor, a non-nucleoside reverse-transcriptase inhibitor, or an additional nucleoside reverse-transcriptase inhibitor. All other types of ART (mono- or dual-nucleoside reverse-transcriptase inhibitors) were defined as pre-HAART. CD4+ T-lymphocyte count was considered according to the Centers for Disease Control’s revised surveillance case definition for HIV infection [18 ]. The classes of HIV-related immunodeficiency were reported in accordance with the WHO immunologic classification for established HIV infection [19 ]. These classifications identify the following classes: none or not significant for a CD4+ T-cell count of 500 cells/µL; mild for a CD4+ T-cell count of 350–499 cells/µL; advanced for a CD4+ T-cell count of 200–349 cells/µL; and severe for a CD4+ T-cell count of 200 cells/µL.
Gardella B., Agarossi A., Dominoni M., Pagano I., Del Frati S., Di Giminiani M., Cammarata S., Melito C., Pasquali M.F., Zanchi L., Savasi V, & Spinillo A. (2023). Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up. Vaccines, 11(2), 265.
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Publication 2023
Antiretroviral Therapy, Highly Active Biological Assay Biopsy Carcinogenesis CD4 Positive T Lymphocytes CD4+ Cell Counts Cells Cervical Intraepithelial Neoplasia, Grade III Cervix Uteri Colposcopy Communicable Disease Control Congenital Abnormality Curettage Cytological Techniques Endocervix Ethics Committees, Research Gynecologist High-Grade Squamous Intraepithelial Lesions HIV Infections Human Papillomavirus Hysterectomy Immunologic Deficiency Syndromes Low-Grade Squamous Intraepithelial Lesions Malignant Neoplasms Neck Nucleosides Pathologists Patients Persistent Infection Pharmaceutical Preparations Physical Examination Pregnancy Protease Inhibitors Reverse Transcriptase Inhibitors Therapeutics Vagina Vaginal Smears

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More about "Antiretroviral Therapy, Highly Active"

Highly Active Antiretroviral Therapy (HAART) is a potent combination of three or more antiretroviral drugs used to treat HIV infection and AIDS.
This highly effective treatment regimen, also known as cART (Combination Antiretroviral Therapy) or ART (Antiretroviral Therapy), can suppress viral replication and improve immune function, leading to significant reductions in HIV-related morbidity and mortality.
The combination therapy utilizes multiple classes of antiretroviral agents, such as nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs), to target the virus at different stages of its life cycle.
Optimal treatment outcomes with HAART require strict adherence to the prescribed regimen and careful monitoring by healthcare providers.
The powerful combination of antiretroviral drugs, when taken consistently, has revolutionized the management of HIV/AIDS, transforming it from a terminal illness to a chronic, manageable condition.
Tools like SAS 9.4, Stata 12.0, MultSpec-1501, FE-SEM, FACSCalibur, Universal ATR spectrometer, FACSCount, and Human Cytokine Array C5 have been instrumental in advancing research and understanding of HAART and its impact on HIV/AIDS treatment and management.