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Adefovir dipivoxil-induced hypophosphatemic osteomalacia and osteoporosis: a case report and literature review.

The nephrotoxicity of adefovir dipivoxil (ADV) can induce Fanconi syndrome, which causes hypophosphatemic osteomalacia. We report a case of a 67-year-old postmenopausal woman who had been receiving long-term adefovir dipivoxil therapy for chronic hepatitis B. She presented with severe bone pain and multiple pseudofractures, and was diagnosed with drug-induced hypophosphatemic osteomalacia. Following discontinuation of adefovir and supplementation with vitamin D and phosphate, her biochemical parameters normalized and bone pain significantly improved, indicating that osteomalacia had been essen

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… Tenofovir-induced osteopenia and hyperparathyroidism: 314 A case report and literature review . Front Endocrinol . ( 2023 ) 13 : 1043954 . doi: 10.3389/fendo.2022.1043954 , PMID: 36714555 PMC9875041 2 Song K Yan Q Yang Y Lv M Chen Y Dai Y . … Clinical management of hypophosphatemic osteomalacia induced by adefovir and tenofovir: Insights from a case report . Medicine . ( 2024 ) 103 : e40746 . doi: 10.1097/md.0000000000040746 , PMID: 39612388 PMC11608679 16 He H Zhang Y-J . …

Fanconi Syndrome in an Adult With Chronic Alcohol Use Disorder: A Rare Etiology.

Fanconi syndrome is described as a defect in the proximal tubular reabsorption of glucose, amino acids, uric acid, phosphate, and bicarbonate, falling under type 2 renal tubular acidosis (RTA). Some common causes include drugs, heavy metals, infections, and genetics (particularly mitochondrial disorders).  We present a case of a 33-year-old Caucasian female with chronic alcohol use disorder. She was treated for acute kidney injury (AKI) but had persistent hypophosphatemia, hypokalemia, hypouricemia, low bicarbonate, along with glycosuria consistent with Fanconi syndrome. An exhaustive workup r

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… Acquired forms are more prevalent in the adult population, and known etiologies include drugs such as tenofovir [ 2 ] and cisplatin, lead poisoning, and autoimmune diseases like Sjogren’s syndrome and primary biliary cholangitis [ 3 ]. … Acute renal failure and Fanconi syndrome in an AIDS patient on tenofovir treatment--case report and review of literature. Malik A, Abraham P, Malik N. J Infect. 2005;51:0. doi: 10.1016/j.jinf.2004.08.031. 3. Fanconi syndrome associated with didanosine therapy. Izzedine H, Launay-Vacher V, Deray G. …

Plasmablastic Lymphoma. A State-of-the-Art Review: Part 2-Focus on Therapy.

The objective of this two-part review is to present a current and comprehensive understanding of the diagnosis and management of plasmablastic lymphoma. The first part, which was published previously, focused on the study of epidemiology, etiology, clinicopathological characteristics, differential diagnosis, prognostic variables, and the impact of plasmablastic lymphoma on specific populations. This second part addresses the difficult topic of the treatment of plasmablastic lymphoma, specifically examining both the conventional, consolidated approach and the novel therapeutic strategy.

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… In addition to tenofovir and emtricitabine (FTC) or lamivudine (3TC), a third HIV drug should be administered. 174 , 175 Tenofovir alafenamide (TAF) should be preferred over tenofovir disoproxilfumarate (TDF) because it has a more favorable safety profile and is equally effective against HBV. 175 Therefore …

Comparison of post-authorisation measures from regulatory authorities with additional evidence requirements from the HTA body in Germany - are additional data requirements by the Federal Joint Committee justified?

ObjectivesThe aim of this study was to compare post-authorisation measures (PAMs) from the European Medicines Agency (EMA) with data requests in fixed-termed conditional appraisals of early benefit assessments from the German Federal Joint Committee (G-BA).MethodsMedicinal products with completed benefit assessments during an assessment period of 3.5 years were considered. PAMs extracted from European Public Assessment Reports (EPARs) were compared with data requests issued by the G-BA in the context of conditional appraisals.ResultsTwenty conditional appraisals (19 products) and 34 EPARs cont

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… The PAM given in the Eylea EPAR refers to AMD; Eylea for CRVO was therefore omitted from the table g Medicinal products with orphan status h For emtricitabine/rilpivirine/tenofovir disoproxil and rilpivirine, the same PAM was requested and was counted twice i Ipilimumab received a license expansion that … disoproxil | Stribild | HIV infection | No | - | 1 | 0.5 Emtricitabine/rilpivirine/tenofovir disoproxil h | Eviplera | HIV infection | No | - | 2 | 1; 2 Eribulin | Halaven | Breast cancer | Yes | 2 | 0 | - Extract of C annabis sativa | Sativex | Multiple sclerosis | Yes | 3 | No centralised procedure …

Successful Treatment with Fusidic Acid in a Patient with Folliculitis Decalvans.

Dear Editor, Folliculitis decalvans (FD) is a rare form of primary neutrophilic cicatricial alopecia. It is a highly distressing disease tha … deficiency virus type 1 (HIV-1) infection 5 years prior and was stable on her regimen of efavirenz, tenofovir, and emtricitabine, with undetectable viral load. She denied application of topical or capillary products. Dermatological examination revealed a patch of cicatricial alopecia with crusts and follicular pustules (Figure 1). Direct microscopic examina …

Doxycycline prophylaxis and meningococcal group B vaccine to prevent bacterial sexually transmitted infections in France (ANRS 174 DOXYVAC): a multicentre, open-label, randomised trial with a 2 × 2 factorial design.

BACKGROUND: Increased rates of sexually transmitted infections (STIs) are reported among men who have sex with men (MSM) and new interventio … re already included in the ANRS PREVENIR study (a cohort of MSM using pre-exposure prophylaxis with tenofovir and emtricitabine for HIV prevention). Participants were randomly assigned (2:1) to doxycycline PEP (two pills of 100 mg each orally within 72 h after condomless sex, with no more than three doses of 200 mg per week) or no PEP groups and were also r …

Perinatal outcomes associated with antiretroviral therapy for pregnant women living with HIV: an umbrella review.

BACKGROUND: The World Health Organization recommends antiretroviral therapy (ART) for pregnant women living with HIV (WLHIV), the vast major … (RR 1.41, 95% CI 1.08-1.83, I 2 0.0%), compared to non-nucleoside reverse transcriptase inhibitors. Tenofovir disoproxil fumarate is associated with a lower risk of adverse perinatal outcomes and zidovudine is associated with an increased risk of perinatal outcomes. Compared to HIV-negative women, WLHIV receiving ART remain at increased risk of adverse peri …

Safety and efficacy of rituximab in patients with diffuse large B-cell lymphoma in Malawi: a prospective, single-arm, non-randomised phase 1/2 clinical trial.

BACKGROUND: There are no clinical trials involving patients with diffuse large B-cell lymphoma (DLBCL) in sub-Saharan Africa since antiretro … ividuals with CNS involvement from DLBCL, chronic hepatitis B infection (unless they were receiving tenofovir plus lamivudine), or any other comorbidities that would compromise the protocol objectives were excluded. Eligible patients received intravenous rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 (maximu …

Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: A randomised controlled trial.

BACKGROUND: In sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly … h raltegravir-intensified ART, with weak evidence of less intermediate- or high-level resistance to tenofovir (p = 0.06), abacavir (p = 0.08), and rilpivirine (p = 0.07). Limitations of the study include limited clinical, radiological, and/or microbiological information for some participants, reflecting available services at the centres, and lack of baselin …

Targeting inflammation as cancer therapy.

Inflammation has accompanied human beings since the emergence of wounds and infections. In the past decades, numerous efforts have been undertaken to explore the potential role of inflammation in cancer, from tumor development, invasion, and metastasis to the resistance of tumors to treatment. Inflammation-targeted agents not only demonstrate the potential to suppress cancer development, but also to improve the efficacy of other therapeutic modalities. In this review, we describe the highly dynamic and complex inflammatory tumor microenvironment, with discussion on key inflammation mediators i

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… The superiority of tenofovir over entecavir in reducing HCC incidence in CHB patients was further confirmed in several other studies [ 303 , 308 ]. … However, some studies failed to identify clinically meaningful difference in the risk of liver-related events or deaths including HCC between entecavir- and tenofovir-treated cohorts, suggesting that the choice between tenofovir or entecavir should be based on patients’ tolerability (NCT019553458) [ …

An update and review of antiretroviral therapy.

The human immunodeficiency virus (HIV) was discovered in 1982, but treatment strategies were not introduced until 5 years later. Early regimens consisted of one or two drugs and often led to treatment failure. Since the advent in 1995 of highly active antiretroviral therapy (HAART), which consists of at least three agents, a dramatic improvement has been seen in the number of patients attaining undetectable viral loads, improved CD4 counts, and improved survival. However, early HAART often consisted of drugs with complex dosing schedules, strict food requirements, treatment-limiting adverse ef

Merkel cell carcinoma and the challenge in its approach: a review based on a clinical context of immunosuppression.

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine cancer with high rate to local relapse and metastasis. Its connection to immunosuppression is well known, with reported association to human immunodeficiency virus (HIV). The authors present an 87-year-old woman, infected by HIV type 2 at advanced stage of the disease, whom presented a painless papule on left cheek in 2011. After its total excision, the histopathology confirmed MCC "in situ," with no regional or distant metastases. Simultaneously, she revealed a viral load of 2220 copies/mL and 224 CD4/mm3. Five months later,

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… She had been followed up in the outpatient ambulatory of the Clinical Immunology Unit since 2004 and had been under antiretroviral therapy (ART) with multiple combinations of drugs such as zidovudine plus lamivudine plus lopinavir/ritonavir, followed by tenofovir plus lamivudine plus atazanavir/ritonavir … , and finally due to chronic renal insufficiency, tenofovir was switched to didanosine. …

Lamivudine induced pure red cell aplasia and HIV-1 drug resistance-associated mutations: a case report.

Adverse effects linked to antiretroviral therapy (ART) may contribute to poor adherence on the patient's side. Consequently, human immunodeficiency virus (HIV) drug resistance mutations could emerge, negatively impacting the body's immune system. Meanwhile, severe immunosuppression can lead to several conditions, including anemia. The cause of anemia in HIV infection is multifactorial, and can be mainly explained by deleterious direct effects of the virus on the bone marrow, and opportunistic infections such as Parvovirus B19. Other causes include blood loss resulting from neoplasms and gastro

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… CASE REPORT This is a 44-year-old single and self-employed female who was initiated on tenofovir disoproxil fumarate (TDF), 3TC and efavirenz (EFV) as an outpatient in July 2012. … Tenofovir-associated kidney disease in Africans: a systematic review. AIDS Res Ther 2019;16:12. Associated Data Supplementary Materials Click here for additional data file. …

Essential Medicinal Chemistry of Essential Medicines.

Since 1977, the World Health Organization publishes a list of essential medicines, i.e., those that satisfy the priority health care needs of the population and are selected with regard to disease prevalence and public health relevance, evidence of clinical efficacy, and safety, as well as comparative costs and cost-effectiveness. The Essential Medicines List (EML) is an invaluable tool for all countries to select those medicines that have an excellent risk/benefit ratio and that are reputed to be of pivotal importance to health. In the present perspective, we describe the chemical composition

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… Moreover, a carbonate (tenofovir disoproxil) and a phosphate ester (dexamethasone phosphate) are also inserted. … Another example is tenofovir disoproxil, a nucleotide analogue reverse-transcriptase inhibitor for the treatment of HIV and HBV. The cleavage of disoproxil releases tenofovir that is phosphorylated to tenofovir diphosphate, the active compound. …

Adult-onset hypophosphatemic osteomalacia as a cause of widespread musculoskeletal pain: A retrospective case series of single center experience.

BACKGROUND: Osteomalacia (OM) is frequently confused with various musculoskeletal or other rheumatic diseases, especially in patients with adult-onset widespread musculoskeletal pain because of its low prevalence and non-specific manifestations. AIM: To facilitate the early diagnosis and etiology-specific treatment of adult-onset hypophosphatemic OM. METHODS: A retrospective review of medical records was performed to screen adult patients who visited a physiatry locomotive medicine clinic (spine and musculoskeletal pain clinic) primarily presenting with widespread musculoskeletal pain at a s

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… Table 3 Etiology, treatment, and outcome of adult-onset hypophosphatemic osteomalacia N/A: Not applicable; ADV: Adefovir; ETV: Entecavir; TAF: Tenofovir alafenamide fumarate. … Three of the six patients with ADV-induced Fanconi syndrome changed the drug to entecavir, one patient was changed to tenofovir alafenamide fumarate, and one patient discontinued the medication altogether. …

Drug assessment by a Pharmacy and Therapeutics committee: from drug selection criteria to use in clinical practice.

BackgroundIn Spain, hospital medicines are assessed and selected by local Pharmacy and Therapeutics committees (PTCs). Of all the drugs assessed, cancer drugs are particularly important because of their budgetary impact and the sometimes arguable added value with respect to existing alternatives. This study analyzed the PTC drug selection process and the main objective was to evaluate the degree of compliance of prescriptions for oncology drugs with their criteria for use.MethodsThis was a retrospective observational study (May 2007 to April 2010) of PTC-assessed drugs. The variables measured

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… 2007 to April 2008 | Eplerenone (C03DA) | Glutamine (B05XB) | Clonidine (C02AC) Botulinum toxin type B (M03AX) | Bortezomib (L01XX) b | Levetiracetam (N03AX) Bemiparin (B01AB) | Entecavir (J05AF) | Olanzapine (N05AH) | Aprepitant (A04AD) | Ranibizumab (S01LA) | Gadobutrol (V08CA) | | Emtricitabine/tenofovir … 2009 | Ibandronic acid (M05BA) | Fosfomycin-trometamol (J01XX) | Insulin analogs (aspart, glulisine and detemir) (A10A) | Chlorthalidone (C03BA) | | Esmolol (C07AB) | | Nitrous oxide/oxygen (N01AX) | | Linezolid (J01XX) | | Pegfilgrastim (L03AA) | | Abatacept (L04AA) | | Emtricitabine/tenofovir …

Treatment outcomes in HIV infected patients older than 50 years attending an HIV clinic in Harare, Zimbabwe: A cohort study.

There is a growing number of older people living with HIV (OPLHIV). While a significant proportion of this population are adults growing into old age with HIV, there are also new infections among OPLHIV. There is a lack of data describing the outcomes of OPLHIV who commenced antiretroviral therapy (ART) after the age of 50 years in sub-Saharan Africa. We conducted a cohort study of patients who enrolled in care at Newlands Clinic in Harare, Zimbabwe, at ages ≥50 years between February 2004 and March 2020. We examined demographic characteristics, attrition, viral suppression, immunological and

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… The top three starting regimens were tenofovir + lamivudine + efavirenz, stavudine + lamivudine + nevirapine, and zidovudine + lamivudine + nevirapine with 124 (29.5%), 95 (22.6%), and 91 (21.7%) patients, respectively. … The antiretrovirals most discontinued due to adverse events were nevirapine, stavudine, zidovudine and tenofovir disoproxil fumarate (TDF). …

Doravirine versus ritonavir-boosted darunavir in antiretroviral-naive adults with HIV-1 (DRIVE-FORWARD): 96-week results of a randomised, double-blind, non-inferiority, phase 3 trial.

BACKGROUND: Doravirine is a novel, non-nucleoside reverse transcriptase inhibitor that has shown non-inferior efficacy to ritonavir-boosted … ay), both with investigator-selected nucleoside reverse transcriptase inhibitors: emtricitabine and tenofovir disoproxil fumarate or abacavir and lamivudine. Participants and investigators were masked to treatment assignment until week 96. The primary efficacy endpoint was the proportion of participants who had a plasma HIV-1 RNA concentration of less than …

A risk-differentiated, community-led intervention to strengthen uptake and engagement with HIV prevention and care cascades among female sex workers in Zimbabwe (AMETHIST): a cluster randomised trial.

BACKGROUND: Female sex workers remain disproportionately affected by HIV. The aim of this study was to determine the effect of risk-differen … the usual care group reported currently taking PrEP, of whom only two (0·4%) of 569 had protective tenofovir diphosphate concentrations in dried blood spots (>700 fmol/dried blood punch). There was no effect of the intervention on the primary endpoint of risk of both HIV transmission and acquisition (intervention group n=1156/2131, RDS-adjusted proportion …

Infectious Diseases

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