Background An zidovudine （AZT）-substitution regimen containing 24-week stavudine （d4T） followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associat...Background An zidovudine （AZT）-substitution regimen containing 24-week stavudine （d4T） followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resourcelimited settings.However,evidence is scarce.This study aims to assess the efficacy and safety of AZT-substitution regimen,aiming to find a regimen with better efficacy,less adverse events,and more affordability in resource-limited settings.Methods This prospective,multicenter study enrolled 499 （190 on d4T regimen,172 on AZT regimen,and 137 on AZT-substitution regimen） HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011.Lamivudine （3TC） and either nevirapine （NVP） or efavirenz （EFV） were the other two drugs in the antiretroviral regimens.Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4,12,24,36,48,60,72,84,and 96.Results In terms of hematological adverse effects,AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group.In comparison with AZT-substitution group,AZT group was associated with higher risk of developing anemia （adjusted hazard ratio （aHR）for anemia ≥ grade Ⅱ,8.44,95％ CI 1.81-39.46） and neutropenia （aHR for neutropenia ≥ grade Ⅱ,1.86,95％ CI 1.19-2.93）.The prevalence of lipodystrophy in d4T group was 19.5％,while that in AZT-substitution group was zero.As to antiretroviral efficacy,these three groups showed no differences.Conclusion AZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.展开更多
Dear Editor,Ebola virus is negative-sense,single stranded RNA virus of the family Filoviridae.Since their discovery in 1976,Ebola viruses have caused numerous outbreaks of severe hemorrhagic fevers in Africa.The emerg...Dear Editor,Ebola virus is negative-sense,single stranded RNA virus of the family Filoviridae.Since their discovery in 1976,Ebola viruses have caused numerous outbreaks of severe hemorrhagic fevers in Africa.The emergence of Ebola virus disease（EVD）in Guinea and its spread to urban centers in neighboring West African countries recently has caused international alarm.展开更多
West African countries are currently suffering the most severe pandemic of Ebola virus disease ever recorded, with 4269 human cases and 2288 deaths （through 6 September 2014）, and the number of cases in the current ...West African countries are currently suffering the most severe pandemic of Ebola virus disease ever recorded, with 4269 human cases and 2288 deaths （through 6 September 2014）, and the number of cases in the current outbreak exceeds the number from all previous outbreaks combined. Ebola virus disease was first described in 1976 originating from the Ebola River in the Democratic Republic of the Congo. Five Ebola viruses have been reported to cause Ebola virus pandemics, including Zaire Ebola virus, Sudan Ebola virus, Ivory Coast Ebola virus, Reston Ebola virus and Bundibugyo Ebola virus. The Zaire Ebola virus is the most deadly with a fatality rate up to 90%. Unfortunately, the current outbreak in the West African countries is caused by the Zaire Ebola virus, and no specific treatment for the disease is yet available.展开更多
High performance liquid chromatography was coupled with UV detection for simultaneous quantification of lopinavir （LPV） and ritonavir （RTV） in human plasma. This assay was sensitive, accurate and simple, and only ...High performance liquid chromatography was coupled with UV detection for simultaneous quantification of lopinavir （LPV） and ritonavir （RTV） in human plasma. This assay was sensitive, accurate and simple, and only used 200μL of plasma sample. Samples were liquid-liquid extracted, and diazepam was used as an internal standard. The chromatographic separation was achieved on a C18 reversed-phase analytic column with a mobile phase of acetonitrile-sodium dihydrogen phosphate buffer （10 mmol L-1, pH 4.80） （60：40, v/v）. UV detection was conducted at 205 nm and the column oven was set at 40℃. Calibration curves were constructed between 0,5-20 μg mL-1 for LPV and 0.05-5 μg mL-1 for RTV. The relative standard deviations were 2.16%-3.20% for LPV and 2.12%-2.60% for RTV for intra-day analysis, and 2.34%-4.04% for LPV and 0.31%-4.94% for RTV for inter-day analysis. The accuracy was within 100%＋10%. The mean extraction recoveries were 79.17%, 52.26% and 91.35% for RTV, LPV and diazepam, respectively. This method was successfully applied to human plasma samples from patients orally administered a salvage regimen of lopinavir-ritonavir tablets.展开更多
文摘Background An zidovudine （AZT）-substitution regimen containing 24-week stavudine （d4T） followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resourcelimited settings.However,evidence is scarce.This study aims to assess the efficacy and safety of AZT-substitution regimen,aiming to find a regimen with better efficacy,less adverse events,and more affordability in resource-limited settings.Methods This prospective,multicenter study enrolled 499 （190 on d4T regimen,172 on AZT regimen,and 137 on AZT-substitution regimen） HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011.Lamivudine （3TC） and either nevirapine （NVP） or efavirenz （EFV） were the other two drugs in the antiretroviral regimens.Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4,12,24,36,48,60,72,84,and 96.Results In terms of hematological adverse effects,AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group.In comparison with AZT-substitution group,AZT group was associated with higher risk of developing anemia （adjusted hazard ratio （aHR）for anemia ≥ grade Ⅱ,8.44,95％ CI 1.81-39.46） and neutropenia （aHR for neutropenia ≥ grade Ⅱ,1.86,95％ CI 1.19-2.93）.The prevalence of lipodystrophy in d4T group was 19.5％,while that in AZT-substitution group was zero.As to antiretroviral efficacy,these three groups showed no differences.Conclusion AZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.
文摘Dear Editor,Ebola virus is negative-sense,single stranded RNA virus of the family Filoviridae.Since their discovery in 1976,Ebola viruses have caused numerous outbreaks of severe hemorrhagic fevers in Africa.The emergence of Ebola virus disease（EVD）in Guinea and its spread to urban centers in neighboring West African countries recently has caused international alarm.
文摘West African countries are currently suffering the most severe pandemic of Ebola virus disease ever recorded, with 4269 human cases and 2288 deaths （through 6 September 2014）, and the number of cases in the current outbreak exceeds the number from all previous outbreaks combined. Ebola virus disease was first described in 1976 originating from the Ebola River in the Democratic Republic of the Congo. Five Ebola viruses have been reported to cause Ebola virus pandemics, including Zaire Ebola virus, Sudan Ebola virus, Ivory Coast Ebola virus, Reston Ebola virus and Bundibugyo Ebola virus. The Zaire Ebola virus is the most deadly with a fatality rate up to 90%. Unfortunately, the current outbreak in the West African countries is caused by the Zaire Ebola virus, and no specific treatment for the disease is yet available.
基金supported by the National Key Technologies R&D Program for the 11th Five-year Plan (Grant No. 2008ZX10001-006)the Key Clinical Program of the Ministry of Health 2010-2012
文摘High performance liquid chromatography was coupled with UV detection for simultaneous quantification of lopinavir （LPV） and ritonavir （RTV） in human plasma. This assay was sensitive, accurate and simple, and only used 200μL of plasma sample. Samples were liquid-liquid extracted, and diazepam was used as an internal standard. The chromatographic separation was achieved on a C18 reversed-phase analytic column with a mobile phase of acetonitrile-sodium dihydrogen phosphate buffer （10 mmol L-1, pH 4.80） （60：40, v/v）. UV detection was conducted at 205 nm and the column oven was set at 40℃. Calibration curves were constructed between 0,5-20 μg mL-1 for LPV and 0.05-5 μg mL-1 for RTV. The relative standard deviations were 2.16%-3.20% for LPV and 2.12%-2.60% for RTV for intra-day analysis, and 2.34%-4.04% for LPV and 0.31%-4.94% for RTV for inter-day analysis. The accuracy was within 100%＋10%. The mean extraction recoveries were 79.17%, 52.26% and 91.35% for RTV, LPV and diazepam, respectively. This method was successfully applied to human plasma samples from patients orally administered a salvage regimen of lopinavir-ritonavir tablets.
