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AIDS Alert. 2011 Mar; 26(3):33-4.In February of 2011, the Food and Drug Administration (FDA) approved new labeling for the antiretroviral drug atazanavir (Reyataz) to include dosing recommendations for treatment of HIV-1 infection during pregnancy and postpartum period. The major revisions to the package insert are summarized in this report, as well as other minor changes made for consistency.
Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time.
AIDS and Behavior. 2009 Jun; 13(Suppl 1):S82-S91.The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.
Guidelines for the use of antiretroviral agents in pediatric HIV infection. Supplement I: Pediatric antiretroviral drug information.
[Unpublished] 2005 Mar 24. 34 p.In order to successfully suppress HIV viral replication without disruption of normal cellular function, it is essential to target specific components unique to the virus. Theoretically, antiretroviral agents that target the initial stages of the viral replicative cycle (prior to provirus formation), should prevent primary infection of cells, yet be ineffective in cells that have already integrated virus and drugs that inhibit steps after viral integration should block new virus production by virally infected cells. Currently FDA approved antiretroviral medications include fusion inhibitors, which prevent viral entry; reverse transcriptase inhibitors (nucleoside, nucleotide, and nonnucleoside), which act at the early stage of replication; and inhibitors of viral protease, which work in the later stage after viral integration. Fusion inhibitors are the newest class of antiretroviral drugs, and act by inhibiting binding or fusion of HIV to target host cells. The NRTIs are potent inhibitors of the HIV reverse transcriptase enzyme, which is responsible for the reverse transcription of viral RNA into DNA; this process occurs prior to integration of viral DNA into the chromosomes of the host cell. The NRTIs require intracellular phosphorylation to their active forms by cellular kinases. (excerpt)