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Open Access Publications from the University of California

Scholarly Works (159 results)

  • Article
  • Peer Reviewed
UCLA Previously Published Works (2018)
HIV-infected individuals on effective antiretroviral therapy experience a number of non-AIDS noncommunicable diseases, such as cardiovascular disease, more frequently than uninfected individuals. Common pathways for such diseases are chronic immune activation and inflammation, including the prolonged inflammation associated with lower nadir CD4+ cell count. Prevention and treatment of non-AIDS conditions include treatment of traditional risk factors, lifestyle interventions, earlier initiation of antiretroviral therapy, and potentially therapies specifically targeting inflammation and immune activation (eg, statins). This article summarizes a presentation by Judith S. Currier, MD, at the IAS-USA continuing education program, Improving the Management of HIV Disease, held in New York, New York, in February 2017.
    Cover page: Management of Long-Term Complications of HIV Disease: Focus on Cardiovascular Disease.
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2014)
    The pathogenesis of atherosclerosis in human immunodeficiency virus (HIV)-infected individuals is incompletely understood and appears to be multifactorial. Proatherogenic changes in blood and tissue lipids are associated with an increased risk of cardiovascular disease among HIV-infected subjects, and these changes may be both quantitative (dyslipidemia) and qualitative. In view of the pivotal role of dyslipidemia in the process of atherosclerosis, the increased incidence of dyslipidemia in HIV-infected individuals, and the emerging role of lipid abnormalities in systemic pathophysiologic processes such as immune activation, we review the contributions of dyslipidemia to cardiovascular risk in HIV infection.
      Cover page: Dyslipidemia and Cardiovascular Risk in Human Immunodeficiency Virus Infection
      • Thesis
      • Peer Reviewed
      UCLA Electronic Theses and Dissertations (2012)

      Hepatotoxicity is a common side effect of antiretroviral therapy with severe hepatotoxicity necessitating a regimen change. This was a retrospective cohort study that investigated the predictors of severe hepatotoxicity in a cohort of HIV-infected patients on antiretroviral therapy identified to have clinically significant elevations in transaminases. Severe hepatotoxicity was defined as an alanine aminotransferase level (ALT) greater than 275 IU/ml. The prevalence of severe hepatotoxicity was 23%. In multivariable stepwise regression analysis, only HBsAg, higher median HIV viral load and lower median ALT at database entry were predictors of severe hepatotoxicity. In a cohort of HIV and hepatitis B (HBV) coinfected patients, only higher log HIV viral load at database entry showed a trend towards significance as a predictor of severe hepatotoxicity, in multivariable stepwise regression analysis. Neither antiretroviral regimen class nor single agent was associated with severe hepatotoxicity. HBV infection, but not HCV infection, was a significant predictor of severe hepatotoxicity in HIV infected patients on antiretroviral therapy. Conclusion: In a cohort of HIV-infected patients receiving antiretroviral therapy, HBV infection, ALT and log HIV viral load at database entry were significant predictors of severe hepatotoxicity, while antiretroviral regimens were not.

        Cover page: Predictors of Hepatotoxicity in Human Immunodeficiency Virus-Infected Patients Receiving Antiretroviral Therapy
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2018)
        This year marked the 25th Conference on Retroviruses and Opportunistic Infections (CROI), and although there is much progress to celebrate in terms of treatment of HIV infection and expanding ART globally, many challenges remain. Tuberculosis is still the leading cause of death among people with HIV infection globally. This year, the results of investments in research to improve the prevention and treatment of tuberculosis were a highlight of the meeting. Noninfectious causes remain an important source of morbidity. Progress in identifying risk factors for non-AIDS complications and improvements in screening and monitoring for such conditions continue to be reported, but to date, despite the efforts of many investigators around the globe, interventions to effectively reduce HIV-related inflammation beyond effective and safer antiretroviral therapy (ART) remain elusive. This section will review highlights of the meeting on tuberculosis and cryptococcal infection as well as complications of long-term ART.
          Cover page: CROI 2018: Complications of HIV Infection and Antiretroviral Therapy.
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2015)
          Noncommunicable diseases, such as cardiovascular disease, hypertension, renal and bone disease, and malignancies are an ongoing concern during the course of treated HIV disease. Research in this area continues to focus on the epidemiology and risk factors associated with these conditions, identifying the contributions of HIV-related immunopathology to specific and collective end-organ diseases, and evaluating interventions to prevent or reduce the morbidity associated with these conditions. Infectious complications of HIV, such as tuberculosis and cryptococcal disease, also continue to cause substantial morbidity and mortality; diagnosis, prevention, and treatment of these is an area of focus. The 2015 Conference on Retroviruses and Opportunistic Infections provided new insights into all of these areas.
            Cover page: CROI 2015: Complications of HIV Infection and Antiretroviral Therapy.
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2019)
            The 2019 Conference on Retroviruses and Opportunistic Infections provided a considerable amount of new information on the progress in implementation of strategies to reduce morbidity and mortality from complications and coinfections that occur in people with HIV infection, and on the clinical management of these important problems. This review will address new insights into the prevention and treatment of tuberculosis, fungal infections, sexually transmitted infections, malignancies, and a range of metabolic complications and noncommunicable diseases.
              Cover page: CROI 2019: complications and coinfections in HIV infection.
              • Article
              • Peer Reviewed
              UCLA Previously Published Works (2017)
              Complications of HIV disease remained a major focus at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI), and included studies focused on noncommunicable chronic diseases (eg, cardiovascular disease, obesity, bone disease, and malignancies) and opportunistic infections (Mycobacterium tuberculosis and cryptococcosis). Progress in identifying predictors of specific complications as well as interventions for the prevention and treatment of these comorbidities are summarized below.
                Cover page: CROI 2017: Complications and Comorbidities of HIV Disease and Its Treatment.
                • Article
                • Peer Reviewed
                UCLA Previously Published Works (2016)
                Noncommunicable conditions such as cardiovascular disease, hypertension, renal and bone diseases, and malignancies as well as infectious complications are an ongoing concern during the course of treated HIV disease. Research in this area continues to focus on the epidemiology and risk factors for these conditions, on identifying the contributions of HIV-related immunopathology to specific and collective end-organ diseases, and on evaluating interventions to prevent or reduce the morbidity associated with these conditions. Data presented at the 2016 Conference on Retroviruses and Opportunistic Infections provided new insights into all of these areas.
                  Cover page: CROI 2016: Complications of HIV Infection and Antiretroviral Therapy.
                  • Article
                  • Peer Reviewed
                  UCLA Previously Published Works (2016)
                  A 25-year-old woman presented with fever of unknown origin, exhibiting malaise and low-grade fevers in evenings. These fevers exhibited a pattern of starting mid-menstrual cycle with resolution around the onset of menses, matching a pattern of "habitual hyperthermia" reported by H. Reimann in the 1930s. Extensive workup was unremarkable, and the fevers improved on oral synthetic estrogen and progesterone therapy.
                    Cover page: Reimann's “Habitual Hyperthermia” Responding to Hormone Therapy
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2013)
                    Studies with direct-acting antivirals (DAAs) for hepatitis C virus (HCV) monoinfection and HIV coinfection were highlighted at the 2013 Conference on Retroviruses and Opportunistic Infections (CROI). In HCV monoinfected patients, several interferon alfa-sparing, all-oral regimens demonstrated cure rates of greater than 90% with 12 weeks of treatment, including for hard-to-treat patients. Cure rates of 75% were attained in HIV/HCV coinfected patients with the addition of the investigational HCV protease inhibitor (PI) simeprevir to peginterferon alfa and ribavirin. Drug-drug interaction data to inform safe coadminstration of antiretroviral therapy with DAA-based HCV treatment were presented. There was continued emphasis on pathogenesis, management, and prevention of the long-term complications of HIV disease and its therapies, including cardiovascular disease, renal disease, alterations in bone metabolism, and vitamin D deficiency, along with a growing focus on biomarkers to predict development of end-organ disease. Understanding the elevated risk for non-AIDS-defining malignancies in the HIV-infected population and optimal management was a focal point of this year's data. Finally, the conference provided important information on tuberculosis coinfection and cryptococcal meningitis.
                      Cover page: CROI 2013: Complications of HIV disease, viral hepatitis, and antiretroviral therapy.
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