didanosine and Kidney-Diseases

Cordyceps sinensis (Berk.) Sacc. is an ascomycete fungus known in China since antiquity, which is still being used today. A summary, showing relevant papers about this fungus, regarding habitat, history, marketing, consumption, nomenclature, pharmacological composition, culture and medical use, is presented.

Topics: Animals; Cordyceps; Cyclosporine; Didanosine; Drug Costs; Drugs, Chinese Herbal; Fingolimod Hydrochloride; History, 19th Century; History, 20th Century; History, Ancient; Humans; Kidney Diseases; Larva; Medicine, Chinese Traditional; Moths; Mycology; Oxygen Consumption; Propylene Glycols; Sphingosine

In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies.

Topics: AIDS-Related Opportunistic Infections; Anti-HIV Agents; Central Nervous System Diseases; Child; Child, Preschool; Cytomegalovirus Infections; Didanosine; Disease Transmission, Infectious; Eye Diseases; Female; Gastrointestinal Diseases; Heart Diseases; Hematologic Diseases; Herpes Simplex; Herpes Zoster; HIV Infections; Humans; Incidence; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Kidney Diseases; Male; Neoplasms; Pregnancy; Prevalence; Risk Factors; Sexual Behavior; Skin Diseases; Transfusion Reaction; Zidovudine

A 48-week open-label study of 11 antiretroviral-naive, human immunodeficiency virus type 1 (HIV-1)-infected adults evaluated once-daily treatment with adefovir dipivoxil, lamivudine, didanosine, and efavirenz. At baseline, the median plasma HIV-1 RNA level was 4.99 log(10) copies/mL, and the median CD4 cell count was 471 cells/mm(3). At 24 and 48 weeks after initiation of treatment, median HIV-1 RNA levels decreased from baseline by 4.77 and 4.99 log(10) copies/mL, respectively, and median CD4 cell counts increased by 135 and 177 cells/mm(3), respectively. The regimen was generally well tolerated. No patients withdrew from the study because of adverse events. However, 7 patients developed adefovir-related nephrotoxicity after >/=20 weeks of treatment; this resolved without sequelae after adefovir was discontinued. Overall adherence was 85%. Once-daily quadruple-drug therapy with adefovir, lamivudine, didanosine, and efavirenz provides pronounced and durable suppression of HIV-1 RNA and elevation of CD4 cell counts over the course of 48 weeks, with generally good tolerability and adherence.

Topics: Adenine; Adult; Alkynes; Benzoxazines; CD4 Lymphocyte Count; Cyclopropanes; Didanosine; Drug Therapy, Combination; Female; HIV Infections; HIV-1; Humans; Kidney Diseases; Lamivudine; Male; Organophosphonates; Oxazines; Pulse Therapy, Drug; Reverse Transcriptase Inhibitors; RNA, Viral; Time Factors; Treatment Outcome

To assess changes in renal function in a cohort of patients infected with the human immunodeficiency virus (HIV) and describe which factors are associated with deterioration.. This was a prospective transversal study. The follow-up period was 12 months. Data were collected at baseline and one year including the glomerular filtration rate (GFR). We analyzed epidemiological data, comorbidities, CD4 lymphocytes, viral load, and AIDS status.. A total of 365 patients. Three hundred and thirteen (85%) were under highly active antiretroviral therapy (HAART); the median CD4 was 606 ± 314 and the CV was undetectable in 85%. At 1-year, we found a mean deterioration in the GFR of 9.7 ml/h. Eighty patients (21.8%) had a fall in GFR > 10 ml/h, while in 20 patients (5.8%) it was > 30 ml/h. An association was found regarding age, treatment with didanosine (DDI) and males (OR 1.89 95% CI 1.3 to 4.08, OR 2.3 95% CI 1.9 to 23 and OR 3.47 95% CI 1.6 to 14.20 respectively). We found a protective role of being under HAART (OR 0.54, 95% CI, 0.25 to 0.8).. There was a protective role of HAART in the deterioration of GFR of patients with HIV infection. Male gender, age and use of DDI were associated with worsening renal function. Tenofovir and protease inhibitors were not associated with further deterioration of renal function.

Topics: Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Cross-Sectional Studies; Didanosine; Female; Glomerular Filtration Rate; HIV Infections; Humans; Kidney; Kidney Diseases; Male; Middle Aged; Prospective Studies; Viral Load

Tenofovir-related tubule damage characterized by Fanconi syndrome, renal insufficiency and nephrogenic diabetes insipidus has been reported in the adult HIV-infected population. To our knowledge there has been no reported case of such complications in the pediatric population. We report the case of a 12-year-old perinatally HIV-infected African-American girl who developed nephrogenic diabetes insipidus, renal insufficiency and Fanconi-like syndrome while taking tenofovir (Viread) in combination with lopinavir-ritonavir (Kaletra) and didanosine (Videx).

Topics: Adenine; Anti-HIV Agents; Child; Diabetes Insipidus, Nephrogenic; Didanosine; Drug Therapy, Combination; Fanconi Syndrome; Female; HIV; HIV Infections; HIV Protease Inhibitors; Humans; Kidney; Kidney Diseases; Lopinavir; Organophosphonates; Pregnancy; Pregnancy Complications; Pyrimidinones; Ritonavir; Tenofovir

Although adverse events in HIV patients taking tenofovir are relatively rare, postmarketing reports of nephrotoxicity have alerted physicians to other potentially serious outcomes. We present a series of 40 patients who developed hypokalemia associated with tenofovir. Identified risk factors included concomitant ritonavir or didanosine use, a lower weight and longer duration of tenofovir use. Recovery or improvement was seen in the majority of patients (66%) after the discontinuation of tenofovir; however, four deaths occurred. The associated consequences of tenofovir-related hypokalemia may be profound and life-threatening.

Topics: Adenine; Adolescent; Adult; Body Weight; Child; Didanosine; Drug Therapy, Combination; Female; HIV Infections; HIV Protease Inhibitors; Humans; Hypokalemia; Kidney Diseases; Male; Middle Aged; Organophosphonates; Reverse Transcriptase Inhibitors; Risk Factors; Ritonavir; Tenofovir; Time Factors

Topics: Adenine; Adult; Anti-HIV Agents; Creatinine; Didanosine; Drug Interactions; Drug Therapy, Combination; Female; HIV Infections; Humans; Kidney Diseases; Male; Middle Aged; Organophosphonates; Tenofovir

Many sessions at the 5th Conference on Retroviruses and Opportunistic Infections dealt specifically with HIV infection and treatment in women. Highlights are presented from several sessions, including indinavir blood levels at various points in the menstrual cycle, abnormal kidney function associated with women taking indinavir, abnormal pap smears in women with high viral load, the relationship between viral load and the increased risk of death in women, and the impact of ddI crossing the placenta in pregnant women. Information is given on each presentation, including clinical trial results, side effects, and impacts on disease progression.

Topics: Anti-HIV Agents; Cervix Uteri; Chicago; Clinical Trials as Topic; Congresses as Topic; Didanosine; Female; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Kidney Diseases; Male; Maternal-Fetal Exchange; Menstrual Cycle; Papanicolaou Test; Papillomavirus Infections; Pregnancy; Risk Factors; RNA, Viral; Tumor Virus Infections; Vaginal Smears; Viral Load