ABSTRACT
BACKGROUND: Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition. METHODS: We randomly assigned 2499 HIV-seronegative men or transgender women who have sex with men to receive a combination of two oral antiretroviral drugs, emtricitabine and tenofovir disoproxil fumarate (FTC-TDF), or placebo once daily. All subjects received HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections. RESULTS: The study subjects were followed for 3324 person-years (median, 1.2 years; maximum, 2.8 years). Of these subjects, 10 were found to have been infected with HIV at enrollment, and 100 became infected during follow-up (36 in the FTC-TDF group and 64 in the placebo group), indicating a 44% reduction in the incidence of HIV (95% confidence interval, 15 to 63; P=0.005). In the FTC-TDF group, the study drug was detected in 22 of 43 of seronegative subjects (51%) and in 3 of 34 HIV-infected subjects (9%) (P<0.001). Nausea was reported more frequently during the first 4 weeks in the FTC-TDF group than in the placebo group (P<0.001). The two groups had similar rates of serious adverse events (P=0.57). CONCLUSIONS: Oral FTC-TDF provided protection against the acquisition of HIV infection among the subjects. Detectable blood levels strongly correlated with the prophylactic effect. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT00458393.).
Subject(s)
Adenine/analogs & derivatives , Anti-HIV Agents/therapeutic use , Deoxycytidine/analogs & derivatives , HIV Infections/prevention & control , Homosexuality, Male , Organophosphonates/therapeutic use , Adenine/adverse effects , Adenine/blood , Adenine/therapeutic use , Administration, Oral , Adolescent , Adult , Anti-HIV Agents/adverse effects , Anti-HIV Agents/blood , Deoxycytidine/adverse effects , Deoxycytidine/blood , Deoxycytidine/therapeutic use , Drug Resistance, Viral , Drug Therapy, Combination , Emtricitabine , Follow-Up Studies , HIV/genetics , HIV/isolation & purification , HIV Antibodies/blood , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Seropositivity/diagnosis , Humans , Incidence , Kaplan-Meier Estimate , Male , Middle Aged , Nausea/chemically induced , Organophosphonates/adverse effects , Organophosphonates/blood , Patient Compliance , RNA, Viral/blood , Tenofovir , Transsexualism , Young AdultABSTRACT
We report a case of botryomycosis and intestinal strongyloidiasis in apatient with HTLV-1 infection. A 23 year-old female patient from Ayacucho, came with a history of a right foot tumor and chronic foot ulcers. The diagnosis of botryomycosis was established by biopsy of the lesion. Because the mild eosinophilia, a microscopic examination of stools was performed and Strongyloides stercoralis rhabditiform larva were found. HTLV-1 ELISA test, performed in order to discharge association with strongyloidiasis, was positive. The clinical presentation, physiopathology of the botryomycosis and the role of the HTLV-1 infection and strongyloidiasis as predisposing factors for botryomycosis are discussed.
