ABSTRACT
OBJECTIVES: To determine etravirine concentrations and the HIV-1 viral load (VL) in blood plasma (BP) and seminal plasma (SP) of HIV-infected patients. METHODS: Ten adult antiretroviral-experienced HIV-1 patients receiving an etravirine-containing regimen for at least 1 month were enrolled. Semen and blood samples were collected ~12 or 24 h after the last etravirine dose, depending on twice-daily or once-daily dosing, respectively. Liquid chromatography tandem mass spectrometry was used to determine etravirine concentrations and HIV-1 VL was determined by real-time PCR (detection limit 40 copies/mL). Results are presented as the median (range) unless otherwise indicated. RESULTS: Ten blood and 20 semen samples were collected. The CD4 count was 502 (252-817) cells/mm(3) and the BP VL was <40 (<40-362) copies/mL. The time on etravirine was 52 (12-124) weeks. The BP etravirine concentration was 452.5 (258-751) ng/mL. The SP etravirine concentration was 62.9 (31.2-166.0) ng/mL and values were above the IC(50) range (0.39-2.4 ng/mL) in all cases. The median etravirine SP:BP ratio was 0.16 (0.07-0.26). The SP VL was <40 copies/mL in all patients, whereas the BP VL was detectable in one patient with poor adherence to treatment. CONCLUSIONS: Etravirine concentrations in male genital secretions are modest, reaching only 16% of the BP concentration. Nevertheless, they are more than 10 times greater than the wild-type IC(50) range (not adjusted for protein binding).
Subject(s)
HIV Infections/metabolism , HIV-1/drug effects , Pyridazines/metabolism , Pyridazines/therapeutic use , Semen/drug effects , Semen/metabolism , Adult , Anti-HIV Agents/blood , Anti-HIV Agents/metabolism , Anti-HIV Agents/therapeutic use , HIV Infections/blood , HIV Infections/drug therapy , HIV-1/metabolism , Humans , Male , Middle Aged , Nitriles , Pyridazines/blood , Pyrimidines , Viral Load/drug effectsABSTRACT
Morbid obesity (MO) is a serious disease caused by genetic and environmental factors, which is associated with multiple comorbid factors that impact very significantly on the amount and life quality. Obesity surgery is a complex surgery but not without complications, which objective is to achieve an ideal weight or cure obesity reducing comorbidities and improving the welfare of patients. The Spanish Society for the Study of Obesity (SEED) and the Spanish Society of Obesity Surgery (SECO) have developed a consensus document that allows the various professionals involved in the treatment of OM practical guidance in developing their own protocols in their work environment. In this context, the general and digestive service of the HUB team developed the clinical course of this surgical procedure because it is a tool that facilitates systematic care and multidisciplinary group of patients with a predictable clinical course, such as whether morbidly obese patients operated by laparotomy or laparoscopy.
Subject(s)
Obesity, Morbid/surgery , Humans , Practice Guidelines as TopicABSTRACT
La obesidad mórbida (OM) es una enfermedad grave, causada por diversos factores genéticos y ambientales, que se asocia a múltiples elementos de comorbilidad que repercuten de forma muy importante en la cantidad y calidad de vida. La cirugía de la obesidad es compleja, no exenta de complicaciones, cuyo objetivo no es alcanzar un peso ideal ni curar la obesidad, sino reducir significativamente las comorbilidades asociadas y mejorar el bienestar de los pacientes. En este contexto, La Sociedad Española para el Estudio de la Obesidad (SEEDO) y la Sociedad Española de Cirugía de la Obesidad (SECO) han elaborado un documento de consenso que proporciona a los distintos profesionales implicados en el tratamiento de la OM una orientación práctica a la hora de desarrollar sus propios protocolo en su ámbito de trabajo. Siguiendo las recomendaciones de la SECO, el equipo de Cirugía General del Servicio del Aparato Digestivo del Hospital Universitario de Bellvitge (HUB) elaboró la trayectoria clínica de este proceso quirúrgico, ya que constituye una herramienta que facilita la atención sistemática y multidisciplinar de grupos de pacientes que presentan un curso clínico predecible, como son los pacientes obesos mórbidos ya sean intervenidos por laparotomía o bien mediante laparoscopia (AU)
Morbid obesity (MO) is a serious disease caused by genetic and environmental factors, which is associated with multiple comorbid factors that impact very significantly on the amount and life quality. Obesity surgery is a complex surgery, but not without complications, which objective is to achieve an ideal weight or cure obesity, reducing comorbidities and improving the welfare of patients. The Spanish Society for the Study of Obesity (SEED) and the Spanish Society of Obesity Surgery (SECO) have developed a consensus document that allows the various professionals involved in the treatment of OM practical guidance in developing their own protocols in their work environment. In this context, the general and digestive service of the HUB team developed the clinical course of this surgical procedure because it is a tool that facilitates systematic care and multidisciplinary group of patients with a predictable clinical course, such as whether morbidly obese patients operated by laparotomy or laparoscopy(AU)
