RESUMO
BACKGROUND: There is no known reason to suspect an adverse drug interaction between dolutegravir-based antiretroviral therapy and sofosbuvir, simeprevir, or ledipasvir. There is a paucity of clinical data for this combination. METHODS: Prospective, open-label study of patients with HIV well controlled on dolutegravir, abacavir, and lamivudine, who were co-infected with HCV genotype 1, and required therapy with simeprevir plus sofosbuvir or sofosbuvir/ledipasvir single-tablet regimen (STR) for 12 weeks. The two primary endpoints were percentage of patients achieving sustained virologic response (SVR) at 12 weeks post-treatment and percentage of patients with a HIV-1 viral load <50 copies/ml at end of the combination therapy. RESULTS: Twenty-eight subjects were enrolled from August 2014 to September 2015. Thirteen patients were treated with simprevir plus sofosbuvir, and 15 subjects were treated with sofosbuvir/ledipasvir. 23 genotype 1a, and 5 genotype 1b were included. Nineteen were treatment naïve, and 2 patients had compensated cirrhosis. The mean age was 59 years (95% CI 58.21-59.78 years). The mean age was 59 years (95% CI: 58.21-59.78 years), and 25 patients were black. Out of the 28 patients who completed this study, SVR 12 was achieved in 27 of 28 patients (96%, 95% CI 89.6-100.0%), and all patients had an HIV virus load <50 copies/ml at week 12 of therapy, for an intent-to-treat rate of 100%. No patients ended therapy secondary to adverse events. CONCLUSION: Our study suggests a good safety and efficacy for the combination of a dolutegravir, abacavir, and lamivudine with sofosbuvir-based DAA therapy.
Assuntos
Terapia Antirretroviral de Alta Atividade , Coinfecção , Infecções por HIV/tratamento farmacológico , Hepatite C/tratamento farmacológico , Sofosbuvir/uso terapêutico , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Contagem de Linfócito CD4 , Didesoxinucleosídeos/administração & dosagem , Quimioterapia Combinada , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1 , Hepacivirus/genética , Hepatite C/virologia , Compostos Heterocíclicos com 3 Anéis/administração & dosagem , Humanos , Lamivudina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Oxazinas , Piperazinas , Piridonas , Sofosbuvir/administração & dosagem , Sofosbuvir/efeitos adversos , Resultado do Tratamento , Carga ViralRESUMO
Stroke mimics constitute 15--20% of all cases presenting to the emergency department, prominent among them being seizures, hypoglycemia, tumors, migraines, and posterior reversible leucoencephalopathy. They have also abnormal computerized tomography perfusion (CTP) findings. We report a case where CTP helped us to diagnose and treat a seizure when initial presentation was that of a stroke.
