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1
Couvreur, Patrick. "La « squalénisation » : un exemple de conception de nanomédicaments anticancéreux et antiviraux." Bulletin de l'Académie Nationale de Médecine 193, no. 3 (March 2009): 663–74. http://dx.doi.org/10.1016/s0001-4079(19)32558-0.
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Hu, Zhao X., Yi N. Ye, Wei G. Wu, Xu J. Liang, Qi W. Wu, Ao Zhang, Xing R. Zheng, Zhi L. Gao, Liang Peng, and Chan Xie. "Real-Life State of Anti-Hepatitis B Virus Drug Choice in Child-Bearing Age Male Patients and Effect on Fertility and Fetal Safety." Canadian Journal of Gastroenterology and Hepatology 2019 (April 1, 2019): 1–8. http://dx.doi.org/10.1155/2019/9703907.
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Research on effects of anti-hepatitis B virus (HBV) nucleoside analogs on male fertility and birth defects is limited and safety of nucleoside analogs in pregnancy is still a concern. Chronic hepatitis B (CHB) patients in Guangdong province were surveyed using a structured questionnaire. We collected data including medication type, fertility, and birth defects. Moreover, a survey of the knowledge of antiviral nucleoside analogs safety in fertility of male patients was conducted among physicians nationwide. Semen samples of 30 patients were collected. We screened 1050 HBV-positive male patients. Reasons for not receiving antivirals in 150 patients were “did not meet criteria for antiviral therapy,” fertility, and financial. Furthermore, 900 participants received antivirals (85.71%, 900/1050), including 792 patients with children and 15.15% (120/792) took anti-HBV treatment when preparing for pregnancy. Based on whether they received antiviral therapy during conception or not, we divided patients into two groups. In the child-bearing age group, 88.33% (106/120) of patients received telbivudine (LDT), whereas the other group mainly received entecavir (ETV) (87.20%, 586/672). No significant difference occurred in birth defect incidence rates between both groups. Furthermore, 558 physicians completed questionnaires. Reasons that influenced drug selection were “patient’s condition,” “fertility demand,” “financial condition,” and “compliance.” Telbivudine was the first-choice drug (32.80%, 183/558) while tenofovir (TDF) was the second (2.69%, 15/558). Additionally, 61.47% of physicians considered telbivudine or tenofovir as the first choice for male patients who met antiviral criteria, whereas 19% suggested delayed therapy and follow-up until childbirth. No significant changes occurred in semen volume, concentration, mobility, and percentage before and after administration of anti-HBV nucleoside analogs, which did not affect male fertility and birth defect incidence while the desire for pregnancy influenced drug selection and timing of administration. Further research on the effects of analogs on male fertility and fetal safety is required.
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Bragina, E. E. "Viral infection of spermatozoa. Part 1. Hepatitis B virus and human papillomavirus (review)." Andrology and Genital Surgery 21, no. 4 (February 12, 2021): 12–19. http://dx.doi.org/10.17650/2070-9781-2020-21-4-12-19.
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Intragametal viral infection of spermatozoa can cause true vertical transmission of viruses through germ cells. Currently, human papilloma-virus, including oncogenic risk strains, and hepatitis B virus, have been detected in spermatozoa. The possibility of vertical transmission of hepatitis B virus and human papillomavirus has been proven.Intragametal infection of spermatozoa with viruses of human papillomavirus and hepatitis B virus leads to abnormalities in the development of the embryo and can cause spontaneous abortions both duringnatural conception and when using assisted reproductive technologies.The development of adequate methods for diagnosing an intragametal spermatozoa virus infection will make it possible to find out, at least in some patients, the cause of infertility and pregnancy abnormalities and apply appropriate antiviral therapy in preparation for natural conception or the use of assisted reproductive technologies.
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Bragina, E. E. "Viral infection of sperm. Part 2. Human herpes viruses, human immunodeficiency virus, hepatitis C virus, Zika virus (review)." Andrology and Genital Surgery 21, no. 4 (February 12, 2021): 20–30. http://dx.doi.org/10.17650/2070-9781-2020-21-4-20-30.
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Intragametal viral infection of spermatozoa can cause true vertical transmission of viruses through germ cells. Currently, human immunodeficiency virus, hepatitis C viruses, herpes simplex virus, cytomegalovirus, Zika virus have been detected in spermatozoa. The possibility of vertical transmission of human immunodeficiency virus, cytomegalovirus, herpes simplex virus and Zika virus has been proven.Intragametal infection of spermatozoa with viruses of the herpes group leads to abnormalities in the development of the embryo and can cause spontaneous abortions both during natural conception and when using assisted reproductive technologies.The development of adequate methods for diagnosing an intragametal spermatozoa virus infection will make it possible to find out, at least in some patients, the cause of infertility and pregnancy abnormalities and apply appropriate antiviral therapy in preparation for natural conception or the use of assisted reproductive technologies.
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Kovalyk, V. Р., V. V. Malinovskaya, A. N. Shuvalov, L. F. Kurilo, К. I. Yurlov, М. A. Gomberg, and A. A. Kushch. "Cytomegalovirus infection and male infertility: case report." Andrology and Genital Surgery 22, no. 1 (April 22, 2021): 85–89. http://dx.doi.org/10.17650/1726-9784-2021-22-1-85-89.
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Objectives. To present a case report of male infertility associated with cytomegalovirus infection and the outcome of antiviral treatment.Clinical observation. A 31-year-old man presented with a history of 6 years of infertility. No pathology was revealed in his wife. High loads of cytomegalovirus (CMV) were detected by PCR: in expressed prostatic secretion (EPS) 8700 copies/ml, in ejaculate – 598 440 copies/ml. Sperm examination revealed necrozoospermia and leukospermia. CMV-associated accessory gland infection was verified. The patient was treated with valacyclovir 500 bid for 90 days and interferon α2β suppository (Viferon®) 1 million IU for 30 days. All sperm parameters improved in 1 month after initiation of antiviral treatment. Sperm concentration and motility increased × 1.5 and × 1.4 respectively, sperm viability and leukocyte count achieved reference values. At the same time, CMV loads decreased: EPS to 300 copies/ml, the ejaculate to 54 000 copies/ml. After 3 months (by the end of the antiviral treatment): EPS-negative, the ejaculate – 6060 copies/ml; after 6 months: EPS – negative, the ejaculate 3900 copies/ml. Within 6 months, the woman became pregnant and gave birth to a healthy baby girl. After 3 years, there was a second pregnancy and the birth of a healthy boy.Conclusion. The male factor has been established as the cause of infertility in a married couple; the only probable etiological agent of pathozoospermia was cytomegalovirus infection. The use of complex antiviral and immunotherapy (interferon α2β with antioxidants, Viferon®) provided positive dynamics in clinical, sperm and laboratory parameters, which led to the conception and birth of two children.
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Déléris, Gérard. "Use of Organosilicon Compounds towards the Rational Design of Antiparasitic and Antiviral Drugs." Metal-Based Drugs 2, no. 3 (January 1, 1995): 143–51. http://dx.doi.org/10.1155/mbd.1995.143.
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One of the major problems met for the conception of antiviral or antiparasitic drugs is to reach a high level of selectivity towards the pathogenic agent versus the host. We shall describe two synthetic approaches where main group organometallics have been used towards this goal. A series of nucleoside sila-analogues was synthesized as potential therapeutic agents designed to inhibit HIV Reverse Transcriptase. In a second approach novel organosilicon derivatives have been synthesized as mimics of antisense oligonucleotides.Infectious agents, namely viruses or parasites, more or less use cellular machinery. Therefore therapeutic agents must interfere with biochemical mechanisms or possess high affinity towards specific molecular cellular components, to reach selectivity.We thought that main group organometallics could show many advantages for designing biologically active molecules in this field. They allow a high synthetic flexibility for the modulations of physico-chemical properties and they show a mechanistic behaviour which may be close to the one of several heteroelements present in living organisms such as sulfur or phosphorus.We tried to use this approach towards two directions involving the synthesis of organosilicon derivatives i.e:-the synthesis of organosilicon derivatives as inhibitors of HIV Reverse Transcriptase,-the synthesis of organosilicon precursors of modified antisense oligonucleotides.
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Rana, Ramesh, Rajkumar Dangal, Yogendra Singh, Ram Bahadur Gurung, Bhim Rai, and Amit Kumar Sharma. "Hepatitis C Virus Infection in Pregnancy and Children: Its Implications and Treatment Considerations with Directly Acting Antivirals: A Review." Journal of Nepal Medical Association 59, no. 241 (September 11, 2021): 942–53. http://dx.doi.org/10.31729/jnma.5501.
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Hepatitis C virus infection (HCV) is a global health problem affecting >71 million people worldwide with chronic hepatitis C, 40% reproductive age group, and 8% pregnant women. Intravenous drug abuse, multi-transfusions are major risk factors in adults, while vertical transmission in pediatric population. It commonly presents as a chronic liver disease, has higher risk of liver cirrhosis and even progression to hepatocellular carcinoma. Therefore, proper screening of high-risk populations including pregnancy is recommended. All diagnosed chronic hepatitis C cases should be treated with directly acting anti-virals (DAAs) including pre-conception which has a cure rate of >95%. This would reduce the disease burden, vertical transmission, and disability associated. However, no DAAs regimens recommendation till date due to lack of evidence on adverse fetal outcomes and are concerned about the pharmacokinetic effect regarding physiological changes during pregnancy. Therefore, in this review, we have tried to explore the possible use of DAAs regimens and their safety issues during pregnancy, and possible consideration of few pan-genotypic regimens in the late 2nd and early 3rd trimester. This would not only prevent vertical transmission and decrease disease burden but also help to meet the WHO 2030 target of HCV elimination as a major public health problem.
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Akbar, Sheikh Mohammad Fazle, Mamun Al Mahtab, Sakirul Khan, Osamu Yoshida, and Yoichi Hiasa. "Development of Therapeutic Vaccine for Chronic Hepatitis B: Concept, Cellular and Molecular Events, Design, Limitation, and Future Projection." Vaccines 10, no. 10 (September 30, 2022): 1644. http://dx.doi.org/10.3390/vaccines10101644.
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Four decades have passed since the first usage of the therapeutic vaccine in patients with chronic hepatitis B (CHB). However, there is no approved regimen of vaccine therapy for the treatment of CHB. This is mainly attributable to faulty conception, an improper understanding of the cellular and molecular mechanisms of CHB, and the impaired design of vaccine therapy for CHB. With the advent of new techniques and a better understanding of cellular and molecular mechanisms underlying the genesis of CHB, the limitations and failures of previous regimens of therapeutic vaccines have been primarily understood. Additionally, the importance of immune therapy for treating millions of CHB patients and achieving the target of “Elimination of Hepatitis by 2030” has been focused on in the international arena. This has been amplified by the apparent limitation of commercially available antiviral drugs that are infinite in duration, endowed with safety concerns, and unable to cure liver damage due to their minimal immune modulation capacities. The proposed review article comprehensively discusses each of these points and proposes evidence-based approaches for viable types of vaccine therapy for the treatment of CHB.
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Lopes Araújo, Daniel, José Eufrazino Júnior, Vinicius Santos Silva, Carla Franco Mendonça de Araújo, Thaynara Hevellin Evangelista, Hilary Hevellin Evangelista, Geovana Maciel Lima, et al. "AVALIAÇÃO DO POTENCIAL TRIPANOCIDA DE DERIVADOS TIOSSEMICARBAZONAS: UMA REVISÃO." RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218 2, no. 9 (October 11, 2021): e29658. http://dx.doi.org/10.47820/recima21.v2i9.658.
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Neglected diseases are a group of communicable diseases that mainly affect tropical regions in developing countries. Among this group of diseases is Chagas disease, which has been classified among the six most important parasitic diseases in the world, and it is estimated that more than one billion people are at risk in countries that are considered endemic. The aim of this study is to conduct a literature review on the trypanocidal activity of thiosemicarbazone derivatives. The study is a review research that used 31 articles to highlight the scientific findings on the trypanocidal activity of the derivatives in question. Articles were included in the time estimate between 2010 - 2021 (last 12 years). The search and selection of the reference studies was performed in Scielo, Science Direct, PubMed and Google Academic databases. The literature highlights that thiosemicarbazones are considered privileged compounds with a wide scientific interest due to their diverse chemical and biological properties, such as: antitumor, antibacterial, antiviral, antiprotozoal, and anti-chagasic. The studies presented here, which demonstrate the investigations of compounds of this class and their derivatives, are an important step towards the conception of therapeutic methods against Trypanosoma cruzi. New studies are necessary to elucidate in an even more specific way the effects of these derivatives in vivo, in order to obtain an alternative pharmacological therapy for Chagas disease.
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Kagramanova, Zh A., P. E. Lanshchakova, V. V. Malinovskaya, A. A. Svistunov, and E. N. Vizhlova. "Correlations in the pathogenesis by early pregnancy loss." Voprosy ginekologii, akušerstva i perinatologii 20, no. 4 (2021): 45–54. http://dx.doi.org/10.20953/1726-1678-2021-4-45-54.
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Objective. To improve the quality of life and outcome by consecutive pregnancy in patients based on the analysis of correlations and differences in markers for the diagnosis by early pregnancy loss (EPL) in early gestation period (up to 12 weeks). Patients and methods. 100 patients aged 18 to 40 years diagnosed with early pregnancy loss (EPL) at 7–8 and 9–10 weeks of obstetric term were examined. The types of EPL were identified by ultrasound criteria; correlations and differences in the EPL mechanism during early pregnancy were determined. Time characteristics of the gestational sac (GS) development from conception to miscarriage and the duration of persistence of an empty sac in the uterine cavity before the diagnosis of EPL were recorded. Molecular genetic testing of the chorion in 42 women with EPL was performed by multi-locus quantitative fluorescent polymerase chain reaction (PCR). The method of manual vacuum aspiration under the control of hysteroscopy was developed, followed by the administration of antibacterial, antiviral, and immunomodulatory therapy with Viferon® rectal suppositories at a dose of 1,000,000 IU 1 suppository twice a day at 12-hour intervals for 10 days and Viferon® gel 36,000 IU on the vaginal region of the cervix at a dose of 2 mL twice a day for 7 days. Results. The period of hospital admission for patients with embryonic miscarriage (EM) as the type of EPL prevailed between 8 and 10 weeks, on the average – 9.5 weeks of obstetric term, in contrast to empty sac (ES, 7–8 weeks). The period of the GS development in ES ranged from 17 to 36 days (2.3 to 5.1 weeks); in EM – 4 to 9 weeks (26 to 69 days) in 96% of patients, and the embryo development was from 3–4 to 6–7 weeks from conception (21 to 49 days). There was a 1.2-week difference in the desynchronization of the development of GS and an embryo. A significant positive correlation between gestational age (before diagnosis) and β-hCG levels (26,348 ± 18,289 mIU/mL) in patients without bloody discharge at the time of hospitalization was observed. However, there was a desynchronization of lag in β-hCG levels by an average of 3 times (8661 ± 7701 mIU/mL) in the presence of bloody discharge, although the sizes of GS according to mean sac diameter (MSD) were comparable (28 ± 13 mm and 30 ± 11 mm). There was a complete lack of synchronization of the abnormal development of GS, an embryo, β-hCG levels, and the duration of GS persistence in the uterine cavity after miscarriage. The following correlations occurred in the pathogenesis of EPL: chromosomal abnormalities (45% in EM and 40% in ES), history of gynecological and viral diseases (49% in EM and 41% in ES). Correlational differences in the developmental period of GS according to MSD, an embryo, the period of persistence in the uterine cavity after miscarriage, the uterine size, and mean β-hCG levels (at week 8-10) in EM were at different gestation periods before the onset of manifestation of miscarriage. Conclusion. Determination of correlation dependencies and differences in the results of monitoring diagnostic markers of different types of EPL makes it possible to develop a personalized approach to the choice of gestational sac aspiration, antibacterial, antiviral, and immunomodulatory therapy with Viferon® (interferon α-2b with antioxidant complex) for a successful consecutive pregnancy and its outcome. Key words: anembryonic pregnancy, embryonic miscarriage, correlations, pathogenesis by early pregnancy loss, early pregnancy loss, persistence of empty sac, β-hCG
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Benabdallah, Mohammed, Oualid Talhi, Fatiha Nouali, Nouredine Choukchou-Braham, Khaldoun Bachari, and Artur M. S. Silva. "Advances in Spirocyclic Hybrids: Chemistry and Medicinal Actions." Current Medicinal Chemistry 25, no. 31 (October 16, 2018): 3748–67. http://dx.doi.org/10.2174/0929867325666180309124821.
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The present review deals with the progress in medicinal chemistry of spirocyclic compounds, a wider class of natural and synthetic organic molecules, defined as a hybrid of two molecular entities covalently linked via a unique tetrahedral carbon. This spiro central carbon confers to the molecules a tridimensional structurally oriented framework, which is found in many medicinally relevant compounds, a well-known example is the antihypertensive spironolactone. Various bioactive natural products possess the privileged spiro linkage and different chemo-types thereof become synthetically accessible since the 20th century. Actually, there has been a growing interest in the synthesis of heterocyclic hybrids gathered via a spiro carbon. Most of these combinations are two moieties in one scaffold being able to interfere with biological systems through sequential mechanisms. Spirocyclic hybrids containing indole or oxindole units are compounds exhibiting higher interaction with biological receptors by protein inhibition or enzymatic pathways and their recognition as promising anticancer agents in targeted chemotherapy is foreseen. These specific, low-weight and noncomplex spirocyclic hybrids are potent inhibitors of SIRT1, Mdm2–p53 and PLK4, showing affinity for anaplastic lymphoma kinase (ALK) receptor. They are also known as excellent DNA binders, acting on cellular division by arresting the cell cycle at different phases and inducing apoptotic cell death. A structural diversity of spirocyclic hybrids has proved neuroprotective effects, anti-HIV, antiviral and antibacterial activities. Hundred of papers are mentioned in this review underlying chemical issues and pharmacological potencies of spiro compounds, which render them impressive synthetic hits for innovative drug conception.
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Meier, Chris. "Nucleoside diphosphate and triphosphate prodrugs – An unsolvable task?" Antiviral Chemistry and Chemotherapy 25, no. 3 (November 3, 2017): 69–82. http://dx.doi.org/10.1177/2040206617738656.
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In this review, our recent advances in the development of nucleoside di- and nucleoside triphosphate prodrugs is summarized. Previously, we had developed a successful membrane-permeable pronucleotide system for the intracellular delivery of nucleoside monophosphates as well, the so-called cycloSal-approach. In contrast to that work in which the delivery is initiated by a chemically driven hydrolysis reaction, for the di- and triphosphate delivery, an enzymatic trigger mechanism involving (carboxy)esterases had to be used. The other features of the new pronucleotide approaches are: (i) lipophilic modification was restricted to the terminal phosphate group leaving charges at the internal phosphate moieties and (ii) appropriate lipophilicity is introduced by long aliphatic residues within the bipartite prodrug moiety. The conceptional design of the di- and triphosphate prodrug systems will be described and the chemical synthesis, the hydrolysis properties, a structure–activity relationship and antiviral activity data will be discussed as well. The advantage of these new approaches is that all phosphorylation steps from the nucleoside analogue into the bioactive nucleoside triphosphate form can be bypassed in the case of the triphosphate prodrugs. Moreover, enzymatic processes like the deamination of nucleosides or nucleoside monophosphates which lead to catabolic clearance of the potential antivirally active compound can be avoided by the delivery of the higher phosphorylated nucleotides.
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Ханыков, В. В., and И. В. Шлёмина. "To the question of «pseudoscientific» principles of mediated psychotherapy of addictions." Научно-практический журнал «Наркология», no. 1() (March 5, 2018): 73–82. http://dx.doi.org/10.25557/1682-8313.2018.01.73-82.
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Появление данной статьи вызвано многочисленными публикациями, дискредитирующими методы опосредованной психотерапии аддикций (ОП) и представляющие их как «сциентистски декорированное шаманство». В качестве основных причин подобной критики авторы статьи отмечают явно недостаточное, особенно в последнее время, количество научных исследований ОП и, соответственно, дефицит убедительных концепций. Рассматривая феномены патологического влечения (ПВ) и ОП с позиций информатики, авторы выделяют ПВ в структуре аддикций в качестве самостоятельного «программного продукта» и предлагают концепцию, согласно которой основным эффектом ОП является формирование антикревинговой программы на подсознательном уровне на основе вовлечения «функции самосохранения». Проводится параллель с антивирусными компьютерными программами. Уточняется важная роль ОП в алгоритме системной терапии аддиктивной патологии. This article is a response to numerous publications, in which methods of mediated psychotherapy of addictions (MP), based on placebo and trance effects, are discredited and presented as »scientific-decorated shamanism». According to the authors, the main reasons for such criticism are insufficient amount of scientific studies of MP (especially in recent times) and as a result - the lack of convincing conceptions. Discussing phenomena of pathological craving (PC) and MP from the point of view of informatics, authors distinguish PC in the structure of addiction as an independent »software product». They offer the concept, according to which the main effect of MP is forming of unconscious anticraving program (similarly to antivirus computer programs) based on self-preservation function. Authors specify important role of MP in the algorithm of systematic treatment of addictions.
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Ханыков, В. В., and И. В. Шлёмина. "To the question of «pseudoscientific» principles of mediated psychotherapy of addictions." Научно-практический журнал «Наркология», no. 1() (February 28, 2018): 73–82. http://dx.doi.org/10.25557/igpp.2018.1.10762.
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Появление данной статьи вызвано многочисленными публикациями, дискредитирующими методы опосредованной психотерапии аддикций (ОП) и представляющие их как «сциентистски декорированное шаманство». В качестве основных причин подобной критики авторы статьи отмечают явно недостаточное, особенно в последнее время, количество научных исследований ОП и, соответственно, дефицит убедительных концепций. Рассматривая феномены патологического влечения (ПВ) и ОП с позиций информатики, авторы выделяют ПВ в структуре аддикций в качестве самостоятельного «программного продукта» и предлагают концепцию, согласно которой основным эффектом ОП является формирование антикревинговой программы на подсознательном уровне на основе вовлечения «функции самосохранения». Проводится параллель с антивирусными компьютерными программами. Уточняется важная роль ОП в алгоритме системной терапии аддиктивной патологии. This article is a response to numerous publications, in which methods of mediated psychotherapy of addictions (MP), based on placebo and trance effects, are discredited and presented as »scientific-decorated shamanism». According to the authors, the main reasons for such criticism are insufficient amount of scientific studies of MP (especially in recent times) and as a result - the lack of convincing conceptions. Discussing phenomena of pathological craving (PC) and MP from the point of view of informatics, authors distinguish PC in the structure of addiction as an independent »software product». They offer the concept, according to which the main effect of MP is forming of unconscious anticraving program (similarly to antivirus computer programs) based on self-preservation function. Authors specify important role of MP in the algorithm of systematic treatment of addictions.
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Kolakowska, Agnieszka, Anaenza Freire Maresca, Intira Jeannie Collins, and Johann Cailhol. "Update on Adverse Effects of HIV Integrase Inhibitors." Current Treatment Options in Infectious Diseases 11, no. 4 (November 16, 2019): 372–87. http://dx.doi.org/10.1007/s40506-019-00203-7.
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Abstract Purpose of review The goal of this paper is to provide an up-to-date review of adverse events related to the class of integrase strand transfer inhibitors (INSTIs), which became the class of choice in few years. We sought answers specifically to issues pertaining to neuropsychiatric adverse events, as well as weight gain, which were the two most important categories of adverse events raised in recent studies based on real-life experience. The primary focus of this paper is on adults with a brief summary on pregnant women and children/adolescents. Recent findings Dolutegravir (DTG) bears the heaviest burden of neuropsychiatric side effects. Weight gain was reported with all INSTIs, although there are methodological caveats in the analyses and the findings need to be interpreted with caution. Moreover, due to recent findings on neural tube defects in infants exposed to dolutegravir during their peri-conception period, its use is not recommended for women of childbearing age without proper birth control method, while raltegravir remains the only drug which may be prescribed without caution. Given the importance of cognitive and metabolic co-morbidities in people living with HIV in regard to their quality of life, future research needs to focus on long-term effects of INSTIs in relation to these adverse events. Pharmacogenetics seems to be a promising tool. Safety during pregnancy is also another important issue to further clarify. Summary INSTIs are a generally well-tolerated class of antiretrovirals (ARV), and has a higher antiviral potency compared to other classes of ARV. Clinicians and patients need however to be aware of some red flags when starting with and monitoring patients on INSTIs. All INSTIs can lead to mild increases in creatinine levels, usually without clinical significance, but caution is needed in patients with low eGFR (<30ml/min), when using other nephrotoxic drugs, such as as tenofovir disoproxil. Neuro-psychiatric (NP) effects are to be monitored with INSTIs, especially with DTG (though reports are at times contradictory); clinicians might want to avoid DTG for patients with history of severe NP symptoms, until clarity is provided. Weight gain was reported with all INSTIs, especially with DTG, with possible differential effects according to sex and ethnicity (female and non-white patients being at increased risk). This is worrying since patients from African descent are at higher risk of cardio-vascular events and increased body mass index (BMI) can cause further increase metabolic risk. There is possibly an additional effect of tenofovir alafenamide (TAF) on weight increase. Discrepancies between clinical trials – with low rates of adverse events – and reports from real-life settings might be due partly to under-representation of some groups of patients in clinical trials, and/or the short duration of follow-up, since some adverse effects may only occur after prolonged exposure. Preliminary data on safety of bictegravir (BIC), from clinical trials and non-trial settings, are very reassuring and seem to show lower rates of adverse events compared to DTG. Elvitegravir/cobicistat (EVG/cobi) need to be used with caution in patients with other co-morbidities given potential for polypharmacy, as it is the case for aging patients, because of the high potential of drug-drug interactions due to effects of the cobicistat booster. We are awaiting the release of cabotegravir (CAB), which could represent a good option for patients struggling with adherence, despite injection site reactions. Pharmacogenetics is a promising way to explore adverse effects occurrence in the INSTI class.
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Olimjanovna, Fazilova Mashxura. "Pre-Conception Preparation in Non-developing Pregnancy taking into account the Conjugal Role." Journal of Regenerative Biology and Medicine, January 1, 2021. http://dx.doi.org/10.37191/mapsci-2582-385x-3(1)-056.
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The article presents the results of monitoring the onset of pregnancy after preconception preparation in 30 women with a burdened gynecological history with a high risk of recurrent non-developing pregnancy. Women, it was divided into 2 groups: group I of 15 women (main), group II of 15 women (control) underwent 2 months of preconception training with traditional antibacterial antiviral therapy, and in the main group of 15 women not only traditional treatment was used, intrauterine insemination with the washing of sperm and the results of this study.
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Dorney, Edwina, Jacqueline A. Boyle, Ruth Walker, Karin Hammarberg, Loretta Musgrave, Danielle Schoenaker, Brian Jack, and Kirsten I. Black. "A Systematic Review of Clinical Guidelines for Preconception Care." Seminars in Reproductive Medicine, May 16, 2022. http://dx.doi.org/10.1055/s-0042-1748190.
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AbstractPreconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.