RESUMO
BACKGROUND: The effect of nonthymidine nucleoside reverse-transcriptase inhibitors (NRTIs) on fat mitochondrial DNA (mtDNA) content and function is unclear. METHODS: A5202 randomized antiretroviral therapy-naive human immunodeficiency virus-infected subjects to abacavir-lamivudine (ABC/3TC) versus tenofovir DF-emtricitabine (TDF/FTC) with efavirenz (EFV) or atazanavir-ritonavir (ATV/r). A5224s, substudy of A5202, enrolled 269 subjects with fat measurements by dual-energy x-ray absorptiometry and computed tomography. A subset of subjects underwent fat biopsies at baseline and week 96 for mtDNA content (real-time polymerase chain reaction) and oxidative phosphorylation nicotinamide adenine dinucleotide (reduced) dehydrogenase (complex I) and cytochrome c oxidase (complex IV) activity levels (immunoassays). Intent-to-treat analyses were performed using analysis of variance and paired t tests. RESULTS: Fifty-six subjects (87% male; median age, 39 years) were included; their median body mass index, CD4 cell count, and fat mtDNA level were 26 kg/m(2), 227 cells/µL, and 1197 copies/cell, respectively. Fat mtDNA content decreased within the ABC/3TC and TDF/FTC groups (combining EFV and ATV/r arms; median change, -341 [interquartile range, -848 to 190; P = .03] and -400 [-661 to -221; P < .001] copies/cell, respectively), but these changes did not differ significantly between the 2 groups (P = .57). Complex I and IV activity decreased significantly in the TDF/FTC group (median change, -12.45 [interquartile range, -24.70 to 2.90; P = .003] and -8.25 [-13.90 to -1.30; P < .001], optical density × 10(3)/µg, respectively) but not the ABC/3TC group. Differences between the ABC/3TC and TDF/FTC groups were significant for complex I (P = .03). CONCLUSIONS: ABC/3TC and TDF/FTC significantly and similarly decreased fat mtDNA content, but only TDF/FTC decreased complex I and complex IV activity levels. CLINICAL TRIALS REGISTRATION: NCT00118898.
Assuntos
Tecido Adiposo/efeitos dos fármacos , Fármacos Anti-HIV/uso terapêutico , DNA Mitocondrial/efeitos dos fármacos , Infecções por HIV/tratamento farmacológico , Inibidores da Transcriptase Reversa/uso terapêutico , Adenina/administração & dosagem , Adenina/análogos & derivados , Adenina/uso terapêutico , Tecido Adiposo/metabolismo , Adulto , Alcinos , Fármacos Anti-HIV/administração & dosagem , Sulfato de Atazanavir , Benzoxazinas/administração & dosagem , Benzoxazinas/uso terapêutico , Ciclopropanos , DNA Mitocondrial/genética , DNA Mitocondrial/metabolismo , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Didesoxinucleosídeos/administração & dosagem , Didesoxinucleosídeos/uso terapêutico , Combinação de Medicamentos , Quimioterapia Combinada , Emtricitabina , Feminino , HIV-1 , Síndrome de Lipodistrofia Associada ao HIV/fisiopatologia , Humanos , Lamivudina/administração & dosagem , Lamivudina/uso terapêutico , Masculino , Mitocôndrias/efeitos dos fármacos , Oligopeptídeos/administração & dosagem , Oligopeptídeos/uso terapêutico , Organofosfonatos/administração & dosagem , Organofosfonatos/uso terapêutico , Piridinas/administração & dosagem , Piridinas/uso terapêutico , Inibidores da Transcriptase Reversa/administração & dosagem , Ritonavir/administração & dosagem , Ritonavir/uso terapêutico , Tenofovir , Resultado do TratamentoRESUMO
OBJECTIVES: A collar containing 10.0% imidacloprid/4.5% flumethrin (Seresto; Bayer Animal Health) controls flea and tick infestations for 8 months and is effective in preventing transmission of Bartonella henselae and Cytauxzoon felis among cats. The purpose of this study was to compare tolerance of client-owned cats for the 10.0% imidacloprid/4.5% flumethrin collar or a physically identical placebo collar. METHODS: A total of 96 client-owned cats were enrolled in the study. Cats that were systemically ill, of hairless breed or declawed in all four limbs were excluded. Cats were randomized by household to wear a placebo collar for 14 days followed by the 10.0% imidacloprid/4.5% flumethrin collar for 14 days or the 10.0% imidacloprid/4.5% flumethrin collar for 28 days. Examinations by a veterinarian were performed on days 0, 14 and 28. Owners recorded daily systemic and local health observations. RESULTS: All but two cats, including one that entrapped the mandible in the collar and one that developed local pyodermatitis (10.0% imidacloprid/4.5% flumethrin collar), completed the 28 day study. The majority of the local lesions or licking associated with the collars occurred in the first 14 days, and licking (but not skin lesions) was more common in cats wearing the 10.0% imidacloprid/4.5% flumethrin collars. No local lesions were reported for placebo cats after switching to the 10.0% imidacloprid/4.5% flumethrin collar, and only one cat wearing the 10.0% imidacloprid/4.5% flumethrin collar had reports of licking after day 14. Housing status, single or multiple cat household, and whether a collar had been worn previously were not associated with side effects. CONCLUSIONS AND RELEVANCE: Adverse events detected for cats wearing 10.0% imidacloprid/4.5% flumethrin collars were similar to those for cats wearing placebo collars and to cats wearing identification collars in a separate study. The data suggest that most cats originally intolerant of collars become receptive over time.
Assuntos
Doenças do Gato/prevenção & controle , Infestações por Pulgas/veterinária , Imidazóis/administração & dosagem , Inseticidas/administração & dosagem , Nitrocompostos/administração & dosagem , Piretrinas/administração & dosagem , Animais , Gatos , Feminino , Infestações por Pulgas/prevenção & controle , Imidazóis/efeitos adversos , Inseticidas/efeitos adversos , Masculino , Neonicotinoides , Nitrocompostos/efeitos adversos , Piretrinas/efeitos adversos , Resultado do TratamentoRESUMO
OBJECTIVE: We explored associations between mitochondrial DNA (mtDNA) haplogroups, epidermal nerve fiber density (ENFD), and HIV-associated sensory neuropathy (HIV-SN) in a randomized trial of Thai patients initiating antiretroviral therapy (ART). DESIGN: The South East Asia Research Collaboration with Hawaii 003 study evaluated toxicity of nucleoside reverse transcriptase inhibitors (stavudine vs. zidovudine vs. tenofovir). We present secondary analyses of mtDNA haplogroups and ENFD changes. METHODS: ENFD, peripheral blood mononuclear cell mitochondrial complex I and IV, and 8-oxo-deoxyguanine (8-oxo-dG) were quantified. Peripheral blood mononuclear cell mtDNA sequences were obtained for haplogroup determination. Multivariate regression of ENFD change was performed. RESULTS: Paired ENFD was available from 118 patients. Median age, CD4 cell count, and height at entry were 34 years, 172 cells/µl, and 162 cm, respectively. Major haplogroups included M (42%), F (21%), and B (16%). Baseline ENFD, CD4 cell count, randomized ART, and biomarkers did not differ by haplogroup. Haplogroup B patients were older (P=0.02) at baseline, and had an increase in median ENFD (+1.5 vs. -2.9 fibers/mm; P=0.03) and 8-oxo-dG break frequency (+0.05 vs. 0.00; P=0.05) compared to other haplogroups. In a multivariate model, haplogroup B was associated with increased ENFD (ß=3.5, P=0.009) at week 24, whereas older age (P=0.02), higher baseline CD4 cell count, (P=0.03), higher complex I level (P=0.03), and higher ENFD (P<0.001) at baseline were all associated with decreased ENFD. Three of the six HIV-SN cases were haplogroup B (P=0.05). CONCLUSIONS: Thai persons belonging to mtDNA haplogroup B had increased ENFD and 8-oxo-dG on ART, and were more likely to develop HIV-SN. These results suggest that mtDNA variation influences early oxidative damage and ENFD changes.