Abacavir versus zidovudine combined with lamivudine and efavirenz, for the treatment of antiretroviral-naive HIV-infected adults.

BACKGROUND: Zidovudine, lamivudine, and efavirenz comprise a highly effective and well-tolerated triple regimen for antiretroviral-naive patients. Evaluating other unique nucleoside reverse-transcriptase inhibitor (NRTI) combinations for long-term viral suppression is desirable. METHODS: This multicenter, randomized, double-blind noninferiority clinical trial compared the efficacy and safety of abacavir with that of zidovudine plus lamivudine and efavirenz in 649 antiretroviral-naive HIV-infected patients. The primary objective was a comparison of proportions of patients achieving plasma HIV-1 RNA levels

Long-term results of initial therapy with abacavir and Lamivudine combined with Efavirenz, Amprenavir/Ritonavir, or Stavudine.

OBJECTIVE: To compare alternative class-sparing antiretroviral regimens in treatment-naive subjects. DESIGN: Open-label, multicenter, randomized trial of up to 3 consecutive treatment regimens over 96 weeks. METHODS: Two hundred ninety-one subjects received abacavir (ABC) and lamivudine and efavirenz (nonnucleoside reverse transcriptase inhibitors [NNRTIs]), ritonavir-boosted amprenavir (protease inhibitor [PI]), or stavudine (nucleoside reverse transcriptase inhibitor [NRTI]) by random assignment. The primary end points were the percentages of subjects with plasma HIV-1 RNA levels <400 copies/mL and time to treatment failure over 96 weeks. RESULTS: Ninety percent of subjects completed 96 weeks of follow-up, and 79% remained on study treatment. At week 96, there were no differences between arms in the percentages of subjects with plasma HIV-1 RNA levels <400 and <50 copies/mL, mean changes in plasma HIV-1 RNA levels, time to treatment failure, time to first or second virologic failure, or CD4 cell counts. The NNRTI arm had a greater percentages of subjects with RNA levels

Infección por Chlamydia Trachomatis en un grupo de mujeres de alto riesgo, trabajadoras del sexo en Costa Rica / Infection by Chlamydia Trachomatis in a group of women of high risk, workers of sex in Costa Rica

Las clamidias son los patógenos más importantes en las enfermedades de transmisión sexual en todo el mundo. Sólo para Estados Unidos se estima que ocurren más de 4 millones de infecciones clamidiales por año. En Costa Rica pocos estudios de la infección por Chlamydia trachomatis (CT) han sido publicados por la falta de introducción de pruebas sensibles y específicas para su tamizaje y diagnóstico. Este estudio pretende determinar la presencia de la infección por CT en un grupo de mujeres trabajadoras de sexo (MTS) para demostrar la necesidad de diagnóstico y tomar las medidas adecuadas de prevención y control. En un estudio descriptivo transversal prospectivo, un total de 457 MTS fueron analizadas, se obtuvieron muestras de endocervical y orina, así como datos epidemiológicos. La prueba de PCR Roche Diagnostic fue usada para detectar la infección por C. Trachomatis. Se determina un 14.7 por ciento de prevalencia de infección afectando principalmente a los grupos etarios de 16 a 34 años así, como su relación con comportamientos de riesgo tales como, edad temprana de inicio de relaciones sexuales (10 a 19 años), baja escolaridad (66 por ciento primaria o menos), múltiples compañeros sexuales (50.7 por ciento de 11 a 50 por semana), no uso del preservativo (43.8 por ciento). No se encontró relación entre la infección por CT y el diagnóstico clínico sintomatológico lo que evidencia la necesidad de la implementación de un método de diagnóstico como las pruebas de amplificación nucleica de gran sensibilidad y especificidad como, su aplicación en diferentes tipos de muestras: endocervicales, uretrales, orina que permitan la detección y prevención de la infección, para brindar los tratamientos oportunos y la disminución de la morbilidad y la transmisión.

The Chlamydia are the most important pathogens in the sexual transmission diseases over the world. An estimated of 4 million Chlamydia infection occurs annually in the United States. In Costa Rica, few studies of the Chlamydia trachomatis (CT) infection have been published because of the lack of sensitive and specific testing introduction methods for screening and diagnostic. This study tries to determine the presence of the infection by CT in a group of women sex workers (WSW) to demonstrate that we must implemented the diagnostic and take the measures from prevention and control. In one descriptive, prospective and transversal study, a total of 457 WSW were analyzed. Endocervicales, urine samples and epidemiological data were obtained from the study. C. Trachomatis infection was detected with the PCR Roche Diagnostic Test. In this study a 14.7% of prevalence is determined, affecting mainly groups of people from 16 to 34 years old. Besides, a connection with early sexual intercourse (10 to 19 years), low schooling (primary 66% or less), multiple sexual partners (50.7% from 11 to 50 per week), non use of condom (43.8%) was found. In the study there was not relation between infection by CT and the clinical diagnostic symptoms that demonstrates the necessity of the implementation of a diagnostic method, like nucleic acid amplifi cation tests, for the great sensitivity and specifi city, and its application in different specimens: urethral, endocervicales, urine that allow the detection and prevention of the infection, to offer the proper treatments and the reduction of the morbidity and the transmission.