Piotr Pulik

HIV infection in ageing population Case report of three patients over 75 years old

Summary Epidemiological data shows, that among HIV infected patients population of persons older then 50 years is steadily growing. This group consists of patients treated successfully with ART and growing older on treatment, and of patients diagnosed with HIV in older age. Data shows, that older age is connected with faster progression to AIDS, faster decline in CD4 cell count and that response to ART is poorer in this group when compare with younger population. Age is a risk factor of developing cardiovascular disease, liver, kidneys and bone disorders. It become apparent, that medical standard of care for older HIV patients needs adjustment. This paper describes three cases of patients age 75 years or more, the oldest patients under care in the clinic in the year 2008.

“Efficacy and safety of nucleoside‐sparing regimen based on raltegravir and ritonavir‐boosted darunavir in HIV‐1‐infected treatment‐experienced patients”

To assess the efficacy and tolerability of dual therapy containing raltegravir (RAL) and ritonavir boosted darunavir (DRV/r) in HIV‐1‐infected treatment‐experienced patients.

Study comparing lipid metabolism disorders and effectiveness of treatment in HIV infected patients on long-term treatment with various thymidine analogues

Summary Disorders in lipid metabolism exist in most patients treated for the long time. In our study were included 186 patients on antiretroviral treatment lasting 96 weeks treated either with AZT/3TC or with D4T/3TC. Performed studies have shown that both d4T/3TC and AZT/3TC regimens are effective as backbone of CART. Similar immunological values are achieved using above mentioned regimens. Elevation of TG and TC level during antiretroviral therapy is much more frequent in persons treated with d4T/3TC and is not dependent on type of the third drug used.

Dual therapy based on raltegravir and boosted protease inhibitors – the experience of Polish centers

Introduction The aim of the study was to present the experience of Polish centers regarding dual therapy based on the integrase inhibitor raltegravir (RAL) and ritonavir-boosted protease inhibitors (PI/r) for treating treatment-naïve and -experienced HIV-infected patients. Material and methods The paper concerns a retrospective multicenter study. The medical databases of six main Polish HIV centers from January 2009 to December 2014 were analyzed for the use of combined antiretroviral treatment consisting of RAL + PI/r. This study included 126 HIV-infected patients receiving RAL + PI/r therapy, of whom 17 patients were treatment-naive and 109 patients were treatment-experienced. Results In treatment-experienced patients, the most common reasons for the introduction of a RAL + PI/r regimen were virologic failure and impaired renal function (45 of 109 patients). In the treatment-naïve group kidney disease was the cause of the RAL + PI/r regimen in 3 of 17 participants. In treatment-experienced patients, 80% of individuals still were on RAL + PI/r treatment after 12 months, 65% after 24 months and 53% of subjects after 60 months. In both groups, the simplification of the antiretroviral regimen was the most common reason for discontinuation of RAL + PI/r based therapy. Conclusions In antiretroviral-experienced patients the dual therapy based on RAL + PI/s is safe and effective. In antiretroviral-naïve patients the RAL + PI/r regimen is rarely used in Poland.

JCV and BKV prevalence in people infected with HIV-1

Summary Human pathogenic viruses of the polyoma type were discovered only in the 70s of the 20th century. So far seroepidemiologic researches concerning these infections have been carried out on small groups and probably are not representative of the entire of population. They showed a past polyomaviruses infection in 35–85% people in a healthy population. In two cases: JSV and BKV reactivation plays a role in a development of diseases in people with impaired immunological response, e.g. HIV infection history. The aim of the study was to examine the frequency of prevalence of JCV and BKV in various body fluids and pathogenicity connected with these viruses in patients infected with HIV-1. The tests included 108 people of both sexes, in whom HIV-1 infection was diagnosed. JCV/BKV infection was diagnosed in 27 (25%) HIV-1 infected patients, where JCV constituted 18 (16.7%) cases and 9 (8.3%) BKV. The infections were proven on the basis of a presence of virus genetic material in urine. In none of the patients was JCV and BKV detected in blood and cerebrospinal fluid. In the patient group with TCD4 lymphocyte count 500 cell/μL JCV DNA was detected in urine in 9 (20.5%) cases and BKV DNA in 1 (2,3%) case.