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19. Trend of HIV Transmitted Drug Resistance After the Introduction of Single-Tablet Regimens in Southern Taiwan

Author

Tsai,Hung-Chin, Chen,I-Tzu, Chang,Hui-Min, Lee,Susan Shin-Jung, Chen,Yao-Shen, Tsai,Hung-Chin, Chen,I-Tzu, Chang,Hui-Min, Lee,Susan Shin-Jung, and Chen,Yao-Shen

Abstract

Hung-Chin Tsai,1– 5 I-Tzu Chen,1 Hui-Min Chang,6– 8 Susan Shin-Jung Lee,1,2 Yao-Shen Chen1,2 1Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; 3Department of Parasitology, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan; 5Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; 6Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 7Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 8Department of Pharmacy and Graduate Institute of Pharmaceutical Technology, Tajen University, Pingtung, TaiwanCorrespondence: Hung-Chin Tsai, Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, Tel +886 7 3422121 ext. 2029, Fax +886 7 346 8292, Email hctsai1011@yahoo.com.tw; tsaihungchin@gmail.comBackground: The prevalence of transmitted drug resistance (TDR) after the universal implementation of STRs is unknown in Taiwan.Objective: This study aimed to investigate the prevalence of TDR in patients with HIV-1 infection, clarify the risk factors for pol resistance, and compare differences in HIV drug resistance before and after the implementation of STRs in Taiwan.Methods: Adult patients infected with HIV-1 were enrolled in this study from 2013 to 2021. Mutations associated with drug resistance were identified using the 2019 International Antiviral Society-USA list of drug resistant mutations in HIV, and drug susceptibility was assessed according to the Stanford HIV Drug Resistance Database edition 9. A logistic regression model was used to analyze the risk factors for pol resistance, and the differences in the prevalence of drug resista

Published
2022

20. High Prevalence of Doravirine Resistance in HIV-1-Infected Patients with Virological Failure to an NNRTI-Based Single-Tablet Regimen

Author

Tsai,Hung-Chin, Chen,I-Tzu, Chang,Hui-Min, Lee,Susan Shin-Jung, Chen,Yao-Shen, Tsai,Hung-Chin, Chen,I-Tzu, Chang,Hui-Min, Lee,Susan Shin-Jung, and Chen,Yao-Shen

Abstract

Hung-Chin Tsai,1– 5 I-Tzu Chen,1 Hui-Min Chang,6– 8 Susan Shin-Jung Lee,1,2 Yao-Shen Chen1,2 1Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; 3Department of Parasitology, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan; 5Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; 6Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 7Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 8Department of Pharmacy and Graduate Institute of Pharmaceutical Technology, Tajen University, Pingtung, TaiwanCorrespondence: Hung-Chin Tsai, Division of Infectious Diseases, Department of Medicine Kaohsiung Veterans General Hospital, #386 Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, Tel +886 7 3422121 ext. 2029, Fax +886 7 346 8292, Email hctsai1011@yahoo.com.tw; tsaihungchin@gmail.comPurpose: This study aimed to investigate the prevalence of resistance to a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based single-tablet regimen (STR) in Taiwanese patients and clarify the clinical implications of using doravirine in patients who fail NNRTI treatment.Patients and Methods: Taiwanese patients infected with HIV-1 who failed NNRTI-based STR treatment were enrolled in this retrospective cohort study from 2015 to 2020. Mutations associated with drug resistance were identified using the 2019 International Antiviral Society-USA list of drug-resistant mutations in HIV, and drug susceptibility was assessed according to the Stanford HIV Drug Resistance Database version 9. Median values of continuous variables were compared between two groups using the Mann–Whitney U-test, and categorical variables were compared using the

Published
2022

22. Outcomes After Switching to BIC/FTC/TAF in Patients with Virological Failure to Protease Inhibitors or Non-Nucleoside Reverse Transcriptase Inhibitors: A Real-World Cohort Study

Author

Chang,Hui-Min, Chou,Pei-Yun, Chou,Chen-Hsi, Tsai,Hung-Chin, Chang,Hui-Min, Chou,Pei-Yun, Chou,Chen-Hsi, and Tsai,Hung-Chin

Abstract

Hui-Min Chang,1– 3 Pei-Yun Chou,4,5 Chen-Hsi Chou,2 Hung-Chin Tsai4– 6 1Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Department of Pharmacy and Master Program, Collage of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan; 4Section of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 5National Yang Ming Chiao Tung University, Taipei, Taiwan; 6Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, TaiwanCorrespondence: Hung-Chin TsaiSection of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, #386 Ta-Chung 1st Road, Kaohsiung, 813, TaiwanTel +886-7-3422121 ext. 2029Fax +886-7-346-8292Email hctsai1011@yahoo.com.twChen-Hsi ChouInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanEmail chenhsi@mail.ncku.edu.twPurpose: This study evaluated the real-world tolerability and treatment effectiveness of BIC/FTC/TAF in treatment-experienced patients living with HIV-1 in Taiwan, especially in those with viremia at switch.Patients and Methods: This was a retrospective cohort study of adult patients in Taiwan with HIV-1 who received BIC/FTC/TAF from between November 2019 and November 2020. The primary endpoint was the rate of viral suppression (plasma HIV RNA load < 50 copies/mL) while on BIC/FTC/TAF. The secondary endpoints included durability of treatment, incidence of and reasons for discontinuation of BIC/FTC/TAF, and changes in weight and lipid profiles.Results: A total of 175 patients were switched to BIC/FTC/TAF. Among them, 74 patients (42%) were using INSTI based regimen, 34 patients (19%) NNRTI based regimen and 65 patients (37%) with PI based regimen before switching. Before starting BIC/FTC/TAF, 84.6% of the patients were virologically

Published
2021

24. Durability of single tablet regimen for patients with HIV infection in Southern Taiwan: data from a real-world setting

Author

Chang, Hui-Min, Chou, Chen-Hsi, and Tsai, Hung-Chin

Subjects
Adult, Anti-HIV Agents, Taiwan, HIV, HIV Infections, Infectious and parasitic diseases, RC109-216, Durability, Antiretroviral therapy, Drug Combinations, Infectious Diseases, Drug resistance, Emtricitabine, Humans, Research Article, Single tablet regimen, Retrospective Studies, Tablets
Abstract

Background A single-tablet regimen (STR) has been associated with better drug adherence. However, the durability of different STRs was unknown in the real-world settings. Our aim was to investigate the durability of different initial STR regimens in antiretroviral-naive patients starting STR in southern Taiwan. Method This was a retrospective study of antiretroviral-naive patients that initiated first-line antiretroviral regimens with STRs between May 2016 and December 2017. The primary endpoint was time to virological failure. Secondary endpoints were STR discontinuation due to toxicity/intolerance. Durability was defined as time from the initiation until discontinuation/modification. Kaplan- Meier curves were plotted assessing time to virological suppression, treatment failure and discontinuation for the three STRs and Cox proportional hazards model was used to analyze the factors associated with time to viral suppression, treatment failure or discontinuation. Results Two hundred and twenty-three patients were included: The median follow-up duration (IQR) was 73.9 (48–101.6) weeks, 25 patients (11%) experienced virological failure; the 48 weeks probability of treatment failure was 22.9% (16/70) for Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate (EFV/FTC/TDF), 24.1% (13/54) for Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate (FTC/RPV/TDF) and 24.2% (24/99) for Abacavir/Dolutegravir/Lamivudine (ABC/DTG/3TC) (p=0.16). Fifty-six patients (25%) discontinued their STRs owing to toxicity/intolerance. When compared to EFV/FTC/TDF, treatment with FTC/RPV/TDF (aHR 8.39, CI 1.98–35.58, p = 0.004) and ABC/DTG/3TC (aHR 8.40, CI 2.39–29.54, p=0.001) were more likely to have treatment failure. The predictors for treatment failure included age ≦ 30 years old (aHR 3.73, CI 1.25–11.17, p = 0.018), switch between different STR (aHR 2.3, CI 1.18–4.50, p = 0.001) and free of active syphilis infection (aHR 0.24, CI 0.08–0.73, p = 0.012). The risk factor for treatment discontinuation included younger age ≦ 30 years old (aHR 3.82, CI 1.21–12.37, p = 0.023), treatment with EFV/FTC/TDF (aHR 8.65, CI 2.64–28.39, p Conclusion Younger age was associated with treatment failure and drug discontinuation. Active syphilis infection s/p treatment was associated with free from treatment failure and discontinuation. This probably driven by the more frequently sexual health education and counseling when patients had syphilis infection. Treatment with ABC/DTG/3TC was associated with higher risk of treatment failure. The STR durability was dependent on the drug toxicity/intolerance, age and syphilis infection.

Published
2020

31. Letters to the Editor

Author

Stellman, Steven D., Harville, David A., Driscoll, Michael F., Keselman, H. J., Algina, James, Kowalchuk, Rhonda K., Khattree, Ravindra, Sen, Ananda, Hamer, Robert M., Jones, Lyle V., Adams, Bryan E., Adams, Amber G., Chang, Hui-Min, Etzel, Carol, Kuo, Jo-Kang, Montemayor, Jorge, and Schucany, William R.

Published
2000

34. Additional file 4: of Efficacy and safety of switching from nevirapine immediate-release twice daily to nevirapine extended-release once daily in virologically suppressed HIV-infected patients: a retrospective cohort study in Taiwan

Author

Lee, Chun-Yuan, Chang, Hui-Min, Kunin, Calvin, Lee, Susan, Chen, Yao-Shen, and Hung-Chin Tsai

Abstract

PCR-restriction fragment length polymorphism analysis of CYP2B6 516. Three cases (A, B, C) participating in genotype analysis of CYP2B6 516 in the current study are shown. Lane M represents a size marker. After digestion with BsrI restriction enzyme, wild-type GG (case B) is visible as one band of 152 base pair. Heterozygous GT (case C) is visible as two bands (152 base pair and 204 base pair); homozygous mutant TT (case A) is visible as one band of 204 base pair. (PPTX 122Â kb)

Published
2017
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35. Additional file 2: of Efficacy and safety of switching from nevirapine immediate-release twice daily to nevirapine extended-release once daily in virologically suppressed HIV-infected patients: a retrospective cohort study in Taiwan

Author

Lee, Chun-Yuan, Chang, Hui-Min, Kunin, Calvin, Lee, Susan, Chen, Yao-Shen, and Hung-Chin Tsai

Subjects
humanities
Abstract

Comparison of demographic characteristics, steady-state plasma concentration of NVP, and genotype analysis of CYP2B6 516 in 48 HIV-infected patients enrolled in KVGH from January 1, 2014 to December 31, 2014, by patients enrolled or not enrolled in the retrospective part of the current study. The 22 patients enrolled in the retrospective analysis of the current study were older (37 vs. 27.5, P

Published
2017
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36. Additional file 1: of Efficacy and safety of switching from nevirapine immediate-release twice daily to nevirapine extended-release once daily in virologically suppressed HIV-infected patients: a retrospective cohort study in Taiwan

Author

Lee, Chun-Yuan, Chang, Hui-Min, Kunin, Calvin, Lee, Susan, Chen, Yao-Shen, and Hung-Chin Tsai

Subjects
immune system diseases, virus diseases
Abstract

Multivariate analysis of treatment failure in 84 virologically suppressed HIV-infected patients. In Cox regression, the hazard ratios for TLOVR between NVP regimen (NVP-XR vs. NVP-IR) was 0.940 (95% CI, 0.254–3.484; P = 0.926). (DOCX 14 kb)

Published
2017
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38. Effect of Thaizolidinedione on Gene Expression in NIH3T3-L1 Adipocytes

Author

LIN, WEN-SHIN, CHANG, HUI-MIN, TAI, TONG-YUAN, and CHUANG, LEE-MING

Subjects
Diabetes -- Research, Health
Abstract

Insulin stimulated glucose uptake in the 3T3-L1 cells is markedly increased in the adipocytes after induction of differentiation as compared to the parental fibroblasts. To study for the genes which [...]

Published
1999

39. Efficacy and safety of switching from nevirapine immediate-release twice daily to nevirapine extended-release once daily in virologically suppressed HIV-infected patients: a retrospective cohort study in Taiwan.

Author

Chun-Yuan Lee, Hui-Min Chang, Kunin, Calvin M., Susan Shin-Jung Lee, Yao-Shen Chen, Hung-Chin Tsai, Lee, Chun-Yuan, Chang, Hui-Min, Lee, Susan Shin-Jung, Chen, Yao-Shen, and Tsai, Hung-Chin

Subjects
NEVIRAPINE, ANTIRETROVIRAL agents, VIROLOGY, MICROBIOLOGY, OCCUPATIONAL therapist & patient, CONTROLLED release preparations, DRUG monitoring, DRUG administration, HIV, RETROSPECTIVE studies, ANTI-HIV agents, THERAPEUTICS
Abstract

Background: Whether the non-inferior efficacy and safety results of switching virologically suppressed HIV-1-infected patients from nevirapine immediate-release (NVP-IR) to NVP extended-release (NVP-XR) demonstrated in the TRANxITION study conducted in Europe and North America are also applicable to virologically suppressed HIV-infected Taiwanese patients remains unknown. We evaluated the comparative safety and efficacy of continuing NVP-IR versus switching to NVP-XR in virologically suppressed HIV-infected Taiwanese adults receiving combined antiretroviral therapy (cART) regimens.Methods: We conducted a retrospective cohort study at Kaohsiung Veterans General Hospital from April 1, 2013, to March 31, 2015. Eighty-four virologically suppressed HIV-infected adults receiving NVP-IR cART were split into two groups: those continuing with NVP-IR (n = 49) and those being switched to NVP-XR (n = 35). Demographic characteristics, clinical variables, and laboratory findings were compared. Therapeutic drug monitoring of steady-state plasma NVP concentrations and genotype analysis of CYP2B6 516 were also performed in 22 participants. The primary endpoint was continued virological suppression at the end of the study. Secondary endpoints were time to loss of virological response and adverse events.Results: During a mean follow-up of 18.4 months, the NVP-XR group demonstrated similar success at maintaining virological response compared with the NVP-IR group (82.9% vs. 85.7%; P = 0.72). Cox regression analysis indicated that there were no significant differences between NVP regimens for time to loss of virological response (hazard ratio: 0.940; P = 0.754). Furthermore, there were no significant differences in adverse events between these two groups. In the 22 participants, there was a non-significantly lower level of steady-state plasma NVP concentrations in the NVP-XR group than in NVP-IR recipients (5145.0 ng/mL vs. 6775.0 ng/mL; P = 0.267). The prevalence of CYP2B6 516 GT was 86.6%, and there was no significant difference in the distribution of CYP2B6 516 between these two groups.Conclusions: We found that switching from NVP-IR to NVP-XR appeared to have similar safety and efficacy compared with continuing NVP-IR among virologically suppressed, HIV-infected Taiwanese patients. Our finding of higher Ctrough levels in both groups compared with other studies conducted in Caucasian populations and the high prevalence of CYP2B6 516 GT requires further investigation in a larger Taiwanese cohort. [ABSTRACT FROM AUTHOR]

Published
2017
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50. Indium chloride-induced micronuclei via reactive oxygen species in Chinese hamster lung fibroblast V79 cells.

Author

Lin, Ruey‐Hseng, Yang, Ming‐Ling, Li, Yi‐Ching, Chang, Hui‐Min, and Kuan, Yu‐Hsiang

Subjects
INDIUM chlorides, NUCLEOLUS, HAMSTERS as laboratory animals, FIBROBLASTS, GENETIC toxicology
Abstract

We study the cytotoxicity of indium chloride (InCl3) in Chinese hamster lung fibroblasts, the V79 cells, using MTT assay. The results showed that InCl3 did not induce significant cytotoxicity at various concentrations tested. In addition, the frequency of micronuclei (MN) was assayed to evaluate the genotoxic effects of InCl3 in V79 cells. InCl3 at concentrations ranged 0.1-1 μM significantly increased MN frequency in a concentration-dependent manner. Both catalase and superoxide dismutase at concentrations of 75 and 150 μg/mL significantly inhibited InCl3-induced MN. Similarly, Germanium oxide (GeO2) and dimercaprol expressed antigenotoxic effects. From these findings, it is concluded that InCl3 is a potent genotoxic chemical, which may be mediated partly by inducing oxidative stress. The significance of this study shows that the workers in the semiconductor factories should be cautious in exposing to the hazardous genotoxic InCl3. © 2011 Wiley Periodicals, Inc. Environ Toxicol 28: 595-600, 2013. [ABSTRACT FROM AUTHOR]

Published
2013
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