Clinically, it should be considered that, in the absence of a dedicated test for microalbuminuria, it is not possible to distinguish between patients with and without elevated levels of urinary albumin using only a urine dipstick. Given that microalbuminuria is a risk factor for proteinuria, knowledge of its presence through dedicated testing might be indicated to eventually guide clinicians to the optimal prevention of progression of renal disease in HIV-infected persons. LAS’s work was supported by a grant from the National Kidney Foundation of North Carolina and by grant DK02724-01A1 from the National
Institutes of Health. JAB is supported by the following grants from http://www.selleckchem.com/products/apo866-fk866.html the US National Institutes of Health/National Institute of Allergy and Infectious Diseases: International Studies of AIDS-Associated Co-infections (ISAAC) (AI062563), HIV/AIDS Clinical Trials Unit (AI069484), and the find more Duke University Center
for AIDS Research (CFAR) (AI645180). This research was supported in part by the University of North Carolina at Chapel Hill Center for AIDS Research (CFAR), an NIH-funded programme (P30 AI50410). Conflicts of interest No investigators have any content-specific conflicts of interest regarding the material presented in this paper. “
“The aim of this study was to describe the long-term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to a long-term decline in the immune system via low-grade
chronic immune activation/inflammation, then one might expect to see a greater or earlier decline in CD4 counts in older HIV-positive patients with increasing duration of cART. Retrospective and prospective data were examined from long-term virologically stable HIV-positive adults from the Australian HIV Observational Database. We estimated mean CD4 cell count changes following the completion of 5 years of cART using linear mixed models. A total of 37 916 CD4 measurements were observed for 892 patients over a combined total of 9753 patient-years. Older patients (> 50 years old) at cART initiation had estimated mean (95% confidence interval) changes in CD4 counts by year-5 Leukotriene-A4 hydrolase CD4 count strata (< 500, 500–750 and > 750 cells/μL) of 14 (7 to 21), 3 (–5 to 11) and –6 (–17 to 4) cells/μL/year. Of the CD4 cell count rates of change estimated, none were indicative of long-term declines in CD4 cell counts. Our results suggest that duration of cART and increasing age do not result in decreasing mean changes in CD4 cell counts for long-term virologically suppressed patients, indicating that the level of immune recovery achieved during the first 5 years of treatment is sustained through long-term cART. “
“Bacterial pneumonia still contributes to morbidity/mortality in HIV infection despite effective combination antiretroviral therapy (cART).