Of 800 patients receiving the nevirapine XR formulation, 15 reported tablet remnants in stools, an incidence rate of 1.19% in VERxVE and 3.05% in the TRANxITION study. The difference in event rate was highly significant between the XR and immediate release (IR) formulations (P < 0.001), but not between trials (P = 0.061). All patients (15 of 15)
reporting remnants achieved learn more the primary study endpoint of HIV-1 suppression (< 50 HIV-1 RNA copies/mL), whereas overall 81% of patients in the VERxVE trial and 94% in the TRANxITION trial did so. The mean nevirapine trough concentration was 3431.4 ng/mL in patients reporting remnants. Tablet remnants retrieved from the stools of three subjects revealed a percentage nevirapine recovery of 22.8–42.2% of original drug. Subgroup analysis of gender, age, race and geographical region revealed no risk factor association with the finding of remnants. The finding of nevirapine tablet remnants
in stools is a rare event, with an incidence of approximately 2%, restricted to the XR formulation. Affected patients responded fully to antiretroviral therapy by achieving the primary study endpoint and demonstrating no relevant safety risks; nevirapine pharmacokinetic analysis of blood and stool samples ruled out underexposure. “
“Existing tools for rapid cognitive assessment in HIV-positive individuals with mild cognitive deficits lack sensitivity or do not meet psychometric requirements for tracking changes in cognitive ability over time. Seventy-five nondemented Trametinib HIV-positive patients were evaluated with the G protein-coupled receptor kinase Montreal Cognitive Assessment (MoCA), a brief battery of standardized neuropsychological tests, and computerized tasks evaluating frontal-executive function and processing speed. Rasch analyses were applied to
the MoCA data set and subsequently to the full set of data from all tests. The MoCA was found to adequately measure cognitive ability as a single, global construct in this HIV-positive cohort, although it showed poorer precision for measuring patients of higher ability. Combining the additional tests with the MoCA resulted in a battery with better psychometric properties that also better targeted the range of abilities in this cohort. This application of modern test development techniques shows a path towards a quick, quantitative, global approach to cognitive assessment with promise both for initial detection and for longitudinal follow-up of cognitive impairment in patients with HIV infection. Mild cognitive impairment has been increasingly recognized as a common feature of chronic HIV infection, even in patients with good viral control on highly active anti-retroviral therapy (HAART) [1]. It occurs in 30–50% of patients, depending on both the cohort under study and how the impairment is identified [1–8].