Exposed: The Reasons Why Temsirolimus Would Make People Happier
In this retrospective study, we reviewed the medical records of HIV-infected patients aged 18 years or older who were NVP-na?ve and initiated NVP-containing cART between February 2000 and October 2012 at the National Taiwan University Hospital and Far Eastern Memorial Hospital, the two major designated hospitals for HIV care in northern Taiwan. Patients who were not followed for 4 weeks after starting NVP-containing regimens or who were pregnant were excluded. A standardized case record form was used to collect information on demographics, serology of HBV and hepatitis C virus (HCV), concurrent medications, aminotransferases, CD4, and plasma HIV RNA load before and during NVP-containing cART. The study was approved by the research ethics committees of the two participating hospitals and informed consent was waived (REC registered number 201003112R). The plasma HIV RNA load was quantified using the Cobas Amplicor Pfizer Licensed Compound Library supplier HIV-1 Monitor test (Cobas Amplicor version 1.5; Roche Diagnostics Corporation, IN, USA) with a lower detection Pifithrin-�� mw limit of 40 copies/ml. The CD4 count was determined using FACFlow (BD FACSCalibur; Becton Dickinson, CA, USA). Hepatitis B surface antigen (HBsAg) was determined with the use of a quantitative, fully automated chemiluminescent microparticle immunoassay (ARCHITECT HBsAg; Abbott Diagnostics, Wiesbaden, Germany), and antibodies to HCV were determined with the use of a quantitative, fully automated chemiluminescent microparticle immunoassay (ARCHITECT Anti-HCV; Abbott Temsirolimus Diagnostics, Wiesbaden, Germany). Hepatotoxicity was defined as follows: grade 0 as an increase in aminotransferase level to 10 times ULN, for those patients with normal aminotransferase levels at baseline.19 For patients with abnormal aminotransferase levels at baseline, hepatotoxicity was defined as a two-fold or greater increase from baseline levels. The severity of NVP-associated skin rashes was graded according to the National Institutes of Health Division of AIDS guidelines.19 The decision to discontinue NVP when a skin rash or hepatotoxicity occurred was made at the discretion of the treating physicians. An unsatisfactory virological response was defined as failure to achieve an at least 1 log10 copies/ml decrease in plasma HIV RNA load from baseline at week 4 of treatment in the antiretroviral-na?ve patients. Treatment failure was defined as failure to achieve a plasma HIV RNA load of