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Treats HIV infection. This medicine does not cure HIV or AIDS, but it may slow the progress of the disease.

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Results: 18

Caesarean Section

This guidance is a partial update of NICE clinical guideline 13 (published April 2004) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2011
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Hydroxyurea for the Treatment of Sickle Cell Disease

To synthesize the published literature on the efficacy, effectiveness, and toxicity of hydroxyurea (HU) when used for treatment of sickle cell disease (SCD); and to review the evidence regarding barriers to its use.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: February 2008
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Enabling Medication Management Through Health Information Technology

The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: April 2011
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When used with AZT, ddI and perhaps ddC, can delay HIV disease progression and death

Zidovudine (AZT) was the first antiretroviral drug used in HIV and AIDS. It is expensive and has several adverse effects including nausea, vomiting, blood problems (anaemia and neutropenia) and myopathy (muscle weakness). The next two drugs developed for HIV were didanosine (ddI) and zalcitabine (ddC). The adverse effects of ddI include nausea, vomiting, diarrhoea and problems with the pancreas (pancreatitis) and nerves in the arms and legs (peripheral neuropathy). Adverse effects of ddC are mouth ulcers and peripheral neuropathy. The review of trials found that both HIV disease progression and death are delayed by ddI, and perhaps also by ddC, at least when used with AZT.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Nucleoside reverse transcriptase inhibitors in combination therapy for HIV patients: systematic review and meta-analysis

Treatment guidelines recommend dual nucleoside reverse transcriptase inhibitors (NRTI ) as a part of combination antiretroviral therapy. The objective of this study was to assess the relative efficacy and toxicity of the dual NRTI part of the regimen in antiretroviral-naïve HIV-1-infected adults. A systematic review and meta-analysis of randomized controlled trials assessing highly active antiretroviral therapy (HAART) for treatment-naïve HIV-infected adults with a 48-week follow-up were done. We searched the PubMed, CENTRAL, and EMBASE electronic databases up to April 2009. Proceedings from conferences were reviewed. Data were extracted independently by two reviewers. Primary outcome was viral suppression at 48 weeks. The odds ratio (OR) is reported with its corresponding 95% confidence interval (CI). Twenty-two randomized controlled trials, including 8,184 HIV-treatment-naïve patients, were included. The combination didanosine + lamivudine/emtricitabine (four trials, 1,148 patients) was more effective (OR 0.53, 95% CI 0.41-0.68) for viral load (VL) >50 copies/ml and less toxic (OR 0.52, 95% CI 0.36-0.76) for discontinuation due to adverse events (AE) than its comparators. The combination tenofovir + lamivudine/emtricitabine was more effective and less toxic (OR 0.75, 95% CI 0.58-0.96) only in the 144-week follow-up data (two trials, 1,119 patients). Abacavir + lamivudine had similar efficacy to its comparators (OR 0.81, 95% CI 0.8-1.1), but more AIDS-defining events (OR 3.22, 95% CI 1.24, 8.40). The once-daily combination didanosine + lamivudine/emtricitabine was found to be effective and tolerable. This combination, soon to be generic, should be compared to the current standard of care in a large randomized trial. An effective, safe, and inexpensive alternative to current options is needed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Reducing the number of drugs in combination antiretroviral therapy for HIV after initial virologic response reduces the effectiveness of the treatment

Combination antiretroviral therapy can lower the amount of HIV in the blood, improve immune system function, and slow the progress of HIV. It is thought these drugs will need to be used for life. Keeping up this therapy, though, is difficult, and there are concerns about the adverse effects of the drugs and the development of resistance to the drugs over time. Therefore, attempting to use fewer drugs has been tried. However, the review of trials comparing combinations of three or four drugs, in patients who successfully completed initial therapy, with using fewer drugs found that a reduced number of drugs could not suppress the virus as well.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Efficacy and tolerability of initial antiretroviral therapy: a systematic review

This review concluded that many factors influenced antiretroviral therapy (ART) success. Didanosine was an effective option for initial ART, particularly in settings with limited resources. And ART guideline development may benefit from an ongoing systematic review of the evidence. These conclusions are appropriate in view of the limited duration and reporting of safety data in included studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Clinical efficacy of antiretroviral combination therapy based on protease inhibitors or non-nucleoside analogue reverse transcriptase inhibitors: indirect comparison of controlled trials

This review compared triple antiretroviral regimens based on protease-inhibitors and non-nucleoside analogue reverse transcriptase inhibitors (non-NRTIs) in adults who were human immunodeficiency virus (HIV-1) positive. The authors concluded that indirect comparisons suggest that protease-inhibitor-based regimens are superior to non-NRTI-based regimens in patients with advanced immunodeficiency previously treated with NRTIs. The authors correctly highlighted limitations of the indirect comparisons and drew appropriately cautious conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Once-a-day highly active antiretroviral therapy: a systematic review

The review assessed once-a-day highly active antiretroviral therapy (HAART) in patients infected with the human immunodeficiency virus. The authors concluded that some once-a-day HAART regimens had a virological efficacy at least similar to that of conventional HAART, an overall CD4 cell increase of at least 114 lymphocytes/microlitre, and good tolerability. The conclusions of this well-conducted systematic review are supported by the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Antiretrovirals for reducing the risk of mother‐to‐child transmission of HIV infection

At the end of 2009, 2.5 million children under the age of 15 years were estimated to be living with HIV/AIDS (WHO 2011). The majority of these children acquired their infections as a result of mother‐to‐child transmission during pregnancy, labor, or breastfeeding. Antiretroviral drugs administered to the HIV‐infected mother and/or to her child during pregnancy, labor, or breastfeeding can reduce mother‐to‐child transmission of HIV. The objective of this review is to determine whether a regimen of antiretroviral drugs leads to a significant reduction in HIV transmission during pregnancy and labor without serious side‐effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Drug Class Review: Neuropathic Pain: Final Update 1 Report [Internet]

We compared the effectiveness and harms of anticonvulsants, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors (SNRIs), and the lidocaine patchin adults with neuropathic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2011
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Changes in hematologic parameters and efficacy of thymidine analogue-based, highly active antiretroviral therapy: a meta-analysis of six prospective, randomized, comparative studies

This review assessed the effects of zidovudine- and stavudine-based triple regimens on haematological outcomes, CD4+ T-cell counts and viral load in patients infected with the human immunodeficiency virus. The authors concluded that zidovudine regimens reduced haemoglobin and increased neutropenia events in comparison with stavudine-based regimens. Since most of the studies used different co-treatments and did not assess validity, it is difficult to judge the reliability of the conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Emergence of drug resistance in HIV type 1-infected patients after receipt of first-line highly active antiretroviral therapy: a systematic review of clinical trials

This review compared drug resistance profiles of patients with HIV type 1 infection after treatment with first-line antiretroviral therapy. The authors concluded that initial treatment with a boosted protease inhibitor-based regimen was associated with less resistance within and across drug classes. The reliability of this conclusion is unclear due to potential methodological weaknesses and gaps in the reporting process.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Initial highly-active antiretroviral therapy with a protease inhibitor versus a non-nucleoside reverse transcriptase inhibitor: discrepancies between direct and indirect meta-analyses

This review evaluated the effectiveness of initial highly-active antiretroviral therapy (HAART) with a protease inhibitor (PI) and a non-nucleoside reverse transcriptase inhibitor (non-NRTI). The authors concluded that non-NRTI-based HAART is more effective than PI-based HAART for virological suppression, but the interventions are similar for clinical outcomes. Despite some possible limitations, the conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Screening for HIV: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation [Internet]

A 2005 U.S. Preventive Services Task Force (USPSTF) review found good evidence that HIV screening tests are accurate and that identification of undiagnosed HIV infection and treatment of immunologically advanced disease is associated with substantial clinical benefits. However, it found insufficient evidence to estimate effects of diagnosis and subsequent interventions on transmission risks, or to estimate clinical benefits of antiretroviral treatment in patients with less immunologically advanced disease.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2012
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Screening for HIV in Pregnant Women: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation [Internet]

A 2005 U.S. Preventive Services Task Force (USPSTF) review found good evidence that prenatal HIV screening is accurate and can lead to interventions that reduce the risk of mother-to-child transmission.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2012
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Peginterferon Alfa and Ribavirin for Chronic Hepatitis C in Patients Eligible for Shortened Treatment, Re-Treatment or in HCV/HIV Co-Infection: A Systematic Review and Economic Evaluation

To assess the clinical effectiveness and cost-effectiveness of peginterferon alfa and ribavirin for the treatment of chronic hepatitis C virus (HCV) in three specific patient subgroups affected by recent licence changes: those eligible for shortened treatment courses [i.e. those with low viral load (LVL) and who attained a rapid virological response (RVR) at 4 weeks of treatment], those eligible for re-treatment following previous non-response or relapse, and those co-infected with human immunodeficiency virus (HIV).

Health Technology Assessment - NIHR Journals Library.

Version: April 2011
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Peritoneal Dialysis: Peritoneal Dialysis in the Treatment of Stage 5 Chronic Kidney Disease

Two main types of dialysis are available, haemodialysis and peritoneal dialysis. The main factors that determine what type of dialysis people with chronic kidney disease have are patient preferences about which treatment fits best within their lifestyle, availability of options within a service and clinical contraindications. Factors patients and carers may need to consider about peritoneal dialysis are: the ability to carry out dialysis themselves; the support services they need to carry out dialysis; integration of dialysis with work, school, hobbies, and social and family activities; opportunities to maintain social contacts; possible modifications to their home; the distance and time travelling to hospital; flexibility of daily treatment, diet and medication regimens; and possible changes to body image and physical activities because of dialysis access points.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: July 2011
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Systematic Reviews in PubMed

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