Journal Article Legionnaires' Disease in Patients Infected with Human Immunodeficiency Virus Get access Félix Gutiérrez Rodero, Félix Gutiérrez Rodero Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Reprints or correspondence: Dr. Félix Gutiérrez Rodero, Servicio de Medicina Interna, Hospital del SVS de Villajoyosa, 03570 Villajoyosa, Alicante, Spain. Search for other works by this author on: Oxford Academic PubMed Google Scholar Victoria Ortiz de la Tabla, Victoria Ortiz de la Tabla Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Search for other works by this author on: Oxford Academic PubMed Google Scholar Carmen Martínez, Carmen Martínez Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Search for other works by this author on: Oxford Academic PubMed Google Scholar María del Mar Masiá, María del Mar Masiá Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Search for other works by this author on: Oxford Academic PubMed Google Scholar Eusebio Chiner, Eusebio Chiner Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Search for other works by this author on: Oxford Academic PubMed Google Scholar José Luis Calpe José Luis Calpe Servicios de Medicina Interna, Microbiología y Neumología, Hospital del SVS de Villajoyosa, Villajoyosa, Alicante, Spain Search for other works by this author on: Oxford Academic PubMed Google Scholar Clinical Infectious Diseases, Volume 21, Issue 3, September 1995, Pages 712–713, https://doi.org/10.1093/clinids/21.3.712 Published: 01 September 1995
In the Long-Acting Antiretroviral Treatment Enabling Trial 2 (LATTE-2) phase 2b study, long-acting (LA) injectable cabotegravir + rilpivirine dosed every 8 weeks (Q8W) or every 4 weeks (Q4W) demonstrated comparable efficacy with daily oral antiretroviral therapy (ART) through 96 weeks in ART-naive adults with human immunodeficiency virus type 1 (HIV-1). Here we report efficacy, tolerability, and safety of cabotegravir + rilpivirine LA over approximately 5 years.After 20 weeks of oral cabotegravir + abacavir/lamivudine, participants were randomized to cabotegravir + rilpivirine LA Q8W or Q4W or continue oral ART through the 96-week maintenance period. In the extension period through week 256, participants continued their current LA regimen (randomized Q8W/Q4W groups) or switched from oral ART to Q8W or Q4W LA therapy (extension-switch groups). Endpoints assessed included proportion of participants with HIV-1 RNA <50 copies/mL (Snapshot algorithm) and adverse events (AEs).At week 256, 186 of 230 (81%) participants in randomized Q8W/Q4W groups and 41 of 44 (93%) participants in extension-switch groups had HIV-1 RNA <50 copies/mL. No protocol-defined virologic failures occurred after week 48. Injection wsite reactions infrequently resulted in discontinuation (4 [2%] and 1 [2%] participants in randomized Q8W/Q4W and extension-switch groups, respectively). Three participants in randomized Q8W/Q4W groups experienced drug-related serious AEs, including 1 fatal serious AE (Q4W group); none occurred in extension-switch groups. Of 25 participants with AEs leading to withdrawal, 20 were in the randomized Q4W group; no AE leading to withdrawal occurred in >1 participant.Cabotegravir + rilpivirine LA exhibited long-term efficacy and tolerability, demonstrating its durability as maintenance therapy for HIV-1 infection.Clinical Trials Registration. NCT02120352.
Stenotrophomonas (Xanthomonas) maltophilia is a rare cause of endocarditis. The extensive resistance of this organism to several antibiotics leaves few options for antimicrobial therapy. In vitro synergism of the combination of trimethoprim-sulfamethoxazole (TMP-SMZ) and ticarcillin/clavulanic acid (TIC/CA) has been demonstrated. To our knowledge, we report the first case of ventriculoatrial cerebrospinal fluid shunt-associated endocarditis due to S. maltophilia. The patient was cured with combination therapy with TMP-SMZ and TIC/CA along with catheter removal. This is also the first report of S. maltophilia endocarditis successfully treated with this antibiotic combination. In a review of the medical literature, only 16 cases of S. maltophilia endocarditis were found. Most patients were intravenous drug users (43.8%) or had either prosthetic heart valves (50%) or an indwelling vascular catheter (18.8%). Although S. maltophilia is usually considered a nosocomial pathogen, about one-half of the cases were community-acquired. Twelve of sixteen patients had left-sided endocarditis. Therapy with a combination of two or more antibiotics was employed in most cases. Seven patients had been given TMP-SMZ therapy, but none had been treated with TIC/CA before. One-half of the patients required cardiac surgery. The overall mortality rate was 33%. Although the optimal antibiotic treatment for S. maltophilia endocarditis remains unknown, the case reported herein reinforces in vitro findings that the combination of TMP-SMZ and TIC/CA may be effective therapy.