Prominent publications by Andrew D Carr

KOL Index score: 18549

OBJECTIVE: Metabolic syndrome is a cluster of risk factors for cardiovascular disease and type 2 diabetes. Definitions exist to identify those "at risk." Treatment of HIV infection with highly active antiretroviral therapy can induce severe metabolic complications including lipodystrophy, dyslipidemia, and insulin resistance. The purpose of this study was to report the prevalence of metabolic syndrome in HIV-infected patients and compare insulin resistance and total body, limb, and ...

Also Ranks for: Metabolic Syndrome |  insulin resistance |  active antiretroviral |  infected patients |  body fat
KOL Index score: 17281

OBJECTIVE: To describe a syndrome of peripheral lipodystrophy (fat wasting of the face, limbs and upper trunk), hyperlipidaemia and insulin resistance in patients receiving potent HIV protease inhibitor therapy.

DESIGN: Cross-sectional study.

SETTING: Outpatient clinic of a university teaching hospital.

PATIENTS: HIV-infected patients either receiving at least one protease inhibitor (n=116) or protease inhibitor-naive (n=32), and healthy men (n=47).


Also Ranks for: Peripheral Lipodystrophy |  insulin resistance |  hiv protease |  triglyceride levels |  body composition
KOL Index score: 16426

Both HIV infection and antiretroviral therapy (ART) are associated with lower bone mineral density (BMD) and increased fracture risk. Because the relative contributions of ART and untreated HIV to BMD loss are unclear, it is important to quantify the effect of ART on bone. We compared the effect of early ART initiation (CD4 >500 cells/μL) with deferred ART on change in BMD in the START Bone Mineral Density substudy, a randomized trial evaluating the effect of immediate ART initiation ...

Also Ranks for: Antiretroviral Therapy |  bone mineral |  hiv infection |  art bmd |  density substudy
KOL Index score: 13658

BACKGROUND: Lipodystrophy (LD; peripheral lipoatrophy, central adiposity) hyperlipidaemia and insulin resistance often complicate protease inhibitor-containing antiretroviral therapy. Lipoatrophy and abdominal distension were observed in protease inhibitor-naive nucleoside analogue reverse transcriptase inhibitor (NRTI) recipients with lactic acidaemia and hepatic impairment, which are known NRTI-induced mitochondrial toxicities.

DESIGN AND SETTING: Case-control study in a ...

Also Ranks for: Protease Inhibitor |  lactic acidaemia |  lipodystrophy syndrome |  nucleoside analogue |  peripheral lipoatrophy
KOL Index score: 13609

Effects of a human immunodeficiency virus (HIV) type 1 protease inhibitor, ritonavir, were evaluated in 21 patients enrolled in a phase I/II study. The magnitude and rates of CD4 and CD8 lymphocyte increase, changes in subsets of CD4 and CD8 lymphocytes, and proliferative responses to mitogen and antigens were analyzed. Significant increases were noted in CD4 and CD8 lymphocyte counts; numbers of CD4CD45RO lymphocytes increased significantly by week 1 of therapy. Increases in the ...

Also Ranks for: Human Immunodeficiency Virus |  protease inhibitor |  immune response |  increases cd4 |  cd8 lymphocyte
KOL Index score: 13187

OBJECTIVE: Alterations in glucose and lipid metabolism, lactic acidemia, bone disorders, and abnormal body fat distribution have been recognized recently as frequent complications associated with HIV-1 infection and potent antiretroviral therapy, but limited data are available regarding the appropriate management of these disorders. These recommendations were developed to guide physicians actively involved in HIV care in the management of metabolic complications that occur primarily ...

Also Ranks for: Metabolic Complications |  antiretroviral therapy |  hiv1 infection |  lactic acidemia |  aids society
KOL Index score: 13028

BACKGROUND: Tenofovir, particularly when given with a ritonavir-boosted protease inhibitor (rPI), reduces bone mineral density (BMD) and increases bone turnover markers (BTMs), both of which are associated with increased fracture risk. Raltegravir has not been associated with bone loss.

METHODS: In an open-label, nonrandomized, pilot study, tenofovir was switched to raltegravir in adults also receiving a rPI for at least 6 months with a spine or hip T-score ≤ -1.0 and plasma HIV RNA < 50 ...

Also Ranks for: 48 Weeks |  bone turnover |  mineral density |  spine bmd |  total hip
KOL Index score: 12830

Long-term survivors (LTS) of human immunodeficiency virus type 1 (HIV-1) infection provide an opportunity to investigate both viral and host factors that influence the rate of disease progression. We have identified three HIV-1-infected individuals in Australia who have been infected for over 11 years with viruses that contain deletions in the nef and nef-long terminal repeat (nef/LTR) overlap regions. These viruses differ from each other and from other nef-defective strains of HIV-1 ...

Also Ranks for: Immunodeficiency Virus |  gene products |  nef ltr |  type 1 |  hiv long
KOL Index score: 12784

Hypersensitivity to trimethoprim-sulphamethoxazole (TMP-SMX) in patients with HIV infection may be a result of either immune dysregulation, a direct cytotoxicity of the SMX-hydroxylamine metabolite (SMX-HA) (rather than SMX per se), or glutathione deficiency. We evaluated the in vitro cytotoxicity of SMX and SMX-HA to peripheral blood mononuclear cells (PBMC) of HIV-infected subjects to determine if the degree of in vitro cytotoxicity is associated with hypersensitivity, whether ...

Also Ranks for: Vitro Cytotoxicity |  smx hiv |  infected patients |  hypersensitivity glutathione |  sulfamethoxazole drug
KOL Index score: 12633

BACKGROUND: Metabolic syndrome (MS) identifies individuals at risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Little is known about MS and its consequences following initiation of antiretroviral therapy (ART).

METHODS: HIV-infected adults (881) initiating ART were evaluated for prevalence and incidence of MS and subsequent diagnosis of CVD and T2DM over a 3-year period. MS was defined by criteria of the National Cholesterol Education Program Expert Panel on ...

Also Ranks for: Diabetes Mellitus |  cardiovascular disease |  antiretroviral therapy |  metabolic syndrome |  hiv infection
KOL Index score: 12286

BACKGROUND: Those receiving tenofovir/emtricitabine (TDF-FTC) had greater bone loss compared with abacavir/lamivudine (ABC-3TC) in a randomized simplification trial (STEAL study). Previous studies associated increased bone turnover and bone loss with initiation of antiretroviral treatment, however it is unclear whether change in bone mineral density (BMD) was a result of specific drugs, from immune reconstitution or from suppression of HIV replication. This analysis determined predictors ...

Also Ranks for: Bone Loss |  tenofovir emtricitabine |  abacavir lamivudine |  tdf ftc |  infected patients
KOL Index score: 12156

OBJECTIVES: With the use of potent antiretroviral therapy in patients with HIV disease, changes in lipid parameters and glucose homeostasis have been noted. However, these effects have been difficult to interpret because of the varied demographic and treatment characteristics of the cohorts and the complexity of differentiating the effect of HIV disease from that of the drugs used in its treatment. This study was designed to explore these issues.

METHODS: Demographic information and ...

Also Ranks for: Hiv Disease |  insulin levels |  hdl cholesterol |  lipid parameters |  demographic characteristics
KOL Index score: 11930

BACKGROUND: Osteopenia has been associated with antiretroviral therapy, particularly with protease inhibitors. Osteopenia in HIV-uninfected men is associated with mitochondrial defects.

METHODS: Bone density was assessed by dual-energy X-ray absorptiometry (DEXA) in 221 HIV-infected men (mean age 43 years) recruited to a lipodystrophy prevalence survey. Additional parameters assessed were demographics, exercise, smoking, type(s) and duration of all antiretroviral therapy, lipodystrophy ...

Also Ranks for: Antiretroviral Therapy |  osteopenia osteoporosis |  lower weight |  asymptomatic lactic acidemia |  bone density
KOL Index score: 11446

BACKGROUND: Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear.

METHODS: 92 HIV- infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV-) subjects underwent (1)H Magnetic Resonance Spectroscopy (MRS) of ...

Also Ranks for: Hiv Cvd |  frontal white matter |  posterior cingulate cortex |  cardiovascular disease |  biomarkers brain

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Andrew D Carr:Expert Impact

Concepts for whichAndrew D Carrhas direct influence:Antiretroviral therapy,  Hiv infection,  Insulin resistance,  Methamphetamine dependence,  Metabolic syndrome,  Human immunodeficiency virus,  Treated hiv,  Body composition.

Andrew D Carr:KOL impact

Concepts related to the work of other authors for whichfor which Andrew D Carr has influence:Antiretroviral therapy,  Hiv infection,  Protease inhibitors,  Insulin resistance,  Human immunodeficiency virus,  Metabolic syndrome,  Infected patients.



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St Vincent’s Hospital, Darlinghurst, Sydney, NSW, Australia | Centre for Applied Medical Research, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia | St Vincent’s Hospital, Darlinghurst, New South Wales Australia | Department of