The term naïve patient refers to two specific categories: i) patients with no previous therapeutic exposure to originator (“primary naïve”), and ii) patients with previous exposure to the originator but with a wash-out period of time adequately long based on the judgment of the clinician (“secondary naïve”). 3.
Full Answer
What is a treatment naive person?
Susan Olender, MD, is an assistant professor of medicine at Columbia University College of Physicians and Surgeons in New York City. A person is considered to be treatment naive if they have never undergone treatment for a particular illness.
What does treatment naive mean in STDs?
More in STDs. A person is considered to be treatment naive if they have never undergone treatment for a particular illness. In the world of sexually transmitted infections, the term is most often used to refer to people who are HIV-positive and who have never taken any antiretroviral therapy for their infection.
Do treatment-naive patients have more options for antiretroviral therapy?
In general, treatment-naive patients have more options for antiretroviral therapy than treatment-experienced patients. This is because doctors have little to no concern that they may have developed resistance to one or more drugs or classes of drugs.
Are biosimilars a viable therapeutic option for primary naïve patients?
The Italian Medicines Agency considers biosimilars as a valid therapeutic option with an economic advantage, especially in primary naïve patients with no previous exposure to the originator or with a sufficiently long wash-out period (“secondary naïve”).
When Is it Better to Be Treatment-Naive?
Why are treatment naive patients more likely to get antiretroviral treatment?
Why is early treatment becoming more common?
Can you postpone HIV treatment?
Does Verywell Health use peer reviewed sources?
Is it better to treat hepatitis as soon as it is detected?
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About this website
What is a treatment naive patient?
A person is considered to be "treatment-naive" if they have never undergone treatment for a particular illness. 1 In the world of sexually transmitted infections (STIs), the term is most often used to refer to people who are HIV-positive and who have never taken any antiretroviral therapy for their infection.
What is a naïve patient?
The term naïve patient refers to two specific categories: i) patients with no previous therapeutic exposure to originator (“primary naïve”), and ii) patients with previous exposure to the originator but with a wash-out period of time adequately long based on the judgment of the clinician (“secondary naïve”) [7].
What is antiretroviral naive?
An antiretroviral (ARV) regimen for a treatment-naive patient generally consists of two nucleoside reverse transcriptase inhibitors (NRTIs) administered in combination with a third active ARV drug from one of three drug classes: an integrase strand transfer inhibitor (INSTI), a non-nucleoside reverse transcriptase ...
What is the best ARV combination?
A triple-drug combination of zidovudine, didanosine and nevirapine has been found to outperform combination therapy with two nucleosides as demonstrated by changes in the viral load and the CD4+ count.
What is first-line ART treatment?
The recommended first-line HIV treatments for most people all include an integrase inhibitor: either dolutegravir or bictegravir. It is usually taken together with a nucleotide backbone as part of a three-drug combination. There are five options: Dolutegravir / tenofovir disoproxil / emtricitabine.
What is opportunistic infection?
Listen to pronunciation. (AH-per-too-NIS-tik in-FEK-shun) An infection caused by an organism that does not normally cause disease. Opportunistic infections occur in people with weakened immune systems.
How many types of ARVs are there?
There are six main types ('classes') of antiretroviral drugs. Each class of drug attacks HIV in a different way. Generally, drugs from two (or sometimes three) classes are combined to ensure a powerful attack on HIV.
What is the meaning of RVD positive?
If your patient or others do not know what the. euphemism means, they will soon pick it up. ▪ Never use a misleading euphemism. “ RVD” means retroviral DISEASE, which means AIDS. This is clearly.
Why do some meds have different doses?
As to why some meds are dosed differently depending on prior treatment history, it has to do with risk of resistance being present. Treatment experienced patients who are starting a new regimen often do so after virologic failure of a prior regimen. Resistance mutations acquired earlier can reduce the effectiveness of a subsequent regimen and also reduce the 'forgiveness' of a regimen for less than optimal adherence or when levels are low as is sometimes seen before a dose of some drugs dosed once a day.
Is it desirable to have high levels of a drug?
In such cases, having consistently high levels of the drug is desirable.
Is HIV treatment experienced?
Trust me, it is not bad to be treatment experienced .
What is a naive patient?
The term naïve patient refers to two specific categories: i) patients with no previous therapeutic exposure to originator (“primary naïve”), and ii) patients with previous exposure to the originator but with a wash-out period of time adequately long based on the judgment of the clinician (“secondary naïve”) [7].
Why is secondary naiveness challenging?
Hence, the definition of “secondary naïve” patients is challenging because of the persistence of the potential immunogenicity of all the biologicals and the immune response against a given drug.
What are the limitations of biologics?
The main limitation of biologics is related to their costs and their use may result very expensive overtime. Patents for several biologics will expire over the next decade, removing a barrier to the development and marketing of biosimilars [2], [3], [4].
How long does it take to wash out a tumor necrosis factor inhibitor?
No data are actually available, but a randomized clinical trial regarding the cycling from one tumor necrosis factor inhibitor (TNFi) to another TNFi suggests a wash-out period of at least 8 weeks for drugs with sub-cutaneous administration (i.e. adalimumab or etanercept) and 12 weeks for those with intravenous one (i.e. infliximab) [13], just considering their pharmacological effects.
Why is it necessary to maintain a balance between the need for health care cost containment and protection of the patients'?
The current economic situation makes it necessary to ensure a balance between the need for health care cost containment and protection of the patients' right to health, in terms of safety of prescribed treatments and continuity of care [29]. The attention to proper allocation of resources is a legal obligation for the physician in the Italian legal system. This is required for the systematic reduction of waste of available resources through scientific medicine and effective and appropriate interventions [30], [31].
Can biosimilars be used to treat the same conditions?
The biosimilar and its reference product are expected to display the same safety and efficacy profile and are generally used to treat the same conditions [6]. Biosimilars can be authorized only if highly similar to the original drug from an analytical and clinical perspective point of view and supported by a “comparability exercise” [5].
Does rituximab deplete CD20?
Rituximab is a monoclonal antibody that selectively depletes B cells expressing the cell surface antigen CD20 [8]. CD20 is expressed on pre-B cells and mature B cells but not on stem cells, pro-B cells, or plasma cells [9]. Because CD20 is not expressed on stem cells or plasma cells, depletion of CD20 positive B cells does not appear to compromise either B-cell recovery (from stem cells) or immunoglobulin production (by plasma cells). Rituximab causes a rapid and complete depletion of CD20 + B cells in the bone marrow and incomplete depletion in the peripheral blood [10]. The effects of rituximab are exerted by antibody-dependent and complement-mediated cytotoxicity, as well as by apoptosis-inducing effects that last for a minimum of 16 weeks [11]. Studies in patients with Non-Hodgkin Lymphoma (NHL) have shown that treatment with rituximab results in a sustained but reversible depletion of peripheral CD20 positive B cells for up to 6 months following completion of treatment [12]. So, a therapeutic interval of more than 6 months could be reasonable taking into account the pharmacological effect of the drug, while its immunogenicity is unrelated to its pharmacological effect.
How long does velpatasvir last?
Glecaprevir (300 mg) / pibrentasvir (120 mg) to be taken with food for a duration of 8 weeks. Sofosbuvir (400 mg) / velpatasvir (100 mg) for a duration of 12 weeks.
What is the role of education in a patient?
Education: Educate the patient about proper administration of medications, adherence, and prevention of reinfection.
What is the clinical evidence of cirrhosis?
Clinical evidence of cirrhosis (eg, liver nodularity and/or splenomegaly on imaging, platelet count <150,000/mm 3, etc)
Is liver follow up recommended for noncirrhotic patients?
No liver-related follow-up is recommended for noncirrhotic patients who achieve SVR.
When Is it Better to Be Treatment-Naive?
Although medications are often more effective in treatment-naive patients, that doesn't mean that you necessarily want to postpone treatment to wait for a better option to emerge, particularly when talking about HIV treatment. There is a growing body of research that shows how important early treatment for HIV can be, especially when trying to reduce the long-term consequences of infection. 2
Why are treatment naive patients more likely to get antiretroviral treatment?
This is because doctors have little to no concern that they may have developed resistance to one or more drugs, or classes of drugs. However, although most people who are treatment naive have many treatment options, ...
Why is early treatment becoming more common?
Another reason why early treatment is becoming more common is that doctors now understand that they can use treatment as prevention. Reducing an infected individual's viral load with appropriate treatment turns out to be a great way of reducing the likelihood that they'll pass their infection to others.
Can you postpone HIV treatment?
Although medications are often more effective in treatment-naive patients, that doesn't mean that you necessarily want to postpone treatment to wait for a better option to emerge, particularly when talking about HIV treatment. There is a growing body of research that shows how important early treatment for HIV can be, especially when trying to reduce the long-term consequences of infection. 2
Does Verywell Health use peer reviewed sources?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. Department of Health and Human Services. Treatment-naive.
Is it better to treat hepatitis as soon as it is detected?
Unlike with HIV, there is not necessarily an advantage in treating hepatitis infections as soon as they are detected. Except on rare occasions where HCV is detected in the acute phases of infection, treatment is often not started until the infection has not only become chronic but when the virus has begun to have noticeable effects on a person's liver.
