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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings</title><author><name sortKey="Chu, C" sort="Chu, C" uniqKey="Chu C" first="C" last="Chu">C. Chu</name></author><author><name sortKey="Cheng, V" sort="Cheng, V" uniqKey="Cheng V" first="V" last="Cheng">V. Cheng</name></author><author><name sortKey="Hung, I" sort="Hung, I" uniqKey="Hung I" first="I" last="Hung">I. Hung</name></author><author><name sortKey="Wong, M" sort="Wong, M" uniqKey="Wong M" first="M" last="Wong">M. Wong</name></author><author><name sortKey="Chan, K" sort="Chan, K" uniqKey="Chan K" first="K" last="Chan">K. Chan</name></author><author><name sortKey="Chan, K" sort="Chan, K" uniqKey="Chan K" first="K" last="Chan">K. Chan</name></author><author><name sortKey="Kao, R" sort="Kao, R" uniqKey="Kao R" first="R" last="Kao">R. Kao</name></author><author><name sortKey="Poon, L" sort="Poon, L" uniqKey="Poon L" first="L" last="Poon">L. Poon</name></author><author><name sortKey="Wong, C" sort="Wong, C" uniqKey="Wong C" first="C" last="Wong">C. Wong</name></author><author><name sortKey="Guan, Y" sort="Guan, Y" uniqKey="Guan Y" first="Y" last="Guan">Y. Guan</name></author><author><name sortKey="Peiris, J" sort="Peiris, J" uniqKey="Peiris J" first="J" last="Peiris">J. Peiris</name></author><author><name sortKey="Yuen, K" sort="Yuen, K" uniqKey="Yuen K" first="K" last="Yuen">K. Yuen</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">14985565</idno><idno type="pmc">1746980</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746980</idno><idno type="RBID">PMC:1746980</idno><idno type="doi">10.1136/thorax.2003.012658</idno><date when="2004">2004</date><idno type="wicri:Area/Pmc/Corpus">000D25</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D25</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings</title><author><name sortKey="Chu, C" sort="Chu, C" uniqKey="Chu C" first="C" last="Chu">C. Chu</name></author><author><name sortKey="Cheng, V" sort="Cheng, V" uniqKey="Cheng V" first="V" last="Cheng">V. Cheng</name></author><author><name sortKey="Hung, I" sort="Hung, I" uniqKey="Hung I" first="I" last="Hung">I. Hung</name></author><author><name sortKey="Wong, M" sort="Wong, M" uniqKey="Wong M" first="M" last="Wong">M. Wong</name></author><author><name sortKey="Chan, K" sort="Chan, K" uniqKey="Chan K" first="K" last="Chan">K. Chan</name></author><author><name sortKey="Chan, K" sort="Chan, K" uniqKey="Chan K" first="K" last="Chan">K. Chan</name></author><author><name sortKey="Kao, R" sort="Kao, R" uniqKey="Kao R" first="R" last="Kao">R. Kao</name></author><author><name sortKey="Poon, L" sort="Poon, L" uniqKey="Poon L" first="L" last="Poon">L. Poon</name></author><author><name sortKey="Wong, C" sort="Wong, C" uniqKey="Wong C" first="C" last="Wong">C. Wong</name></author><author><name sortKey="Guan, Y" sort="Guan, Y" uniqKey="Guan Y" first="Y" last="Guan">Y. Guan</name></author><author><name sortKey="Peiris, J" sort="Peiris, J" uniqKey="Peiris J" first="J" last="Peiris">J. Peiris</name></author><author><name sortKey="Yuen, K" sort="Yuen, K" uniqKey="Yuen K" first="K" last="Yuen">K. Yuen</name></author></analytic><series><title level="j">Thorax</title><idno type="ISSN">0040-6376</idno><idno type="eISSN">1468-3296</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background:</bold> The clinical response of patients with severe acute respiratory syndrome (SARS) to a combination of lopinavir/ritonavir and ribavirin was examined after establishing the in vitro antiviral susceptibility of the SARS associated coronavirus to a panel of antiviral agents. </p><p><bold>Methods:</bold> The in vitro susceptibility of the prototype of SARS associated coronavirus to a panel of nucleoside analogues and protease inhibitors currently licensed for clinical use was studied. Forty one patients with SARS followed for 3 weeks were treated with a combination of lopinavir/ritonavir and ribavirin. The clinical progress and virological outcomes were monitored and compared with 111 patients treated with ribavirin only who served as historical controls. </p><p><bold>Results:</bold> In vitro antiviral activity against SARS associated coronavirus was demonstrated for lopinavir and ribavirin at concentrations of 4 µg/ml and 50 µg/ml, respectively, only at 48 hours. The adverse clinical outcome (ARDS or death) was significantly lower in the treatment group than in the historical controls (2.4% <italic>v</italic> 28.8%, p<0.001) at day 21 after the onset of symptoms. The adverse outcome remained significantly lower in the treatment group than in the controls—both those diagnosed early (p<0.001) and those diagnosed later in the course of the epidemic (p = 0.002)—but there was no significant difference in adverse outcome rates between the two time periods (p = 0.548). No time related difference in outcome was observed in the control groups. A reduction in steroid usage and nosocomial infections was seen in patients initially treated with lopinavir/ritonavir, and these patients had a decreasing viral load and rising peripheral lymphocyte count. Multivariate analysis showed that age, hepatitis B carrier status, and lack of treatment with this antiviral combination were independent predictors of an adverse outcome. Lopinavir/ritonavir treatment was associated with a better outcome even when adjusted for baseline lactate dehydrogenase level. </p><p><bold>Conclusions:</bold> The apparent favourable clinical response with lopinavir/ritonavir and ribavirin supports further randomised placebo controlled trials in patients with SARS. </p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Thorax</journal-id><journal-title>Thorax</journal-title><issn pub-type="ppub">0040-6376</issn><issn pub-type="epub">1468-3296</issn><publisher><publisher-name>BMJ Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">14985565</article-id><article-id pub-id-type="pmc">1746980</article-id><article-id pub-id-type="doi">10.1136/thorax.2003.012658</article-id><article-categories><subj-group subj-group-type="heading"><subject>Respiratory Infection</subject></subj-group></article-categories><title-group><article-title>Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chu</surname><given-names>C</given-names></name></contrib><contrib contrib-type="author"><name><surname>Cheng</surname><given-names>V</given-names></name></contrib><contrib contrib-type="author"><name><surname>Hung</surname><given-names>I</given-names></name></contrib><contrib contrib-type="author"><name><surname>Wong</surname><given-names>M</given-names></name></contrib><contrib contrib-type="author"><name><surname>Chan</surname><given-names>K</given-names></name></contrib><contrib contrib-type="author"><name><surname>Chan</surname><given-names>K</given-names></name></contrib><contrib contrib-type="author"><name><surname>Kao</surname><given-names>R</given-names></name></contrib><contrib contrib-type="author"><name><surname>Poon</surname><given-names>L</given-names></name></contrib><contrib contrib-type="author"><name><surname>Wong</surname><given-names>C</given-names></name></contrib><contrib contrib-type="author"><name><surname>Guan</surname><given-names>Y</given-names></name></contrib><contrib contrib-type="author"><name><surname>Peiris</surname><given-names>J</given-names></name></contrib><contrib contrib-type="author"><name><surname>Yuen</surname><given-names>K</given-names></name></contrib></contrib-group><aff>Department of Microbiology and Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.<email>kyyuen@hkucc.hku.hk</email></aff><pub-date pub-type="ppub"><month>3</month><year>2004</year></pub-date><volume>59</volume><issue>3</issue><fpage>252</fpage><lpage>256</lpage><self-uri xlink:role="pdf" xlink:type="simple" xlink:href="http://thorax.bmj.com/cgi/reprint/59/3/252.pdf"></self-uri><self-uri xlink:role="abstract" xlink:type="simple" xlink:href="http://thorax.bmj.com/cgi/content/abstract/59/3/252"></self-uri><self-uri xlink:role="fulltext" xlink:type="simple" xlink:href="http://thorax.bmj.com/cgi/content/full/59/3/252"></self-uri><abstract><p><bold>Background:</bold> The clinical response of patients with severe acute respiratory syndrome (SARS) to a combination of lopinavir/ritonavir and ribavirin was examined after establishing the in vitro antiviral susceptibility of the SARS associated coronavirus to a panel of antiviral agents. </p><p><bold>Methods:</bold> The in vitro susceptibility of the prototype of SARS associated coronavirus to a panel of nucleoside analogues and protease inhibitors currently licensed for clinical use was studied. Forty one patients with SARS followed for 3 weeks were treated with a combination of lopinavir/ritonavir and ribavirin. The clinical progress and virological outcomes were monitored and compared with 111 patients treated with ribavirin only who served as historical controls. </p><p><bold>Results:</bold> In vitro antiviral activity against SARS associated coronavirus was demonstrated for lopinavir and ribavirin at concentrations of 4 µg/ml and 50 µg/ml, respectively, only at 48 hours. The adverse clinical outcome (ARDS or death) was significantly lower in the treatment group than in the historical controls (2.4% <italic>v</italic> 28.8%, p<0.001) at day 21 after the onset of symptoms. The adverse outcome remained significantly lower in the treatment group than in the controls—both those diagnosed early (p<0.001) and those diagnosed later in the course of the epidemic (p = 0.002)—but there was no significant difference in adverse outcome rates between the two time periods (p = 0.548). No time related difference in outcome was observed in the control groups. A reduction in steroid usage and nosocomial infections was seen in patients initially treated with lopinavir/ritonavir, and these patients had a decreasing viral load and rising peripheral lymphocyte count. Multivariate analysis showed that age, hepatitis B carrier status, and lack of treatment with this antiviral combination were independent predictors of an adverse outcome. Lopinavir/ritonavir treatment was associated with a better outcome even when adjusted for baseline lactate dehydrogenase level. </p><p><bold>Conclusions:</bold> The apparent favourable clinical response with lopinavir/ritonavir and ribavirin supports further randomised placebo controlled trials in patients with SARS. </p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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