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Publication Measurements of tenofovir-diphosphate and emtricitabine-triphosphate concentrations in dried blood spots of people receiving pre-exposure prophylaxis for HIV with co-formulated tenofovir disoproxil fumarate and emtricitabine.(2025-03-08)Background/purpose(s): Data regarding the concentrations of tenofovir-diphosphate (TFV-DP) and emtricitabine-triphosphate (FTC-TP) in the Asian population receiving pre-exposure prophylaxis (PrEP) for HIV with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) (TDF/FTC) are limited, and the associations between the frequency of TDF/FTC administration and drug concentration among people receiving on-demand PrEP remain unclear. Methods: Fifty-seven participants receiving daily TDF/FTC and 113 participants receiving on-demand TDF/FTC were enrolled in this study. The concentrations of TFV-DP and FTC-TP were measured in dried blood spots using liquid chromatography‒mass spectrometry. Results: Thirty-six (62.2 %) daily PrEP users and 38 (33.6 %) on-demand PrEP users achieved TFV-DP concentrations ≥700 fmol/punch. Higher proportions of undetectable FTC-TP were observed in participants whose TFV-DP concentrations were ≤350 fmol/punch, regardless of the frequency of TDF/FTC administration. In participants who used on-demand PrEP, the TFV-DP and FTC-TP concentrations were moderately correlated with the TDF/FTC tablets taken when sampling was performed within 12–24 h after the last dose of TDF/FTC (R = 0.63, p = 0.006 and R = 0.75, p = 0.0005). In addition, on-demand PrEP users who had received 8 tablets within the last 28 days had a median TFV-DP concentration similar to that of those participants who had received 16 tablets (544.6 vs. 556.9 fmol/punch, p > 0.99). Conclusions: These results underscore the importance of well-controlled sampling times for obtaining reliable TFV-DP and FTC-TP concentrations to estimate the adherence and effectiveness of on-demand PrEP. - Some of the metrics are blocked by yourconsent settings
Publication Efficacy and Safety of Long-Acting Subcutaneous Lenacapavir in Heavily Treatment-Experienced People with Multidrug-Resistant HIV-1: Week 104 Results of a Phase 2/3 Trial.(2025-03-17)Background. Lenacapavir is a long-acting human immunodeficiency virus type 1 (HIV-1) capsid inhibitor for treatment of HIV-1 infection. We evaluated the efficacy and safety of lenacapavir in combination with an investigator-selected optimized background regimen (OBR) after 104 weeks in adults with multidrug-resistant HIV-1. Methods. This ongoing, international, Phase 2/3 trial at 42 sites included 72 adults with multidrug-resistant HIV-1. Following a 2-week oral lenacapavir loading phase, participants received subcutaneous lenacapavir every 26 weeks with an OBR. HIV-1 RNA, CD4 cell counts, and adverse events were assessed over 104 weeks. One participant did not enter the extension phase. Results. At Week 104, 44 of 71 participants (62%, 95% confidence interval [CI]: 50; 73) had HIV-1 RNA <50 copies/mL via US Food and Drug Administration (FDA) snapshot algorithm. When missing data (including discontinuations) were excluded, 44 of 54 participants (82%) had HIV-1 RNA <50 copies/mL at Week 104, mean CD4 cell count increased by 122 cells/µL (95% CI: 80; 165), and the proportion of participants with CD4 cell count <200 cells/µL decreased from 64% (46 of 72) at Baseline to 29% (16 of 55). Fourteen participants had treatment-emergent lenacapavir resistance; 7 resuppressed (HIV-1 RNA <50 copies/mL) while maintaining lenacapavir use. There were no Grade 4 or serious treatment-related adverse events. One participant discontinued study drug due to an injection site reaction. Conclusions. Treatment with subcutaneous lenacapavir in combination with an OBR was well tolerated and resulted in a high rate of virological suppression over 104 weeks. Lenacapavir represents an important treatment option in people with multidrug-resistant HIV-1. - Some of the metrics are blocked by yourconsent settings
Publication Recommendations and guidance for human papillomavirus (HPV) vaccination for adults in Taiwan.(2025-03-28)Human papillomavirus (HPV) is the most prevalent viral infection globally, transmitted primarily through sexual or intimate skin-to-skin contact. Certain HPV types can cause anogenital warts and has the potential to cause cervical cancer, other anogenital, and oropharyngeal cancers. Adjuvanted, non-live, HPV recombinant vaccines, including the bivalent, quadrivalent, and 9-valent vaccines, are widely recommended for adolescents and young adults to prevent HPV infection and lower the incidence of HPV-related cancers. However, recommendations for adults aged 26 years or older have been lacking due to insufficient evidence until recently. The Working Group on Adult Immunization Practice of the Infectious Diseases Society of Taiwan (IDSTAIP working group) addressed this gap and drafted recommendations for HPV vaccination in adults using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. These recommendations were then reviewed and revised by expert panels and endorsed by eight national medical societies. This document is positioned as a guidance to provide recommendations for HPV vaccination in adults, considering gender, age, immune status, and prior HPV vaccination history. Safety evaluations, dosing schedules, and special considerations regarding the occupational exposure of healthcare providers, based on potential modes of HPV transmission, are provided. In summary, a 3-dose HPV vaccination schedule is recommended for all adults through age 45 years, regardless of sex, to prevent genital warts, anogenital cancers, as well as oropharyngeal infections and cancers. This guidance serves to assist healthcare providers in facilitating shared decision-making but does not supersede clinical judgment in assessing individual risk and making specific recommendations. - Some of the metrics are blocked by yourconsent settings
Publication Long-Term Effects of Daily Versus Alternate-Day Chlorhexidine Bathing on Central-Line-Associated Blood Stream Infection in Medical Intensive Care Units: A Four-Year Observational Study.(2025-05)Background: Daily chlorhexidine gluconate (CHG) bathing may reduce central line-associated bloodstream infections (CLABSI) in critically ill patients, but evidence remains inconclusive, particularly regarding long-term effects and varying frequencies of use. Aim: This study aimed to examine the association between different CHG bathing frequencies and CLABSI rates in medical intensive care units (MICUs). Study Design: A retrospective analysis was conducted in three MICUs in northern Taiwan from March 2018 to June 2022. One MICU implemented daily CHG bathing for 21 months, followed by every-other-day CHG bathing for 30 months, while two MICUs used water and soap as standard care. CLABSI rates per 1000 central line days and other clinical outcomes were compared. Results: Across 46 409 central line days and 5482 admissions, 357 CLABSI events were recorded. No significant difference in CLABSI rates was found between the CHG and standard care groups (IRR = 1.1, p = 0.36) or between the different CHG bathing frequencies (IRR = 0.68, p = 0.06). Other clinical outcomes showed no significant differences. Conclusions: CHG bathing, whether daily or alternate-day, was not significantly associated with lowering CLABSI rates in MICU. The association may vary depending on hospital-specific conditions and infection profiles. Relevance to Clinical Practice: CHG bathing should not be regarded as a universal infection control strategy in ICUs. It should be evaluated within the context of each ICU's specific conditions and infection prevention strategy. - Some of the metrics are blocked by yourconsent settings
Publication Real-world use and treatment outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan: A multicenter retrospective study.(2025-06)Objectives: Ceftazidime-avibactam (CAZ-AVI) has been launched in Asian countries for five years, but local real-world data about patient characteristics, efficacy, and safety of CAZ-AVI is limited. We conducted a multicenter, retrospective study to investigate the clinical characteristics, microbiology, and outcomes of patients treated with CAZ-AVI for Gram-negative bacterial infection in Taiwan. Methods: This investigation was conducted as a multicenter retrospective cohort study involving five medical centers in Taiwan. Adult patients with documented/suspected Gram-negative bacterial infection and received ≥ 24 hours of CAZ-AVI were eligible for study cohort enrollment. In-hospital mortality was defined as the primary outcome, while symptom resolution or significant improvement, considered the secondary outcome, was defined as clinical success. Results: Among the 472 patients treated by CAZ-AVI, 46.2 % (218/472) had respiratory tract infections, 22.0 % (104/472) had complicated urinary tract infections, 14.0 % (66/472) had complicated intra-abdominal infections, and 10.0 % (47/472) had primary bacteremia. Most patients receiving ceftazidime/avibactam in Taiwan are old (mean: 70.6 years old), have a high SOFA score (mean 8.4), and have a high Charlson Comorbidity Index score (345/472, 73.1 % ≥ 4). 90 % of CAZ-AVI were used as targeted therapy for pathogens, including Klebsiella pneumoniae (64.4 %, 304/472), Pseudomonas aeruginosa (17.8 %, 84/472), Escherichia coli (8.3 %, 39/472), and Enterobacter spp. (2.3 %, 11/472). The overall clinical success rate is 58.1 % (274/472). The in-hospital mortality rate is 41.1 % (194/472). Conclusions: Most patients receiving CAZ-AVI as targeted therapy in Taiwan with characteristics of older age, high SOFA scores, and high CCI scores. Receiving immunomodulators, higher SOFA score, and Enterobacter spp. infections were the significant factors associated with in-hospital mortality, whereas early initiating CAZ-AVI treatment and CAZ-AVI monotherapy are associated with better outcome.
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Person PEI-LIN LEEPei-Lin Lee serves as Clinical Associate Professor, School of Medicine, National Taiwan University; Consultant, Center of Sleep Disorder, National Taiwan University Hospital. Her current academic positions at international sleep societies include American Academy of Sleep Medicine Fellow and Co-Chair International Assembly; Asian Society of Sleep Medicine, Sleep Medicine Education Task Force committee member. Her current research focuses on the era of new technology and big data in sleep medicine; and intervention on sleep and metabolism in sleep disordered breathing.5116 42 - Some of the metrics are blocked by yourconsent settings
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