Evolution of Environmental Economics: Insights from History to Future Visions
Nature's economic importance has been recognized throughout history, with prominent economists like Riccardo and Mill analyzing its role in production. The valuation of nature has evolved from bartering to the neoclassical focus on cost, leading to the emergence of environmental economics as a discipline tackling the challenges of natural resource management. Historical perspectives and future visions highlight the critical link between economic growth, natural capital, and sustainable development.
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Switch ABC/3TC to TDF/FTC SWIFT Study
SWIFT Study: Switch ABC/3TC to TDF/FTC Design Randomisation* 1 : 1 Open-label W48 TDF/FTC + PI/r (N = 155) 311 HIV+ adults On ABC/3TC + PI/r 3 months HIV-1 RNA < 200 c/mL 3 months No prior resistance to study drugs ABC/3TC + PI/r (N = 156) * Stratification by PI: 32% LPV/r vs 68% non-LPV/r PI/r at baseline LPV/r ATV/r FPV + RTV 100 mg FPV + RTV 200 mg DRV/r 48/311 (15%) 62/311 (20%) 22/311 (7%) 12/311 (4%) 9/311 (3%) TDF/FTC 53/311 (17%) 60/311 (19%) 12/311 (4%) 19/311 (6%) 11/311 (4%) ABC/3TC Objective Primary endpoint : proportion of patients with HIV-1 RNA < 200 c/mL through W48 (TLOVR failure = virologic failure [confirmed RNA 200 c/mL or last value 200 c/mL], premature discontinuation, ARV modification) ; lower limit of the 95% CI for the difference = - 12% SWIFT Campo R, CID 2013, Jan 29 (epub ahead of print)
SWIFT Study: Switch ABC/3TC to TDF/FTC Baseline characteristics and patient disposition TDF/FTC (N = 155) ABC/3TC (N = 156) 83% 86% Male 90% 93% HIV RNA < 50 c/mL 2% 1% HIV RNA 200 c/mL 532 532 CD4/mm3, median 43% 51% Lipid modifying agent N = 17 (11%) N = 17 (11%) Discontinuation by W48 7 3 For adverse event 0 1 For lack of efficacy Consent withdrawal/Lost to follow-up/ Investigator discretion/Protocol violation/Pregnancy 5/4/0/1/0 4/5/3/0/1 SWIFT Campo R, CID 2013, Jan 29 (epub ahead of print)
SWIFT Study: Switch ABC/3TC to TDF/FTC HIV RNA < 200 c/mL at W48, ITT-TLOVR 100% Virologic failure N 86 83 15 p=0.034 11/156 80 60 10 40 5 3/155 20 0 0 TDF/FTC TDF/FTC ABC/3TC ABC/3TC 95% CI of the difference: - 5.1 ; 11.2 Confirmed HIV RNA 200 c/mL or last value 200 c/mL SWIFT Campo R, CID 2013, Jan 29 (epub ahead of print)
SWIFT Study: Switch ABC/3TC to TDF/FTC Adverse event leading to study drug discontinuation * Creatinine elevation ** Renal failure/dehydration *** Multiple CNS symptoms and rash ; malaise and lower back pain ; sepsis ; rash ; decreased weight TDF/FTC ABC/3TC 1* 1** Renal event 1 2 Death 5*** 0 Other eGFR (MDRD) (mL/min/1.73 m2) 120 100 - 4.2 80 - 9.2 60 p=0.008 40 TDF/FTC ABC/3TC 20 0 0 4 12 24 36 48 Weeks SWIFT Campo R, CID 2013, Jan 29 (epub ahead of print)
SWIFT Study: Switch ABC/3TC to TDF/FTC Fasting Lipids: median change from baseline to W48, mg/dL [mmol/L] TDF/FTC ABC/3TC p<0.001* p=0.007* p=0.26* p=0.074* 5 2 [0.05] 0 - 0 [0.00] - 1 [- 0.03] - 3 [- 0.08] - 5 - 7 [- 0.18] HDL-c mg/dL - 10 - 9 [- 0.10] LDL-c - 15 - 18 [- 0.20] - 20 - 21 [- 0.54] TG - 25 Total chol No significant difference between groups in total cholesterol/HDL-c ratio at W48 * Wilcoxon rank-sum test SWIFT Campo R, CID 2013, Jan 29 (epub ahead of print)
