Topics in HIV medicine : a publication of the International AIDS Society, USA最新文献_第2页

When to start antiretroviral therapy. 何时开始抗逆转录病毒治疗。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-08-01

Mari M Kitahata

{"title":"When to start antiretroviral therapy.","authors":"Mari M Kitahata","doi":"","DOIUrl":"","url":null,"abstract":"The question of when to initiate antiretroviral therapy has been a central controversy in HIV management for more than 15 years, yet there are limited data from randomized controlled trials addressing it. A major obstacle to performing such a study is the need for large numbers of asymptomatic, antiretroviral therapy-naive individuals observed over many years beginning from when their CD4+ cell counts are above 500/mm3. Observational cohort studies with substantial person-years of follow-up have informed this debate in the absence of randomized trials. Emerging evidence regarding the damage caused by untreated HIV infection-related inflammation and immune activation at all stages of disease, and the benefits of modern antiretroviral therapy in preventing both AIDS- and non-AIDS-related morbidity and mortality has supported a return to starting treatment early. The NA-ACCORD (North American AIDS Cohort Collaboration on Research and Design) study compared long-term outcomes of immediate versus deferred therapy at 2 CD4+ cell count thresholds. Results showed a 94% increased risk of all-cause mortality when antiretroviral therapy was deferred at CD4+ cell counts greater than 500/mm3. This article summarizes presentations made by Mari M. Kitahata, MD, MPH, at the International AIDS Society-USA continuing medical education programs held in November 2009 in New York City and May 2010 in San Francisco. The original presentations are available as Webcasts at www.iasusa.org.","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"18 3","pages":"121-6"},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29330178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

HIV vaccine development. 艾滋病毒疫苗开发。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

David I Watkins

{"title":"HIV vaccine development.","authors":"David I Watkins","doi":"","DOIUrl":"","url":null,"abstract":"Updates on the Thai clinical vaccine trial, the discovery of additional neutralizing antibodies, and several new, nonhuman primate vaccine studies were presented at the 17th Conference on Retroviruses and Opportunistic Infections this year. Interestingly, the vaccine effect observed in the Thai trial diminished with time and was most effective in individuals who reported low-risk behavior. Two new neutralizing monoclonal antibodies were reported that were more potent and broadly reactive than the previously described monoclonal antibodies, giving the neutralization field an important boost. New studies were presented in macaques showing that a DNA prime modified vaccinia virus Ankara boost regimen can reduce acquisition of infection after a low-dose mucosal challenge with a heterologous pathogenic simian immunodeficiency virus (SIV) strain. Data suggesting that attenuated SIV vaccines can induce cellular immune responses that control viral replication were also discussed. Finally, and perhaps most encouragingly, vaccination with cytomegalovirus-expressing SIV antigens provided robust levels of protection against the highly pathogenic SIVmac239 viral isolate. All of these promising results should serve to energize the HIV vaccine field.","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"18 2","pages":"35-6"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29028787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in basic science. 基础科学的进步。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

Mario Stevenson

引用次数: 0

Neurologic complications of HIV disease and their treatment. 艾滋病的神经系统并发症及其治疗。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

Scott L Letendre, Ronald J Ellis, Beau M Ances, J Allen McCutchan

{"title":"Neurologic complications of HIV disease and their treatment.","authors":"Scott L Letendre, Ronald J Ellis, Beau M Ances, J Allen McCutchan","doi":"","DOIUrl":"","url":null,"abstract":"Findings on the nervous system complications of HIV disease and their impact on people living with HIV continue to accumulate. New reports at the 17th Conference on Retroviruses and Opportunistic Infections this year confirmed that HIV-associated neurocognitive disorders (HAND) are common, even among effectively treated individuals. Risk of HAND correlated with nadir CD4+ cell counts and with cerebrospinal fluid (CSF) viral loads that were at least as high as plasma viral loads. Other new data regarding risk factors for HAND implicated vascular disease, apolipoprotein E and mannose binding lectin genotypes, reduced resting cerebral blood flow, and HIV mutants that cause macrophages to shed the HIV gp120 protein. Two analyses linked worse neurocognitive performance to use of efavirenz, raising concerns about neurotoxicity. Analyses comparing differences in estimated distribution of antiretroviral drugs into the central nervous system (CNS) to neurocognitive outcomes using the 2008 version of the CNS penetration-effectiveness (CPE) ranking system did not support a hypothesis of neurotoxicity but did have mixed results, some supporting a benefit and some supporting no effect. Of note, a revised version of the CPE ranking system was presented that was more strongly associated with CSF viral loads than the 2008 version. Reports also estimated that primary CSF virologic failure occurs in 3% to 10% of treated individuals, although the clinical consequences of this remain uncertain. New data on common coinfections in people with HIV identified that a specific strain of Treponema pallidum may be more neurovirulent than other strains, that hepatitis C virus Core protein may be neurotoxic, and that hepatitis B virus may replicate in the nervous system. The extensive data presented will inform new research and clinical decisions in the coming year.","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"18 2","pages":"45-55"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077300/pdf/nihms721014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29028789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

HIV epidemiology, testing strategies, and prevention interventions. 艾滋病毒流行病学、检测策略和预防干预。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

Susan Buchbinder

引用次数: 0

Advances in antiretroviral therapy. 抗逆转录病毒治疗的进展。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

Timothy J Wilkin, Noga Shalev, Hong-Van Tieu, Scott M Hammer

引用次数: 0

Complications of HIV disease and antiretroviral treatment. 艾滋病毒疾病并发症和抗逆转录病毒治疗。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-04-01

Anne F Luetkemeyer, Diane V Havlir, Judith S Currier

引用次数: 0

Medical interventions for addictions in the primary care setting. 初级保健机构对成瘾的医疗干预。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-02-01

R Douglas Bruce

引用次数: 0

Dermatologic manifestations of HIV in Africa. 非洲艾滋病毒的皮肤病学表现。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-02-01

Erin Huiras Amerson, Toby A Maurer

引用次数: 0

Pathogenesis of HIV infection: total CD4+ T-cell pool, immune activation, and inflammation. HIV感染的发病机制:总CD4+ t细胞池、免疫激活和炎症。

Topics in HIV medicine : a publication of the International AIDS Society, USA Pub Date : 2010-02-01

H Clifford Lane

{"title":"Pathogenesis of HIV infection: total CD4+ T-cell pool, immune activation, and inflammation.","authors":"H Clifford Lane","doi":"","DOIUrl":"","url":null,"abstract":"Recent studies have yielded important findings on the pathogenesis of HIV infection. HIV infection leads to immune dysfunction through CD4+ T-cell depletion (immunodeficiency) and immune activation (immunosuppression). In vivo imaging studies of nonhuman primates indicate that the total body pool of CD4+ T cells may provide more accurate quantitation of immune depletion in HIV infection than the peripheral blood CD4+ count. Immune activation appears to be driven by both a homeostatic response to CD4+ cell depletion and an inflammatory response to HIV infection. The evidence is mounting that ongoing inflammation and coagulation account for the increased risk of serious nonopportunistic events in patients with HIV infection. Studies in long-term nonprogressors indicate that the HIV-specific immune responses in these patients are distinguished by clonal expansions of antigen-specific CD8+ T cells. Additional study of the precise mechanisms that allow immunologic control of infection in these patients may contribute to development of vaccines and immune-based therapies. This article summarizes a presentation made by H. Clifford Lane, MD, at the International AIDS Society-USA continuing medical education program held in May 2009 in Chicago. The original presentation is available as a Webcast at www.iasusa.org.","PeriodicalId":85800,"journal":{"name":"Topics in HIV medicine : a publication of the International AIDS Society, USA","volume":"18 1","pages":"2-6"},"PeriodicalIF":0.0,"publicationDate":"2010-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28846588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0