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Treatment and prevention of cytomegalovirus-associated diseases in HIV - 1 infection in the era of HAART HAART时代HIV - 1感染巨细胞病毒相关疾病的治疗和预防
HIV therapy Pub Date : 2010-07-07 DOI: 10.2217/HIV.10.30
D. Meyer-Olson, R. Schmidt, Benjamin A. Bollmann
{"title":"Treatment and prevention of cytomegalovirus-associated diseases in HIV - 1 infection in the era of HAART","authors":"D. Meyer-Olson, R. Schmidt, Benjamin A. Bollmann","doi":"10.2217/HIV.10.30","DOIUrl":"https://doi.org/10.2217/HIV.10.30","url":null,"abstract":"Cytomegalovirus (CMV) infection is one of the most common chronic viral infections and is one of the most important opportunistic infections in HIV-infected patients. Although HAART has substantially improved the morbidity and mortality of HIV-infected patients and decreased the frequencies of AIDS-related diseases, opportunistic infections including CMV end-organ diseases still remain a significant clinical challenge. Here we review the clinical manifestation and diagnosis of CMV end-organ diseases including the potential role of CMV infection in the pathogenesis of cardiovascular disease. We explain how HAART has changed the epidemiology of CMV disease in HIV infection and discuss how this influences current treatment guidelines for the prevention of CMV disease and CMV-associated immune recovery syndrome.","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"6 1","pages":"413-436"},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81957991","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: 8
HIV diagnostics: challenges and opportunities 艾滋病毒诊断:挑战与机遇
HIV therapy Pub Date : 2010-07-07 DOI: 10.2217/HIV.10.29
E. Wong, I. Hewlett
{"title":"HIV diagnostics: challenges and opportunities","authors":"E. Wong, I. Hewlett","doi":"10.2217/HIV.10.29","DOIUrl":"https://doi.org/10.2217/HIV.10.29","url":null,"abstract":"Accurate HIV diagnostic testing continues to pose challenges, but there are also opportunities for assay performance improvements in key areas for specific intended-use settings. The genetic diversity of HIV can result in false and discordant results in assays that fail to detect new variant strains. The use of antiretroviral therapies has resulted in drug-resistant variants that require monitoring by sequencing and genotyping methods. Nucleic acid testing is the most sensitive and reliable platform for detection, but it is costly and limited to centralized testing facilities, making implementation difficult in resource-limited settings where HIV has hit the hardest. Rapid antibody tests suitable for point-of-care use are becoming more accessible in resource-limited settings, but these tests may not detect HIV during the acute infection stage. Emerging antigen/antibody combination assays are viable alternatives to nucleic acid testing for diagnosis of recent infections. Although patient monitoring (e.g., ...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"7 1","pages":"399-412"},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87217309","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: 11
Micronutrients and HIV infection 微量营养素和艾滋病毒感染
HIV therapy Pub Date : 2010-07-07 DOI: 10.2217/HIV.10.36
A. Campa, M. Baum
{"title":"Micronutrients and HIV infection","authors":"A. Campa, M. Baum","doi":"10.2217/HIV.10.36","DOIUrl":"https://doi.org/10.2217/HIV.10.36","url":null,"abstract":"The immune system requires several essential micronutrients to maintain an effective immune response. HIV infection destroys the immune system and promotes nutritional deficiencies, which further impair immunity. This article reviews the role of several micronutrients (vitamins A, C, E and D, the B vitamins, and minerals, selenium, iron and zinc) that are relevant for maintaining immune function. In addition, the deficiencies of these micronutrients have been associated with faster progression of HIV-1 disease. This review examines the evidence from observational studies of an association between micronutrient status and HIV disease, as well as the effectiveness of micronutrient supplementation on HIV-disease progression, pregnancy outcomes and nutritional status, among others, utilizing randomized clinical trials. Each micronutrient is introduced with a summary of its functions in human physiology, followed by the presentation of studies conducted in HIV-infected patients in relation to this specific mic...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"20 1","pages":"437-469"},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81151699","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: 4
Effect of maternal HIV infection on measles susceptibility during early infancy: implications for optimizing protection of the infant. 母婴HIV感染对婴儿早期麻疹易感性的影响:优化婴儿保护的意义。
HIV therapy Pub Date : 2010-07-07 DOI: 10.2217/HIV.10.31
A. Kruczek, C. Cutland, S. Madhi
{"title":"Effect of maternal HIV infection on measles susceptibility during early infancy: implications for optimizing protection of the infant.","authors":"A. Kruczek, C. Cutland, S. Madhi","doi":"10.2217/HIV.10.31","DOIUrl":"https://doi.org/10.2217/HIV.10.31","url":null,"abstract":"The measles virus was first isolated as the causative pathogen of measles approximately 50 years ago by John Enders and Thomas Peebles. Despite a safe and effective vaccine extant for nearly the same amount of time, control of measles nevertheless remains a challenge in developing countries. This article investigates the possible contribution of maternal HIV infection on measles susceptibility in infants. The current WHO position on measles vaccination in HIV-infected children recommends vaccinating asymptomatic HIV-infected infants as early as 6 months of age, followed with two additional doses at 9 and 18 months. This is rarely implemented due to logistical constraints related to early HIV diagnosis in infants and access to vaccines in low-resource settings. In addition, measles vaccine safety and immunogenicity in HIV-infected children are based on very low levels of scientific evidence. There are no specific recommendations for measles immunization of HIV-uninfected children born to HIV-infected mothe...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"1 1","pages":"471-482"},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89743485","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: 6
HIV gene therapy that's not a SIN HIV基因疗法不是罪恶
HIV therapy Pub Date : 2010-07-07 DOI: 10.2217/HIV.10.32
Min-Hsuan Lin, H. Sivakumaran, D. Harrich
{"title":"HIV gene therapy that's not a SIN","authors":"Min-Hsuan Lin, H. Sivakumaran, D. Harrich","doi":"10.2217/HIV.10.32","DOIUrl":"https://doi.org/10.2217/HIV.10.32","url":null,"abstract":"Evaluation of: Wang Z, Tang Z, Zheng Y et al.: Development of a nonintegrating Rev-dependent lentiviral vector carrying diphtheria toxin A chain and human TRAF6 to target HIV reservoirs. Gene Ther. (2010) (Epub ahead of print). HIV infection is incurable, but can be effectively controlled by antiviral therapy using a combination of drugs. HIV persistence during therapy is attributed to long-lived cells harboring genome-integrated HIV maintained in a transcriptionally silent state, which are refractory to current antiviral drugs. Transient and periodic activation of HIV in these cellular reservoirs leads to continual viremia. Wang et al. tackle the question of whether gene therapy using nonintegrating lentiviral vectors expressing cytotoxic proteins can specifically target HIV-infected cells. This approach has advantages since there is little chance of tumorigenesis through activation or mutation of proto-oncogenes typically associated with integrating viral vectors. These conditional vectors also express ...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"16 1","pages":"395-398"},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83804961","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: 1
Innate immune natural killer cells and their role in HIV and SIV infection. 先天免疫自然杀伤细胞及其在 HIV 和 SIV 感染中的作用。
HIV therapy Pub Date : 2010-07-01 DOI: 10.2217/HIV.10.28
Pavel Bostik, Yoshiaki Takahashi, Ann E Mayne, Aftab A Ansari
{"title":"Innate immune natural killer cells and their role in HIV and SIV infection.","authors":"Pavel Bostik, Yoshiaki Takahashi, Ann E Mayne, Aftab A Ansari","doi":"10.2217/HIV.10.28","DOIUrl":"10.2217/HIV.10.28","url":null,"abstract":"<p><p>The findings that early events during HIV-1 and SIV infection of Asian rhesus macaques dictate the levels of viremia and rate of disease progression prior to the establishment of mature and effective adaptive immune responses strongly suggest an important role for innate immune mechanisms. In addition, the fact that the major target of HIV and SIV during this period of acute infection is the gastrointestinal tissue suggests that whatever role the innate immune system plays must either directly and/or indirectly focus on the GI tract. The object of this article is to provide a general overview of the innate immune system with a focus on natural killer (NK) cells and their role in the pathogenesis of lentivirus infection. The studies summarized include our current understanding of the phenotypic heterogeneity, the putative functions ascribed to the subsets, the maturation/differentiation of NK cells, the mechanisms by which their function is mediated and regulated, the studies of these NK-cell subsets, with a focus on killer cell immunoglobulin-like receptors (KIRs) in nonhuman primates and humans, and finally, how HIV and SIV infection affects these NK cells in vivo. Clearly much has yet to be learnt on how the innate immune system influences the interaction between lentiviruses and the host within the GI tract, knowledge of which is reasoned to be critical for the formulation of effective vaccines against HIV-1.</p>","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"4 4","pages":"483-504"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922771/pdf/nihms226936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29204865","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
Neurocognitive disorders during antiretroviral treatment, despite full HIV RNA suppression 抗逆转录病毒治疗期间的神经认知障碍，尽管完全抑制HIV RNA
HIV therapy Pub Date : 2010-05-04 DOI: 10.2217/HIV.10.24
J. Arribas, A. Hill
{"title":"Neurocognitive disorders during antiretroviral treatment, despite full HIV RNA suppression","authors":"J. Arribas, A. Hill","doi":"10.2217/HIV.10.24","DOIUrl":"https://doi.org/10.2217/HIV.10.24","url":null,"abstract":"After the introduction of HAART in the late 1990s, there were dramatic reductions in HIVrelated neurological disorders such as dementia, CNS lymphoma and cerebral toxoplasmosis [1]. However, minor neurocognitive disorders are still detected in a high proportion of patients receiving antiretrovirals, even if HIV RNA levels are suppressed below 50 copies/ml in plasma [2,3]. HIV-associated neurocognitive disorders are defined by asymptomatic neurocognitive impairment, minor neurocognitive disorders and HIV-associated dementia. These disorders are identified either by clinical diagnosis and/or neurocognitive testing. In some studies, samples of cerebrospinal fluid (CSF) have been tested for HIV RNA and plasma PK levels of antiretrovirals. There is a background incidence of neurological disorders in the general population [4,5], and there may be other confounding factors such as recreational drug use, psychiatric illness, a lcohol abuse/use and hepatitis B or C infection [6].","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"8 1","pages":"257-260"},"PeriodicalIF":0.0,"publicationDate":"2010-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87795008","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: 3
Management of oropharyngeal and esophageal candidiasis in patients with HIV infection. HIV感染患者口咽和食管念珠菌病的治疗。
HIV therapy Pub Date : 2010-05-04 DOI: 10.2217/HIV.10.18
J. Vázquez
{"title":"Management of oropharyngeal and esophageal candidiasis in patients with HIV infection.","authors":"J. Vázquez","doi":"10.2217/HIV.10.18","DOIUrl":"https://doi.org/10.2217/HIV.10.18","url":null,"abstract":"Mucocutaneous candidiasis is frequently one of the first signs of HIV infection. Over 90% of patients with AIDS will develop oropharyngeal candidiasis at some time during their illness. Although numerous antifungal agents have been developed, azoles, both topical (clotrimazole) and systemic (fluconazole, itraconazole, voriconazole and posaconazole), have replaced older topical antifungals (gentian violet and nystatin) in the management of oropharyngeal candidiasis in these patients. The systemic azoles are generally safe and effective agents in HIV-infected patients with oropharyngeal candidiasis. A constant concern in these patients are relapses, which depend on the degree of immunosuppression and are commonly encountered after topical therapy rather than with systemic azole therapy. In patients with fluconazole-refractory mucosal candidiasis, treatment options now include itraconazole solution, voriconazole, posaconazole and the newer echinocandins (caspofungin, micafungin and anidulafungin). The object...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"421 1","pages":"325-343"},"PeriodicalIF":0.0,"publicationDate":"2010-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77032132","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: 5
Tenofovir disoproxil fumarate and the kidney in HIV-infected patients: the evidence thus far. 富马酸替诺福韦二氧吡酯和hiv感染患者的肾脏:迄今为止的证据。
HIV therapy Pub Date : 2010-05-04 DOI: 10.2217/HIV.10.16
M. Danjuma, A. Mohiuddin, M. Pirmohamed, S. Khoo
{"title":"Tenofovir disoproxil fumarate and the kidney in HIV-infected patients: the evidence thus far.","authors":"M. Danjuma, A. Mohiuddin, M. Pirmohamed, S. Khoo","doi":"10.2217/HIV.10.16","DOIUrl":"https://doi.org/10.2217/HIV.10.16","url":null,"abstract":"Tenofovir disoproxil fumarate (TDF) is an integral part of the initial treatment regimen for HIV and a subgroup of hepatitis B coinfected patients, after its safety and efficacy were demonstrated in a number of prospective studies. However, concerns still remain regarding its potential for kidney injury. The nature of kidney involvement is variable, with various phenotypes reported in different studies. Proximal kidney tubular dysfunction (PKTD) has been reported as one of the commonly recurring phenotypes from most studies. The exact mechanism of TDF-induced PKTD is unknown, but it has been suggested to be due to a combination of functional polymorphisms in the genes that encode efflux transporter proteins and raised proximal tubular cell concentrations of TDF, resulting in oxidative stress and mitochondrial dysfunction. Gaps still remain in our understanding of this novel concept of TDF-induced kidney toxicity, and conflicting observations are made with accumulating evidence. For instance, whether HIV p...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"68 1","pages":"345-359"},"PeriodicalIF":0.0,"publicationDate":"2010-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89312604","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: 1
The DUET trials: etravirine in the management of treatment-experienced HIV-1-infected patients DUET试验:依曲维林在治疗经验的hiv -1感染患者的管理
HIV therapy Pub Date : 2010-05-04 DOI: 10.2217/HIV.10.14
A. Mills
{"title":"The DUET trials: etravirine in the management of treatment-experienced HIV-1-infected patients","authors":"A. Mills","doi":"10.2217/HIV.10.14","DOIUrl":"https://doi.org/10.2217/HIV.10.14","url":null,"abstract":"The non-nucleoside reverse transcriptase inhibitor (NNRTI) etravirine has been approved for use in treatment-experienced, HIV-1-infected patients. The Phase III DUET trials evaluated the long-term efficacy and safety of etravirine versus placebo, each in combination with an antiretroviral background regimen including twice-daily darunavir/ritonavir 600/100 mg, in treatment-experienced patients failing therapy (with baseline plasma viral load of more than 5000 copies/ml and NNRTI and protease inhibitor resistance). At week 24 in DUET-1, 56% of etravirine-treated patients reached the primary end point of viral load below 50 copies/ml compared with 39% of placebo-treated patients (p = 0.0050); in DUET-2, response rates were 62 versus 44%, respectively (p = 0.0003). Pooled data at weeks 48 and 96 confirmed the durability of response with etravirine. With the exception of rash, the safety and tolerability profile of etravirine was similar to that of placebo over the treatment period. Etravirine is expected to ...","PeriodicalId":88510,"journal":{"name":"HIV therapy","volume":"40 1","pages":"265-280"},"PeriodicalIF":0.0,"publicationDate":"2010-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81639105","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: 1
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