1,721,664 research outputs found
Il macrofago e l’infezione da HIV. Ruolo delle cellule lungo sopravviventi nella patogenesi e nella terapia
No full textImpact of different HIV resistance interpretation by distinct systems on clinical utility of resistance testing.
No full textPURPOSE OF REVIEW: Genotypic assays are widely used tools for determining HIV-1 drug resistance and for guiding treatment. Several systems have been developed to interpret the complex influence of amino acid substitutions in HIV reverse transcriptase or protease on the phenotypic susceptibility or clinical response to the 18 available antiretroviral agents. In this review we analyse both studies comparing interpretations by different systems and studies showing correlation of interpretations with clinical outcome, in order to identify discordance and how this may affect prediction of subsequent therapy outcomes. RECENT FINDINGS: During the last year, several studies analysing interpretation systems, individually or comparatively, have shown substantial variability of the predicted drug activities and therapeutic outcomes. Discrepant interpretation was detected mostly for nucleoside reverse transcriptase inhibitors and rarely for non-nucleoside reverse transcriptase inhibitors. Better correlation with treatment outcome was found with most recently updated systems, while a weaker prediction was found with systems interpreting activity of nucleoside reverse transcriptase inhibitors solely on the basis of phenotypic susceptibility. Virological, patient-related and treatment-related factors can all affect the results of systems' clinical validations. Refinement of resistance interpretation is possible by introducing rules derived from genotype-outcomes correlation or, at least for protease inhibitors, genotype-phenotype correlation. SUMMARY: Papers showing clinical validation of the available interpretation systems are presented with a critical view to help the readers' evaluation of their possible use. There is a need for developing a consensus towards common interpretations. Large clinical and virological databases with quality data will be useful for future improvements
New therapeutic prospects in AIDS [NUOVE PROSPETTIVE TERAPEUTICHE DELL'AIDS]
No full textIn this paper we decribe the current status of the chemotherapy of HIV-related disease, and the newly emerging approaches to this problem. Azidothymidine, the first anti-HIV drug, is now used by thousands of patients with AIDS, and is able to induce a substantial improvement of their clinical status. However, due to its toxicity and its very limited activity against HIV replication in chronically infected cells (the natural reservoir of the virus in the body), it is crucial that new drugs be developed. A number of compounds belonging to the dideoxynucleoside family (the same of AZT) have been synthesized and used in HIV-infected patients, with promising results. Nevertheless, new compounds with different mechanisms of action, and with excellent anti-HIV efficacy need to be developed, particularly those that can inhibit the late stages of HIV replication. This will permit a polychemotherapeutic approach against HIV infection that, as in the case of anticancer chemotherapy, has conceivably better chances to be effective in patients with HVI-related disease
Does residual virus replication during successful HAART lead to HIV-1 genetic evolution?
No full textHIV/HCV co-infection: the magnitude of the problem
No full textHepatitis C virus (HCV) and human immunodeficiency virus (HIV) share routes of transmission, therefore their coinfection is relatively common. Nevertheless, the clinical relevance of this event has been minimal until few years ago when, due to the increased survival of HIV-Infected individuals (favoured by highly active antiretroviral therapy) morbility and mortality caused by pathologies not strictly related to HIV (such as HCV infection) raised sharply. Despite differences in their general characteristics (including lifecycle, target cells, and type of persistence in the infected host) a remarkable level of interaction exists between HCV and HIV; this makes the progression of both liver disease and immunological damage easier and more rapid. A therapeutic approach to HIV/HCV coinfection thus requires the utilization of drugs and strategies effective against both viruses, yet, timing, drug types, and effective combinations still remain poorly defined. New and innovative studies specifically focused on HIV/HCV coinfection are thus warranted to increase the knowledge about their interaction, and define therapeutic strategies aimed to the best management of the infection by both viruses during coinfection
- …
