摘要:

The complexities of the virus-host interaction are still not well known. Recent data indicate, however, that the disease manifestations and rate of progression are closely related to viral tropism and burden. A better understanding of viral pathogenesis is critical to the development of effective antiretroviral therapy and a potentially efficacious prophylactic vaccine.

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Many new agents are currently being evaluated in clinical trials to determine their efficacy in treating patients infected with HIV-1. Nucleoside analogs which inhibit HIV reverse-transcriptase continue to be the mainstay of therapy. Recent observations, published during this review period, questioned the most appropriate time to initiate antiretroviral therapy and have forced the re-examination of previous recommendations. This review will address the recent and significant findings for monotherapy, combination therapy and immunotherapy for HIV-1 infection and discuss the trend towards a more individualized therapeutic approach in managing patients infected with HIV-1.

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

HIV vaccines are urgently needed to help control the relentlessly expanding epidemic. However, the development of a safe and effective vaccine for this rapidly mutating virus which produces life-long infection is elusive. Feasibility of HIV vaccination has been demonstrated by challenge studies in primates and by the presence of neutralizing antibodies which confer passive protection and can be detectedin vitro.Given safety considerations, the first vaccines developed have been recombinant subunit vaccines consisting of viral envelope antigens formulated with adjuvants or incorporated into live vectors, such as vaccinia and avipox. Subunit envelope vaccines have proven to be safe and immunogenic in human phase I trials. Two gp120 subunit products are being considered for phase III trials based on ongoing evaluation of data from a phase II trial, primate-challenge studies, and laboratory studies evaluating the breadth, magnitude, and duration of immunogenic responses, including neutralization against recent isolates. Efficacy trials will be large and complex, involving people at high behavioral risk for infection. Baseline studies with recruitment goals of over 10000 people are being sponsored in the USA, with many additional vaccine preparedness studies being sponsored in developing nations by international and national authorities. Because high-risk populations will be recruited for trials of many year's duration, new approaches to trial design and community participation will be needed in order for these trials to succeed. Systems must be in place to ensure that trial participants receive preventive counseling and services to minimize discrimination from vaccine-related seroconversions. Here we document the urgent need for HIV vaccines, provide a brief preclinical and clinical update, and present the plans and considerations for testing HIV vaccine efficacy.

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Infections caused byMycobacterium tuberculosisandMycobacterium aviumcomplex are the most commonly reported opportunistic bacterial infections in people with HIV disease. The past year has seen much progress in defining those at risk, characterizing pathogen virulence factors and host immune responses, and the development of rapid and sensitive diagnostic tools. Similar accomplishments in the treatment and prophylaxis ofM. aviumcomplex infections have substantially improved our ability to manage patients with advanced HIV disease. The next year should bring new insights into determining the most effective drug regimens for treatment and prevention ofM. aviumcomplex disease. Alternatively, continued development of rapid diagnostic tests, particularly for determining drug susceptibility, and new and more effective drugs is sorely needed to accomplish the same with multidrug-resistant tuberculosis, which will continue to be a major public health issue in the coming year.

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Attesting to the continuing need for newer, more efficacious and less toxic therapies, this year's medical literature is replete with reports describing advances in the treatment and prophylaxis of the serious opportunistic infections associated with AIDS. Patients at risk for these infections, generally considered to be those individuals with fewer than 200 CD4+ lymphocytes per μl, are increasing in number as a direct consequence of survival benefits attributed to antiretroviral therapy and improved treatment and prophylaxis of the major opportunistic infections and cancers. In spite of continued and notable improvements in this area, options for many patients remain severely limited by therapies characterized by suboptimal efficacy and/or intolerable adverse consequences.

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1994

数据来源: OVID