ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Building on the success of combination antiretroviral drug therapy will require a better understanding of the underlying basis for viral persistence. Characterization of the therapeutic, viral, and immunological factors that influence the size and stability of viral reservoirs will foster the development of strategies to control or eliminate HIV-1 from infected individuals. Here we review recent work aimed at delineating the complex interplay between viral replication, the immune system, and viral reservoirs. Finally, we address the implications and clinical significance of the residual replication that persists in infected individuals on potent antiretroviral therapy to evaluate both the possible risks and benefits of ongoing HIV-1 replication.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

In recent years, exciting developments in the understanding of the multi-step HIV-1 entry process have revealed potential approaches for therapeutic intervention that will compensate for the early disappointments of the soluble CD4 antigen approach. Although details of the HIV-1 fusion process are clearly complex, the proof-of-concept in the clinic provided by T-20 gives high hopes that new generation inhibitors of HIV fusion will be developed. This review highlights novel drug discovery technologies that are being employed in the search for such inhibitors.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Highly active antiretroviral therapy rapidly reduces virus replication in the lymphoid tissue. Production of viral RNA, however, may still be detected in the lymphoid tissue despite negative plasma viremia. Continuing virus production and latent infection in resting cells seem to be important factors for viral rebound following treatment interruption. In parallel with viral suppression, immune activation is decreased and CD4+ T cell counts in the lymphoid tissue increase. It is still not known if there is a potential for complete viral suppression and immune reconstitution. Analyses of the lymphoid tissue during therapy may be helpful in addressing these issues.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Treatment of HIV infected patients with antiretroviral drugs often results in the emergence of virus variants with reduced sensitivity to these drugs. However, the viral load often remains partially suppressed below pretherapy levels, which might be explained by a reduced fitness of the drug resistant viral population. This review describes the effects of antiretroviral resistance development on the fitness of the viral population and its clinical implications.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The consequences of treatment interruptions have been investigated in various patient populations. For patients with controlled viraemia, treatment interruption allowing viral rebound may boost HIV-1-specific immunity. The hypothesis that this will be sufficient to control HIV replication in the absence of treatment has received support in studies of patients initiating treatment during primary infections. In patients with chronic infection, treatment interruption has been shown to boost HIV-1-specific immunity in some cases. In patients with virological failure, despite drug-resistant virus, treatment appears to provide benefit, in that interruption results in a decrease in the CD4 cell count and increases in plasma HIV-1-RNA levels. The removal of drug pressure allows the rapid shift to wild-type virus. Whether this will be of benefit to the patient is not clear. Treatment interruption may help reduce the accumulation of long-term toxicities.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

With the description of the complete genome sequence ofTreponema pallidum, the declining rates of primary and secondary syphilis in many developed countries, and the continuing development of easier, cheaper, and more reliable diagnostics, the goal of worldwide syphilis eradication may be achievable. Although syphilis is easy to detect and cure given adequate access to and utilization of healthcare, many barriers exist on the way to its elimination and ultimate eradication. This review discusses current opinions regarding the plans, prospects and obstacles to worldwide syphilis eradication.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Recent advances in diagnostic tests for sexually transmitted diseases include the development of a synthetic Venereal Disease Research Laboratory reagent that will improve the sensitivity and stability of nontreponemal serologic tests for syphilis. A second generation user friendly and high throughput nucleic acid amplification test forChlamydia trachomatisandNeisseria gonorrhoeaehas also been developed.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The biological importance of a group of human papillomaviruses, known as high-risk human papillomaviruses, as the key causal agent for almost all cervical cancer has now been established. Many aspects of the natural history of high-risk human papillomaviruses as sexually transmitted infections and as oncogenic agents have been researched. Although human papillomavirus diagnosis is largely confined to DNA detection techniques in cervical smears, there is accumulating evidence that the best polymerase chain reaction and hybrid capture techniques are more sensitive and probably of similar specificity compared with cervical cytology as a triage test for women with borderline smear abnormalities and for screening older women. This is strong presumptive evidence that high-risk human papillomavirus testing could be useful in cervical screening. Current research is aimed at establishing a place for high-risk human papillomavirus testing in routine screening practice. Randomised clinical trials, long-term natural history studies, mathematical modelling, and economic and psychosocial studies are being used to demonstrate whether this testing can improve both the effectiveness and efficiency of cervical screening in a range of situations.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID