ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Antiretroviral agents target HIV replication within infected cells. It is therefore important to focus on the pharmacology of these drugs at their site of action rather than just in plasma. Activation of nucleoside analogues to a triphosphate is essential for antiretroviral activity. Following activation, by intracellular kinases, drug triphosphates compete with endogenous triphosphates for HIV reverse transcriptase. Methodologies to measure triphosphates in peripheral blood mononuclear cells from HIV patients have been described. This has allowed investigation of once-daily dosing regimens, drug interactions, modulation of intracellular activation and the bypassing of initial phosphorylation steps. Drug accumulation within a cell is a balance between influx and efflux. There is a growing body of evidence indicating that transport proteins are vitally important in regulating intracellular concentrations of antiretroviral drugs. Allelic variants, inhibition (or induction) are all potentially critical determinants of active drug present in the cell. It is hoped that understanding the intracellular pharmacology will improve long-term therapy and reduce the likelihood of cellular resistance in therapeutic failure.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Although HIV-associated lipodystrophy can be diagnosed just from clinical examination, criteria for diagnosis and judgement of severity are not clearly defined. Clinical assessment can be systematized with questionnaires for patients and physicians. Computed tomography, nuclear magnetic imaging and dual-energy X-ray absorptiometry are objective reference methods but are expensive for routine follow-up and diagnosis. Therefore, anthropometry and other non-invasive bedside methods deserve further validation studies.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Therapeutic drug monitoring has the promise to become a part of routine patient care in the treatment of HIV infection. It is known that plasma drug concentrations of protease inhibitors and non-nucleoside reverse transcriptase inhibitors are better predictors of antiviral response or toxicity than drug dose is. Furthermore, high interpatient variability is significant. In addition, therapeutic drug monitoring may be used as a direct and objective instrument to measure non-adherence. This review describes possibilities and limitations of therapeutic drug monitoring in HIV treatment.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Hyperlactatemia associated with use of nucleoside analogue reverse transcriptase inhibitors (NRTIs) is not a single entity but a spectrum of abnormalities. The spectrum reflects varying degrees of derangement in systemic homeostasis in the face of primary drug effects on lactate load. Lactic acidosis, characterized by metabolic acidosis, blood lactate above 5 mmol/l, hepatic steatosis and high mortality, represents the extreme end of this spectrum where there is complete decompensation. Partially compensated states of lactate excess have now been described, ranging from less fulminant symptomatic hyperlactatemia with hepatic steatosis to chronic or intermittent low-grade hyperlactatemia without acidosis, steatosis or any symptoms. At a population level, average venous lactate concentrations do rise following treatment with NRTIs but stabilize long term in the majority of cases. The average increase in systemic lactate turnover that is required to maintain such compensated blood levels is not known and research into this may provide insights into the extent of incipient mitochondrial toxicity associated with chronic NRTI use. At a tissue-specific level, it is not known which tissues or organs (liver, fat, other) are the predominant contributors to an increase in systemic lactate load, nor whether the primary defect is one of increased production, decreased elimination or both.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Genital chlamydial infection, with its possible long-term morbidity, is a serious public health problem. The number of new diagnoses is rising rapidly and, in the UK, recent evidence suggests that the infection rate in young women exceeds 10%. Screening programmes can reduce the population prevalence of infection, but uncertainty remains as to the ideal screening model. This may prove to be opportunistic screening of sexually active young women, less than 25 years of age, in primary care settings, and contact tracing of the partners of those with chlamydia. Recent literature on the practicalities of genital chlamydia screening is reviewed.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Increases in sexually transmitted diseases and sexual risk behaviour among men who have sex with men in the Western world have raised concern with regard to the HIV/AIDS epidemic in this group. The aim of this review is to give an overview of possible explanations for these alarming increases and to indicate what impact they might have on this epidemic.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Haemophilus ducreyicauses the sexually transmitted disease chancroid, which facilitates the transmission of HIV infection. This review focuses on recent advances in the epidemiology, diagnosis, treatment and pathogenesis of this disease.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Genital herpes is a sexually transmitted disease that has been widely investigated from both an epidemiological and a diagnostic viewpoint. Better knowledge of the disease has pointed to the important role of asymptomatic herpes simplex virus type 2 shedding as a major culprit for the spread of the virus in the world, the latest statistics showing that the incidence of genital herpes is constantly increasing. The reference compound for the treatment and prophylaxis of genital herpes is acyclovir. Recently, two drugs with better oral bioavailability, valaciclovir, the oral prodrug of acyclovir, and famciclovir, the oral prodrug of penciclovir, have been made available. Nevertheless, there is a need to develop additional approaches, to extend the therapeutic possibilities and to face the problem of emerging resistant viruses, mostly in immunocompromised patients. Therefore, efforts have been made in different directions including the exploration of new targets for antiviral chemotherapy, the use of immunomodulators and the development of specific vaccines.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The focus of this review will be to highlight articles from 2000 and up to August 2001 that demonstrate the challenges in the evaluation of candidate microbicides, and the ways in which investigators have approached these challenges.

ISSN:0951-7375    

出版商:OVID    

年代:2002

数据来源: OVID