Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.7.49 (reverse transcriptase)
 31,746 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Zidovudine, the first widely used antiretroviral agent, prevents replication of the human immunodeficiency virus (HIV) by inhibiting reverse transcriptase. Its use in patients with acquired immunodeficiency syndrome slows progression of the disease and prolongs survival. Zidovudine also significantly reduces the rate of progression to AIDS in adults with asymptomatic HIV infection and CD4 T-lymphocyte counts below 500 per mm3. The major toxicity of the drug is bone marrow suppression resulting in anemia or granulocytopenia, or both. Recently, lower doses have been shown to be effective and are associated with less toxicity.
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PMID:Zidovudine for the treatment of HIV infection. 204 38

Current estimates suggest that at least 1 million persons in the United States are infected with the human immunodeficiency virus (HIV), the cause of the acquired immunodeficiency syndrome. Knowledge of the life cycle of HIV has provided the fundamental information necessary to initiate programs that will identify drugs to treat the infection. Inhibition of reverse transcriptase represents the only strategy of proved clinical value. Three such drugs are available: zidovudine, didanosine, and zalcitabine. Zidovudine is the only proved agent for therapy of asymptomatic HIV infection; and for symptomatic disease, monotherapy with zidovudine must also be regarded as the first-line approach. For patients who are intolerant, are failing clinically, or have received prior long-term treatment with zidovudine, monotherapy with didanosine or zalcitabine, or a combination of zidovudine and zalcitabine are alternatives. Progress is being made in the treatment of HIV infection, but the considerable challenge to affect the inexorable progressive nature of HIV disease remains daunting.
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PMID:Current perspectives on antiretroviral therapy. 750 1

This document summarizes recommendations from a state-of-the-art conference convened to evaluate the role of nucleoside analogue reverse transcriptase inhibitors in the treatment of human immunodeficiency virus (HIV) infection. Data from controlled clinical trials of zidovudine, didanosine, and zalcitabine were reviewed by an expert panel, which then formulated guidelines to assist clinicians and HIV-infected patients in the use of these agents. Recommendations were framed in the context of clinical scenarios for patients with asymptomatic HIV infection who have not had prior antiretroviral therapy; those with signs and symptoms of HIV-related disease who have not received prior therapy; clinically stable patients who are tolerating initial zidovudine therapy; patients experiencing clinical progression while on zidovudine therapy; and those who are intolerant of antiretroviral therapy. The panel concluded that physicians need to integrate up-to-date scientific knowledge with other relevant needs to improve the care of HIV-infected patients.
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PMID:Antiretroviral therapy for adult HIV-infected patients. Recommendations from a state-of-the-art conference. National Institute of Allergy and Infectious Diseases State-of-the-Art Panel on Anti-Retroviral Therapy for Adult HIV-Infected Patients. 751 16

We report detailed quantitative analysis of human immunodeficiency virus-1 (HIV-1) p24 and HIV-1 RNA in tonsil biopsies from 13 patients with early, asymptomatic HIV infection before and during combination antiretroviral therapy. Using fluorescent microscopy in conjunction with reverse transcriptase-polymerase chain reaction of frozen tissue sections, we show that plasma and tissue viral loads decreased by approximately 3 logs during the 1-year treatment period, with good correlation between the HIV-1 p24 and HIV-1 RNA response in tissue. The decrease of tissue viral load was delayed compared to plasma viral load, possibly explained by the observation that the amount of follicular dendritic cell-associated virus correlated best with the area under the curve of plasma HIV-1 RNA throughout the last 12 weeks. Before and during treatment, the relative proportions of HIV-1 on follicular dendritic cells and within mononuclear cells remained constant, suggesting similar decay characteristics in these two lymphoid tissue compartments. However, viral p24 or RNA remained almost always detectable in tissue despite full suppression of HIV-1 RNA in plasma, and increased even after short-term rebounds in plasma viral load. Thus, full and sustained suppression of viral replication was required to efficiently decrease viral load in lymphoid tissue, but complete abolition of residual viral replication was not achieved.
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PMID:Treatment-induced decline of human immunodeficiency virus-1 p24 and HIV-1 RNA in lymphoid tissue of patients with early human immunodeficiency virus-1 infection. 1085 20