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 (AZT) is a thymidine analogue which inhibits retroviral reverse transcriptase, terminates DNA chain synthesis, and thus inhibits viral replication. The clinical benefit of AZT patients with advanced HIV disease was established in a phase II placebo-controlled study. Administered at dosages of 500 mg per day, AZT benefits asymptomatic patients with CD4 counts below 500, slows progression to AIDS, and increases survival. It has therefore become the major antiviral drug for treating HIV infection. Psoriasis is a common papulosquamous disease affecting 1-2% of the general population. It may also be the initial symptom of HIV infection, potentially very severe and difficult to treat with conventional therapy in such patients. The presence of psoriasis contributes significantly to AIDS morbidity and may be even more disabling than Kaposi's sarcoma. Researchers have, however, reported in the Archives of Dermatology the complete clearing of psoriasis in two patients several weeks after they began AZT therapy for AIDS. 33% of patients had a complete clearing of disease symptoms, while 90% had a partial improvement. A more than 75% reduction in body surface involvement was observed in 47% of patients. Improvement during AZT therapy was correlated with the presence of antigenemia and an increase in mean white blood cell count. While other forms of therapy for severe psoriasis have resulted in profound immunosuppression in some patients with AIDS, may activate HIV, or may be poorly tolerated in patients, AZT therapy seems safe and effective for ameliorating or clearing psoriasis in HIV-infected individuals at dosages of 1200 mg per day. The effectiveness of the drug at lower doses has not been established. Information is also lacking on what effect the early administration of AZT in asymptomatic HIV patients may have on the eventual expression of psoriasis.
Indian Med Trib 1994 Jul 15
PMID:Zidovudine improves psoriasis in HIV-positive males. 1217 18

Possible pathophysiological, clinical and epidemiological interactions between human immunodeficiency virus (HIV) and tropical pathogens, especially malaria parasites, constitute a concern in tropical areas. Two decades of research have shown that HIV-related immunosuppression is correlated with increased malaria infection, burden, and treatment failure, and with complicated malaria, irrespective of immune status. The recent role out of antiretroviral therapies and new antimalarials, such as artemisinin combination therapies, raise additional concerns regarding possible synergistic and antagonistic effects on efficacy and toxicity. Co-trimoxazole, which is used to prevent opportunistic infections, has been shown to have strong antimalarial prophylactic properties, despite its long-term use and increasing antifolate resistance. The administration of efavirenz, a non-nucleoside reverse transcriptase inhibitor, with amodiaquine-artesunate has been associated with increased toxicity. Recent in vivo observations have confirmed that protease inhibitors have strong antimalarial properties. Ritonavir-boosted lopinavir and artemether-lumefantrine have a synergistic effect in terms of improved malaria treatment outcomes, with no apparent increase in the risk of toxicity. Overall, for the prevention and treatment of malaria in HIV-infected populations, the current standard of care is similar to that in non-HIV-infected populations. The available data show that the wider use of insecticide-treated bed-nets, co-trimoxazole prophylaxis and antiretroviral therapy might substantially reduce the morbidity of malaria in HIV-infected patients. These observations show that those accessing care for HIV infection are now, paradoxically, well protected from malaria. These findings therefore highlight the need for confirmatory diagnosis of malaria in HIV-infected individuals receiving these interventions, and the provision of different artemisinin-based combination therapies to treat malaria only when the diagnosis is confirmed.
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PMID:Interactions between malaria and human immunodeficiency virus anno 2014. 2452 18