Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thalidomide has been reported to be an effective therapy for painful oral (mouth) ulcerations associated with AIDS that do not respond to the usual treatment options available. Thalidomide was first developed and marketed in Germany in the 1950s as a sedative. It was withdrawn in 1962 when it was recognized to cause birth defects. Possessing no antibacterial activity, thalidomide is now used to treat a variety of diseases with an autoimmune character. It is unclear how it works to modulate the immune system or whether or not it will accelerate the deterioration of the immunological status of HIV-positive patients. One study suggests that it may suppress HIV viral replication and decrease viral burden. Thalidomide inhibits tumor necrosis factor (TNF). It affects the nervous system, often causing side effects such as drowsiness, dizziness, decreased libido and mood changes, as well as peripheral neuropathy. However, most of the neuropathy cases occurred in patients who had received a high dose for longer than six months. Response to thalidomide occurs at doses ranging from 100mg a day to 400 mg a day, with ulcer pain resolving within two to four days. Randomized placebo-controlled, double-blinded studies are needed to evaluate the efficacy of thalidomide in HIV-positive persons with aphthous ulcers. The AIDS Clinical Trials Unit is doing a six month study comparing thalidomide to placebo for treatment of aphthous ulcers of mouth and esophagus.
 ...
PMID:Thalidomide: an alternative therapy for treatment of apthous ulcers (canker sores). 1136 97

Combination drug therapy and enhanced patient management techniques result in increased survival for many AIDS patients. This phenomenon has brought the issue of fatigue, a common and difficult side effect of HIV/AIDS treatment, to the forefront. Three-quarters of the AIDS patients surveyed in a recent study indicated that fatigue negatively affects their quality of life and influences their willingness to continue aggressive treatment. New advances for combating fatigue include the use of nutritional therapy, anti-depressants, anti-infectives, medications that boost the production of red blood cells, hormone replacement, exercise, massage, and acupuncture. The most common source of fatigue in HIV-positive patients is anemia, which also causes shortness of breath and dizziness. Anti-HIV medications may inhibit red blood cell production. An alternative treatment, Epoetin alfa, works by increasing low levels of naturally producing erythropoietin, a protein manufactured in the kidneys. Fatigue resulting from low testosterone levels can be treated with anabolic steroids. Poorly functioning adrenal glands can be the cause of fatigue in patients with advanced disease. Taking hydrocortisone pills is often effective. Depression is the fourth most common cause of fatigue. Antidepressants work well without traditional side effects.
 ...
PMID:More awareness needed in treatment of fatigue. 1136 53

Certain HIV drugs have significant side effects. There have been reports from Europe that some hemophiliacs using protease inhibitors suffered from spontaneous bleeding. Clofazimine, sold as Lamprene, has been shown to cause harm when used with clarithromycin and ethambutol to treat MAC. Lamprene may cause internal bleeding, nausea, diarrhea, dizziness, drowsiness, and dry skin. Results of a Taiwanese trial of thymosin-alpha indicate that it did not help treat Hepatitis B in a statistically significant way. NAC, an antioxidant, may increase glutathione levels and indirectly increase survival.
 ...
PMID:Pot shots. 1136 15

Four new drugs have been developed to overcome the limitations of the currently available anti-HIV drugs, including inconvenient schedules, side effects, and drug interactions. It is hoped that abacavir, efavirenz, adefovir dipivoxil, and amprenavir will be widely available in the near future. Abacavir, a nucleoside reverse transcriptase inhibitor with a twice-daily schedule, offers good bioavailability and generally mild side effects. Efavirenz, a non-nucleoside reverse transcriptase inhibitor with a once daily schedule, may produce side effects such as rash and dizziness. Adefovir dipivoxil, a nucleotide analog with once daily dosing, can cause carnitine depletion and carnitine supplementation is recommended. Amprenavir, a protease inhibitor with twice-daily dosing, has rather mild side effects. Information on efficacy, availability, and resistance for each of these drugs is given.
 ...
PMID:Antiretroviral agents: the next generation. 1136 27

The U.S. Food and Drug Administration (FDA) has approved Sustiva (efavirenz) as the first HIV drug to have a once-daily dosing schedule. The drug, developed by DuPont Pharmaceuticals, is a non-nucleoside reverse transcriptase inhibitor (NNRTI) and will be used in combination with other anti-HIV drugs for both adult and pediatric patients. Results from clinical trials show that Sustiva reduces plasma viral loads to below quantifiable levels in a majority of treatment naive and experienced individuals in two, three, and four drug combinations. It can be taken with or without food, although high fat meals may interfere with absorption and should be avoided. The drug is generally well tolerated, with the most significant side effects being nervous system related, such as insomnia and dizziness. Mild to moderate skin rashes were also reported in one out of four patients. Women should not become pregnant while taking Sustiva because birth defects have been noted in animal studies. Contact information is provided.
 ...
PMID:FDA approves Sustiva (efavirenz) capsules, first once-daily anti-HIV drug. Food and Drug Administration. 1136 15

The Food and Drug Administration (FDA) approved DuPont Pharma's new non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva, DMP-266). Efavirenz has shown promise in trials with over 2000 participants for up to 24 weeks, and early data suggests it may be as effective as protease inhibitors when used in a combination regimen. It is the first anti-HIV drug approved for once-daily dosing. Efavirenz is well tolerated, and the main side effects reported are dizziness, insomnia, abnormal dreams, and skin rash. Efavirenz has been approved for adults and children, but should not be used by pregnant women. Contact information is provided.
 ...
PMID:FDA approves efavirenz. Food and Drug Administration. 1136 87

We assessed the impact of an efavirenz-containing regimen versus a protease inhibitor-containing regimen on quality of life, emotional status, and adherence of HIV-1-infected patients. In addition, we sought to define the adverse events associated with these treatments, with a special focus on central nervous system disorders in the efavirenz treatment group. This prospective, randomized, two-arm, controlled study included 100 patients for whom initial treatment with a protease inhibitor-containing regimen failed. Patients were randomized to start treatment with two nucleoside retrotranscriptase inhibitors plus efavirenz (group 1; 51 patients) or two nucleoside retrotranscriptase inhibitors plus one or more new protease inhibitors (group 2; 49 patients). Quality of life was assessed by a five-point item adapted from the HIV questionnaire of the Medical Outcomes Study, emotional status was evaluated by the Profile of Mood State questionnaire, and patients self-reported adherence. Data were analyzed by both an as-treated method and an intention-to-treat-last observation carried forward method. Patients in group 1 reported the following findings at week 4: dizziness (66%), abnormal dreaming (48%), light-headedness (37%), and difficulty sleeping (35%). At week 24, dizziness (13%; p <.001), abnormal dreaming (18%; p =.002), light-headedness (13%; p =.01), difficulty sleeping (7%; p =.001), and nervousness (13%; p =.01) decreased in these patients. Irritability, abnormal dreaming, and nervousness persisted at week 48 in 13%, 10%, and 8% of group 1 patients, respectively. Patients in group 2 reported the following findings at week 4: light-headedness (8%), dizziness (5%), difficulty sleeping (4%), nervousness (4%), and headaches (3%). Patients in group 2 reported the following findings at week 48: difficulty sleeping (4%), nervousness (3%), headaches (3%), and light-headedness (2%). In group 1, quality of life (p <.001) and emotional status (week 48; p =.004) improved, both of which were better than those in group 2 (p =.001). Both groups maintained high levels of medication adherence, and no significant differences in the number of patients who had viral loads of <200 copies/mL at week 48 were found (78% of group 1 patients vs. 85% of group 2 patients; p = not significant). At week 48, the mean CD4 cell count +/- SD was 497 +/- 224/mm3 in group 1 and 539 +/- 298/mm3 in group 2 (p = not significant). Despite similar immunologic and virologic outcomes, a second-line efavirenz-containing regimen improved quality of life of HIV-1-infected patients compared with a second-line protease inhibitor-containing regimen. However, close follow-up of patients receiving treatment with efavirenz-based regimens is recommended, especially for those with previous emotional disturbances due to central nervous system disorders in the short term and those with persistence of a low percentage of these disorders in the long term.
 ...
PMID:Quality of life, emotional status, and adherence of HIV-1-infected patients treated with efavirenz versus protease inhibitor-containing regimens. 1187 73

The Contraceptive Report has published a 2-page pamphlet for physicians to distribute to patients considering contraceptive implants. Implants are effective for up to 5 years and consist of 6 small, soft, flexible plastic rods. Trained clinicians insert them under the skin of a woman's upper arm. Women have used implants for 20 years. The US approved them several years ago. As of mid 1993, about 800,000 US women have used implants. The rods slowly release a progestin into the body which suppresses ovulation and thickens cervical mucus. Insertion lasts 10-15 minutes and takes place in a physician's office. Physicians anesthetize the skin beforehand. After a week or so, the incision should heal. The rods will not burst or migrate under the skin. If a woman wants to stop using implants, they can be removed at any time. Removal lasts 20-30 minutes. Changes in the menstrual cycle (e.g., irregular and unpredictable bleeding or no bleeding at all) are the most frequent side effects. These effects tend to lessen with time and are not harmful. Some women experience nausea, headache, nervousness, dizziness, and weight gain. Implants are very effective at preventing pregnancy and very convenient. Incorrect use or forgetfulness are not problems for women using implants. As soon as the physician removes the implants, fertility resumes. Contraceptive implants do not protect against sexually transmitted diseases or HIV/AIDS, so women should use condoms to provide this protection. To determine whether contraceptive implants are an option, women should first discuss it with their health care provider.
 ...
PMID:Facts about contraceptive implants. 1228 27

Human immunodeficiency virus (HIV) protease inhibitors are prone to drug interactions with other agents. As individuals with HIV infection live longer, the clinical significance of many interactions is becoming recognized. A 51-year-old man with HIV infection who was receiving extended-release nifedipine developed symptomatic orthostasis and heart block after starting antiretroviral therapy that included nelfinavir. He experienced dizziness, fatigue, and hypotension and developed complete heart block with a junctional escape rhythm. Electrocardiogram abnormalities abated within 24 hours of discontinuing antiretroviral therapy. The patient developed orthostatic symptoms after restarting nelfinavir. He was switched successfully to an efavirenz-based regimen. Subsequent administration of antiretroviral therapy containing ritonavir and indinavir with extended-release nifedipine resulted in recurrence of his orthostatic symptoms. Discontinuation of atenolol, and nifedipine dosage reduction by 50% were effective in managing his orthostatic changes. Careful monitoring by clinicians is necessary when concomitant administration of HIV protease inhibitors are prescribed with other agents that are metabolized through the cytochrome P450 system.
 ...
PMID:Symptomatic orthostasis with extended-release nifedipine and protease inhibitors. 1238 81

Stavudine administered once daily is a nucleoside analogue reverse transcriptase inhibitor. The efficacy (reduction in viral load and increase in CD4+ lymphocyte counts from baseline) of stavudine once daily-containing triple therapy was similar to that of stavudine immediate release (IR)-containing triple therapy in the treatment of antiretroviral-naive patients with HIV infection in two 48-week, randomised, double-blind trials. In the largest trial (n = 783), 80% of patients receiving stavudine 75 or 100mg once daily in combination with lamivudine 150mg twice daily and efavirenz 600mg once daily, and 75% of patients receiving stavudine IR 30 or 40mg twice daily-containing combination therapy, had HIV RNA levels reduced to below the limit of quantification at 48 weeks (<400 copies/ml; intent-to-treat analysis). These findings are supported by those from the smaller trial in 150 patients. Stavudine once daily triple therapy was well tolerated, with the incidence of adverse events being similar to that with stavudine IR. Grades 2-4 treatment related adverse events occurring in > or =3% of patients in either group were dizziness, rash, abnormal dream, headache, insomnia, fatigue and peripheral neurological symptoms. Peripheral neurological symptoms occurred in 3% of patients receiving long-term treatment with stavudine once daily and 6% of patients receiving stavudine IR in a combined analysis.
 ...
PMID:Stavudine once daily. 1246 9


<< Previous 1 2 3 4 5 6 7 Next >>