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

A 40-year-old HIV-infected woman developed nausea, vomiting, and epigastric pain and died following her third dose (per study protocol) of interleukin (IL)-2. Her HIV infection was diagnosed in 1996. Her last CD4 cell count was 390/microL, and her viral load was negligible (as of November 28, 1998). She had no known general risk factors for thrombosis other than HIV infection, injection drug abuse, and antiretroviral therapy with indinavir. Abdominal films showed no sign of mechanical obstruction but a generalized gas distention of the bowel, which was suggestive of paralytic ileus. Autopsy revealed dilation of the small bowel with extensive necrosis and hemorrhage involving all the segments. The superior and inferior mesenteric arteries revealed severe atherosclerosis. The stenotic celiac artery was occluded by a recent thrombus at the aortic ostium. Clinicians need to be aware of the potential for thrombosis and accelerated atherosclerosis in HIV-infected patients. Both injection drug abuse and protease inhibitors, such as indinavir, have been shown to be risk factors for thrombosis. However, it is likely IL-2 contributed to the severe thrombosis in this patient, although definitive proof is lacking. An acute awareness of intestinal infarction in HIV-infected patients is warranted.
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PMID:Case report. Intestinal infarction due to vascular catastrophe in an HIV-infected patient. 1118 43

(+)-Calanolide A is a novel, naturally occurring, nonnucleoside inhibitor of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase first isolated from a tropical tree (Calophyllum lanigerum) in the Malaysian rain forest. Previous studies have demonstrated that (+)-calanolide A has specific activity against the reverse transcriptase of HIV-1 and a favorable safety profile in animals. In addition, (+)-calanolide A exhibits a unique HIV-1 resistance profile in vitro. The safety and pharmacokinetics of (+)-calanolide A was examined in four successive single-dose cohorts (200, 400, 600, and 800 mg) in healthy, HIV-negative volunteers. In this initial phase I study, the toxicity of (+)-calanolide A was minimal in the 47 subjects treated. Dizziness, taste perversion, headache, eructation, and nausea were the most frequently reported adverse events. These events were not all judged to be related to study medication nor were they dose related. While 51% of subjects reported mild and transient dizziness, in many cases this appeared to be temporally related to phlebotomy. Calculation of the terminal-phase half-life (t(1/2)) was precluded by intrasubject variability in the 200-, 400-, and 600-mg dose cohorts but was approximately 20 h for the 800-mg dose group. (+)-Calanolide A was rapidly absorbed following administration, with time to maximum concentration of drug in plasma (T(max)) values occurring between 2.4 and 5.2 h postdosing depending on the dose. Plasma levels of (+)-calanolide A at all dosing levels were quite variable; however, both the mean concentration in plasma (C(max)), and the area under the plasma concentration-time curve increased proportionately in relation to the dose. Although raw plasma drug levels were higher in women than in men, when doses were normalized for body mass, the pharmacokinetic profiles were virtually identical with those observed for males. In general, levels of (+)-calanolide A in human plasma were higher than would have been predicted from animal studies, yet the safety profile remained benign. In conclusion, this study demonstrated the safety and favorable pharmacokinetic profile of single doses of (+)-calanolide A in healthy, HIV-negative individuals.
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PMID:Safety and pharmacokinetics of single doses of (+)-calanolide a, a novel, naturally occurring nonnucleoside reverse transcriptase inhibitor, in healthy, human immunodeficiency virus-negative human subjects. 1130 99

With the identification of HIV-1 as the etiological agent of AIDS, infected people have pursued to varying degrees pharmaceutical treatment to arrest disease progress. This paper evaluates the use of AZT and other antiretroviral agents, as well as access to, and utilization of, medical and social services among intravenous drug users (IDUs) in Miami, Florida. An ongoing prospective study of street-recruited IDUs in Miami-Dade County identified 20 HIV-infected IDUs who had HIV disease (CDC classification IV), and took antiretroviral and other medications after intervention. Participants included 13 active and 7 inactive IDUs. Longitudinal data and in-depth interviews made possible detailed studies of participants during periods when they were taking antiretroviral medications. Those IDUs who are HIV-positive have also received intensive medical and social services. Participants in the study reported nausea, malaise, insomnia, and dysphoria upon initiating AZT therapy. Eleven readily attributed these symptoms to use of antiretroviral medications, primarily AZT. Nevertheless, 9 reported an overall positive impression of the drug's effects; seven despite initial negative reactions to the medication. These results, plus measurement of medication in the blood, indicate that the IDUs studied not only took the antiviral(s), but often were willing to do so in spite of this medication making them feel bad.
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PMID:Medication therapy among intravenous drug users (IDUs) with HIV infection. 1136 86

The nucleoside reverse transcriptase inhibitor 3TC (lamivudine) appears to induce unusually prolonged HIV suppression when used in combination with AZT, according to the results of four randomized clinical trials. The studies showed that 3TC and AZT had similar antiviral effects when used alone. However, investigators observed a substantial, prolonged increase in CD4 counts and a significant decrease in HIV RNA when the drugs were administered simultaneously. These benefits persisted in all study groups for the 24-week study period, and in several for the six-month follow-up period as well. The combination was well-tolerated by nearly 1000 AZT-naive and AZT-experienced subjects enrolled in these trials, with the most common adverse effects being nausea, vomiting and headaches. A possible explanation for the antiviral effect is suggested by the mutation at HIV codon 184 that is frequently observed in virions exposed to 3TC for extended periods of time. In vitro studies have shown that this mutation confers 3TC resistance. It may also counteract other mutations that would normally lead to AZT resistance, therefore enabling virions exposed to both drugs to remain effectively susceptible to AZT.
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PMID:Combination 3TC/AZT therapy shows promise. 1136 92

Cytovene (ganciclovir) capsules were approved by the Food and Drug Administration (FDA) on December 22, 1994 as an alternative to the intravenous formulation for maintenance therapy of CMV retinitis in patients with HIV disease. This treatment is limited to those whose retinitis is stable following appropriate IV induction therapy, and where the risk of more rapid disease progression is balanced by the benefit of avoidance of daily infusion. FDA approval also allows physicians to prescribe the capsules off-label as a prophylaxis against CMV retinitis. Clinical studies have shown that in patients taking the Cytovene capsules, the mean time to CMV retinitis progression was 5-12 days less than in those patients on the IV formulation. The major side effects of the Cytovene capsules were the same as those associated with IV formulation: granulocytopenia, anemia, and thrombocytopenia. Side effects unique to the oral treatment include diarrhea, fever, leukopenia and nausea. The benefits of Cytovene capsules are fewer serious incidents of sepsis, fewer catheter-related infections, and a lower incidence of both anemia and leukopenia.
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PMID:Cytovene capsules approved. 1136 95

Acupuncture, which is gaining credibility among the Western medical establishment, is just one element of traditional Chinese medicine (TCM) being used to treat fatigue, nausea, insomnia, diarrhea, menstrual problems, and HIV-related peripheral neuropathy. Acupuncture is often used in combination with exercise massage, meditation, and herbal therapy. Special combinations of Chinese herbs are used to treat HIV-conditions, promote digestion, increase energy, and fight fungal infections. "Enhance", "Resist", and "Combination A", are three such formulas. Another benefit of acupuncture and Chinese herbs is their ability to decrease side effects associated with Western medicine. The growing medical interest in acupuncture is evidenced in the progress of CPCRA 022, a phase II/III trial to study acupuncture alone or in combination with amitriptyline, an anti-depressant, as a treatment for peripheral neuropathy. The National Institutes of Health (NIH) recently awarded the Bastyr University in Seattle, with funds to study alternative therapies. Regardless of outcomes, these studies may encourage other organizations to pursue acupuncture trials.
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PMID:Prickly business. The finer points of acupuncture. 1136 4

It was reported at the 1995 Second National Retrovirus Conference that AIDS has now surpassed unintentional injury as the leading cause of death for male Americans between the ages of 25 to 44, and for women, AIDS is fourth behind unintentional injury. A study of multidrug resistant tuberculosis that showed improved survival rates as long as appropriate therapy began within four weeks of diagnosis was also presented. The current recommendation is to consider the PPD skin test positive in persons with HIV if the bump that appears is over five millimeters in diameter. A new ganciclovir implant study demonstrated the implant's effectiveness in preventing CMV disease progression with low rates of complications, suggesting implants should probably replace intravenous ganciclovir as maintenance therapy. Another study demonstrated the effectiveness of cidofovir as a treatment for CMV infection, indicating that cidofovir was appropriate as a salvage therapy for those failing ganciclovir and foscarnet. In vitro studies involving Taxol and Kaposi's sarcoma (KS) show partial responses (55 percent), and some disease stabilization (40 percent). Four of five patients with pulmonary KS responded with clearance of tumor lesions. The first randomized trial involving Loviride with zidovudine has shown a sustained increase in CD4 cells with headache, nausea, and diarrhea as the most common side effects. Preliminary assessments reveal a reduction in viral load using the combination as opposed to monotherapy. Additional Loviride combination trials are being planned in Europe.
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PMID:Second National Retrovirus conference: a further report. 1136 59

The American College of Traditional Chinese Medicine has been funded for three years to provide Chinese medical treatment to over 300 symptomatic HIV-positive patients. A recent study of the medical records of these patients, and of quarterly health surveys, has identified seven HIV-related conditions which appear to be most responsive to Chinese medicine: weight loss, diarrhea/loose stools, abdominal pain, nausea, headaches, enlarged lymph nodes, and neuropathy. For more information about the American College of Traditional and Chinese Medicine, individuals can call 415-282-9603. There is a trend toward coverage by insurers and third party payers to pay for alternative care such as traditional Chinese medicine. Companies are finding that they can save money by paying for alternative care which usually costs much less than Western medicine. Acupuncture is now covered by health insurance companies with home offices in California. For information on how to help expand health-care coverage for traditional Chinese medicine in San Francisco and California, call George Wedemeyer at 415-661-2080.
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PMID:Chinese medicine: where does it work best in HIV/AIDS? 1136 13

The Centers for Disease Control and Prevention (CDC) recommends that immunocompromised people avoid exposure to cryptosporidium in outbreak settings by drinking water that is boiled, filtered, or bottled. A parasite, cryptosporidium is spread when persons ingest infected feces of humans or animals, or eat raw or undercooked vegetables contaminated with an egg-like form of the parasite. Symptoms include watery diarrhea, headache, abdominal cramps, nausea, vomiting and low-grade fever; in immunocompromised patients infection often leads to weight loss, dehydration, and may become life-threatening. Drugs can treat the symptoms, although cryptosporidiosis is not curable and often recurs in severely immunocompromised patients. To prevent becoming infected; HIV-positive people should not drink water from lakes, rivers, and swimming pools; avoid unpasteurized milk or milk products; wash hands after contact with pets or with soil; and follow safe-sex guidelines. The CDC also recommends that in settings with an outbreak of cryptosporidium, individuals boil water for one minute to kill the parasite or use a filter for tap water that is capable of removing particles less than one micron in diameter. A third option is to use bottled water for drinking, although it is difficult to know which is safe since no organization regulates it.
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PMID:CDC provides guidelines on suspect water supplies. Centers for Disease Control and Prevention. 1136 76

The Food and Drug Administration (FDA) approved the first protease inhibitor, saquinavir, for combination treatment with approved nucleoside analogs in adults with advanced HIV. However, it denied the use of saquinavir as a monotherapy. Protease inhibitors prevent infected cells from reproducing viral particles. All saquinavir studies have used a dose of 600mg 3 times per day. Another formulation of saquinavir and higher dosages of the present formulation are being tested to increase the bioavailability. In AZT-naive patients, a combination of saquinavir and AZT produces better improvements in CD4 counts and in viral load reduction compared to either of the drugs alone. In patients with extensive prior AZT therapy, saquinavir in combination with ddC provided greater and longer surrogate marker benefits compared to either drug alone. Saquinavir also improved the activity of ddC plus AZT. The most common side effects were diarrhea and nausea. Altogether, only four percent of patients receiving saquinavir had side effects. Toxicity was not increased when saquinavir was added to AZT and ddC. Cross resistance to other PIs has been found, so the use of saquinavir may limit the benefits of future PIs.
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PMID:No tease this time--pros and cons of a long-awaited anti-HIV drug. 1136 18


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