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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The recent approval of three protease inhibitors introduces a welcome element of choice into HIV treatment programs. Ritonavir (Norvir), indinavir (Crixivan), and saquinavir (Invirase) all prevent HIV from replicating, leading to lower viral loads and a slower disease progression. However, patients must continue taking the drugs once they begin therapy; stopping the treatment or reducing the dosage can lead to resistance. Long term data is not yet available on toxicity or drug interactions. All three drugs are most effective when used in combination therapy.
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PMID:Freedom of choice. 1136 32

The growing chasm between therapeutic options in Europe and America is causing anger and desperation among HIV-infected Europeans and their physicians. Many European doctors and activists accuse Abbott Laboratories and Merck, with the help of Food and Drug Administration (FDA) decisionmaking, of being primarily committed to ensuring that the U.S. market is fully supplied with therapeutic drugs, no matter what the cost is to Europe. Both companies deny any such plans and reveal their manufacturing and supply plans for Norvir (Abbott) and Crixivan (Merck) for the near future in order to meet the needs of the entire AIDS community. The International Association of Physicians in AIDS Care is calling for the replacement of the expanded-access model with a global drug rationing agency which would approve and supervise the distribution of drugs for compassionate use.
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PMID:Europeans outraged over expanded access. 1136 19

A small clinical trial testing a combination of ritonavir, or Norvir, and nucleoside analogs in newly infected HIV patients has shown that the therapy can lower the viral load to undetectable levels for up to two years. The trial, led by Dr. Martin Markowitz of the Aaron Diamond AIDS Research Center, may result in a standard of starting treatment as early as diagnosis. Studies are underway comparing newly infected patients treated with two combinations--ritonavir, zidovudine (AZT), and lamivudine (3TC) versus indinavir (Crixivan), AZT, and 3TC. The push to treat patients early increased in 1995 when Aaron Diamond researchers discovered that HIV begins replicating rapidly from the onset of infection. Moreover, as use of protease inhibitors gains steam, viral load testing will become an important tool for monitoring antiretroviral treatment and patient management. Studies have suggested, but not proven, that survival can be predicted by viral load. How viral load measurements will be used remains to be determined, but most researchers agree that they are useful when the burden is very high or very low.
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PMID:Success of combination therapy drives the push for earlier treatment. 1136 40

The Food and Drug Administration (FDA) approved two new protease inhibitors for treatment of AIDS. Ritonavir (Norvir) and indinavir (Crixivan) have been approved for both monotherapy and combination therapy, and appear to have relatively few side effects. Reports on clinical trials of both drugs are reported. Saquinavir (Invirase) also has FDA approval, but currently has a low absorption rate; better formulations are expected to increase absorption. Early trials indicate that triple drug combinations may suppress HIV replication to very low levels.
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PMID:FDA approves 2 new protease inhibitors: ritonavir (Norvir) and Crixivan (Indinavir sulfate). Food and Drug Administration. 1136 92

Some of the most dramatic reductions in HIV viremia have been observed among patients treated with indinavir sulfate (Crixivan). How the hypothesis that HIV protease maintains the infectious nature of the virus led to Merck's development of indinavir is discussed. Also examined are results of the early clinical studies on indinavir's safety and pharmacokinetics, and research into the dynamics of HIV replication and the mechanisms of resistance. Several studies are highlighted that demonstrate the effectiveness of indinavir in reducing plasma viremia and increasing CD4 cell counts, thus providing the basis for marketing approval. Descriptions of ongoing clinical trials of indinavir, both open and closed trials, are listed, including duration, end points, sites, and contacts.
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PMID:Indinavir: lightening the load. 1136 59

The Food and Drug Administration (FDA) approved two new protease inhibitors--ritonavir and indinavir--for the treatment of HIV infection in adults. Ritonavir (Norvir), developed by Abbott Laboratories, received full approval for use alone or in combination with nucleoside analogue medications in patients with advanced HIV disease. Two encouraging studies on ritonavir are described. An ongoing phase III trial showed mortality to be 43 percent lower than for patients receiving standard therapy alone. In a separate study, untreated HIV-infected individuals who were given a triple combination of ritonavir plus AZT and ddC showed significant increases in CD4+ T cells counts and decreases in viral load for at least six months. Indinavir (Crixivan), developed by Merck, received accelerated approval for monotherapy and combination therapy for the treatment of HIV infection in adults when therapy is warranted. New data on indinavir showed decreases in levels of HIV in 22 out of 25 patients who had taken a triple combination of indinavir, AZT and 3TC. In another study of patients taking a combination of indinavir, ddI, and AZT, 60 percent of the patients' HIV levels were reduced to undetectable levels. In addition to ritonavir and indinavir, saquinavir (Invirase, Hoffmann-La Roche) is another protease inhibitor approved for use in conjunction with nucleoside analogues for the treatment of HIV infection.
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PMID:Two new protease inhibitors approved by FDA. Food and Drug Administration. 1136 99

The AIDS Clinical Trials Group (ACTG) will begin in October 1996, a new clinical trial that will compare three long-term maintenance regimens. Recruits in the randomized double-blind study, ACTG 343, will receive induction therapy with AZT, 3TC, and indinavir (Crixivan; IDV), the Merck protease inhibitor. Volunteers with an undetectable HIV RNA after 6 months will be randomized to one of three maintenance regimens: AZT/3TC vs. IDV alone vs. continuing on AZT/3TC/IDV. Treatment will be withdrawn from subjects with undetectable HIV RNA at 6-month intervals, after the initial 6-month maintenance therapy. If any virus is detected, the combination of AZT/3TC/IDV will be resumed. The investigators hope to compare the proportion of patients who sustain suppression of HIV RNA among the three regimens during the maintenance phase and after therapy is withdrawn.
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PMID:Eradication of HIV: the cutting edge of clinical trial design. 1136 25

Treatment with protease inhibitors, drugs that inhibit HIV protease, an essential enzyme for the survival of the HIV virus, decreases HIV to undetectable levels and has generated great optimism. Although far from finding a cure, these findings are steps toward understanding HIV. In December 1995, the Food and Drug Administration (FDA) approved saquinavir, followed by Norvir and Crixivan, all of which are protease inhibitors. Although the availability of these drugs varies, efforts are being made to provide the drugs to everyone. President Bill Clinton has asked Congress to approve $52 million, a 50 percent increase for AIDS research, to assist people who need these drugs throughout the country. In Latin America, efforts have been made to approve these drugs. According to Miklos Salgo, director of virology at Hoffmann-La Roche, Brazil has been the first country in Central and South America to approve saquinavir. Other scientists are optimistic that these new drugs will arrive in Latin America within a year.
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PMID:[New drugs, new obstacles in the fight against HIV]. 1136 89

Scientists have tried to inhibit or slow down the HIV virus ever since the virus was identified as the cause of AIDS. Although the efforts have not produced a long-term solution, significant progress has been made. There is a correlation between the increase in HIV levels and the advanced state of the disease. Antiviral therapies are discussed, including when to start the treatment, what drugs to use, and how to find out if the treatment is working. Some of the drugs seem to stop the replication of the HIV virus; however, they do not eradicate the virus. AZT (zidovudine/Retrovir), ddI (didadosine/Videx), ddC (zalcitabine/Hivid), d4T (stavudine/Zerit) and 3TC (lamivudine/Epivir) are some of the most common drugs on the market today. Information on research, side effects, doses, interactions with other drugs, and where to get these drugs is provided. Protease inhibitors, another type of drug, include saquinavir, ritonavir and indinavir (Crixivan). Much research has been done with these drugs, however, they are very difficult to produce. The combination of AZT and 3TC have shown positive results, and the future of antiviral therapies seems to be heading toward combination therapy.
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PMID:[ABC of the antivirals] Project Inform. 1136 92

New treatments that are available promoted optimism at the XI International Conference on AIDS, held in Vancouver in July 1996. Topics that were presented at the conference are highlighted, including a global analysis of the epidemic, possible eradication of the virus, pathogenesis of the HIV virus, detection of the viral load change in the blood, and the status of protease inhibitors. A brief report on the combination and activity of Crixivan, AZT and 3TC is presented. The dangers of opportunistic infections such as Pneumocystis carinii pneumonia (PCP), Mycobacterium avium complex (MAC) and cytomegalovirus (CMV), are addressed in detail.
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PMID:[The new age of HIV/AIDS. A special report on the XI International Conference on AIDS]. 1136 80


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