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

Development of a safe and effective AIDS vaccine remains a critical issue, particularly in developing nations where HIV infections will account for 90 percent of all new infections by 2000. The AIDS Vaccine Evaluation Group (AVEG) is conducting phase I and II studies of several candidate HIV-1 vaccines. Technical and ethical issues, including significant problems that need to be addressed in vaccine trials, are discussed. The safety of the current candidate vaccines, their immunogenicity, and the continued spread of HIV-1 in spite of educational efforts indicate that clinical trials are warranted. An extensive bibliography of articles related to vaccine development is included.
STEP Perspect 1997
PMID:Update on HIV vaccines. 1136 29

The Primary Infection Clinic began tracking the natural history of early acute HIV infection in September 1992. Since then, extensive knowledge surrounding acute or primary HIV has been gathered, describing complex clinical symptoms. Variation of symptoms and severity of illness is marked, although comparisons with similar programs in Switzerland and Australia show the same degree of variation. Recent data suggests that people with more severe early symptoms are more likely to rapidly progress to clinical AIDS. There is a strong need to identify these individuals and offer them early treatment. Data also shows that only about half of the HIV-infected people who seek medical care for symptoms are offered HIV screening. Patients referred to the Primary Infection Clinic are interviewed on behavior and risk factors, must sign consent forms for a number of tests, and are enrolled in a program to track their medical progress. Volunteers will be enrolled in ongoing studies designed to observe clinical as well and viral and immunologic parameters of early intervention. A contact telephone number is included for further information.
STEP Perspect 1997
PMID:Primary infection clinic enrolling for NIH studies. National Institutes of Health. 1136 35

People with HIV are also frequently co-infected with herpes simplex viruses (HSV), although the interactions between the two are not fully understood. Evidence suggests that HSV is a risk factor for the transmission of HIV, is a common opportunistic pathogen in HIV-infected persons, and that HSV reactivation appears to regulate HIV replication. The clinical significance of these interactions is not well defined. Current information about the HSV-HIV interaction is reviewed, and future research projects are suggested. Advanced HIV infection has been associated with genital herpes, and unusually severe outbreaks of genital herpes and persistent herpetic ulcerations are an AIDS-defining diagnosis. Chronic anti-HSV therapy may be beneficial in some persons with HIV. Studies are being designed to address some of the outstanding issues in understanding the links between the two infections, and potential volunteers in the trials are invited to participate. Contact the University of Washington Virology Research Clinic for further information.
STEP Perspect 1997
PMID:HSV-2 and HIV: consequences of an endemic opportunistic infection. 1136 36

Although HIV can only become drug-resistant if it is actively replicating, the trend in viral load testing to report HIV levels as below detectable levels is misleading. The most frequently used test is sensitive only to more than 500 viral copies, and ultra-sensitive tests will detect viral loads below 20. Patients need to be informed that in both cases, the virus remains in the patient and is subject to mutation and resistance. Treatment failures can be attributed to noncompliance, drug absorption rates, drug activation, the patient's metabolic rate, interactions with other drugs, and resistance. The results reported from some clinical trials may be artificially high because of the stringent selection requirements for volunteers, insuring that the test group is initially relatively healthy.
STEP Perspect 1997
PMID:HIV drug resistance and the other causes of treatment failure. 1136 37

Researchers have recently found sequences of viral DNA in Kaposi's sarcoma (KS) lesions. This viral DNA was found to belong to a new virus in the herpesvirus family. Other investigators found human herpesvirus-8 (HHV-8) in almost all KS lesions, and there are two reports of researchers who have successfully grown HHV-8 virus in the laboratory. KS is likely to be transmitted by sexual contact, and is found most commonly in gay men with HIV and in organ transplant patients, whose immune systems are suppressed to prevent rejection. Much more work needs to be done on HHV-8 immunosuppression and infection. Laboratory studies suggest that it is susceptible to ganciclovir, foscarnet, and cidofovir, and resistant to acyclovir. It remains unclear if antiviral treatment can prevent KS.
STEP Perspect 1997
PMID:What's new in Kaposi's sarcoma research. 1136 38

HIV-positive individuals are at high risk of developing an anxiety disorder, with a prevalence rate as high as 38 percent. The symptoms may occur anytime during the course of the infection, and can become excessive in some patients, impairing the person's ability to cope with their circumstances. Signs and symptoms include chest pain, headache, numbness, and insomnia. HIV treatments that may cause anxiety symptoms include ddI, d4T, AZT, fluconazole, foscarnet, and isoniazid. Health care providers need to thoroughly evaluate anxiety symptoms during an initial evaluation to rule out substance abuse and pre-existing anxiety. Treatment of anxiety in HIV/AIDS ranges from benzodiazepines to alternative therapies such as massage and acupuncture. A chart lists potential drug interactions between common antidepressive and HIV antiretroviral drugs.
STEP Perspect 1998
PMID:Anxiety and HIV infection. 1136 9

Dr. Mark Gilbert, Medical Director of the biopharmaceutical company Immunex, explains that Highly Active Antiretroviral Therapy (HAART) has provided a foundation to begin addressing the effects of therapy on the immune system. Immunex is focusing on the role that Leukine, a recombinant, yeast-derived GM-CSF, has on both advanced AIDS and the early onset of HIV. A Phase III trial is evaluating whether Leukine can reduce the incidence of opportunistic infections and death in 300 people with AIDS. Dr. Gilbert discusses the importance of the thymus for T cell development and its effect on immune system functions. Immunex is searching for a method to either maintain or to restore the immune system. Restoring the thymus may restore host immunity; however, very little is known about the thymus. According to Gilbert, the most promising idea for restoring immune function is intermittent low-dose interleukin-2 (IL-2). HIV-positive individuals using HAART therapy should consider talking to a health care provider about immune modulation therapy.
STEP Perspect 1998
PMID:A view of the future: Dr. Mark Gilbert of Immunex talks about immune based therapy. Interview by Robert Nielsen. 1136 10

Highly elevated triglyceride levels being reported in HIV-infected people are a concern because they can contribute to heart disease, stroke, and pancreatitis. The elevated levels may be the result of medication on the liver, dietary habits, or malabsorption of key nutrients. Preliminary studies have shown that dietary and vitamin supplements may help lower the levels to a more normal and safe range. Strategies to reduce triglyceride levels are described.
STEP Perspect 1998
PMID:High triglyceride levels: their danger and what can be done. 1136 11

During the past two years, two new classes of drugs have emerged that are effective in treating HIV infection. Since protease inhibitors and non-nucleoside reverse transcriptase inhibitors are highly effective but difficult to take, pharmaceutical manufacturers have developed new formulations of some of these drugs. People taking AZT and ritonavir can sometimes switch to a product called Combivir, a combination of the two. Saquinavir patients may be able to switch to a gel formulation of the same drug, Fortovase, that is more readily absorbed by the body. Potential side effects and impacts on treatment are reviewed.
STEP Perspect 1998
PMID:New ways to take old drugs. 1136 12

Dr. Ronald Moss, Senior Director of Medical and Scientific Affairs at the Immune Response Corporation, provides his opinions on immune restoration and a different approach to immune-based therapies. Dr. Moss explains why he thinks Remune is an effective immune-based therapy rather than a vaccine. Remune will allow the immune system to return to its normal functions as if it were healthy. The reasons that Remune does not evoke a strong antibody response and why it helps the body create more HIV-specific T-cells are explained. The major benefits and side effects of using Remune are detailed. How effectiveness of immune-based therapies can be measured, who would be appropriate for Remune therapy, and the status of Remune clinical trials are also discussed.
STEP Perspect 1998
PMID:Rebuilding the immune system: promising new therapy uses the HIV virus itself to awaken the damaged immune system. Interview by Brian Coppedge and Dan Dawson. 1136 40


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