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)

The last years witnessed significant change in therapeutic and infectious pathology of man, its immunoreactivity changed, especially in elderly patients. Thus, older people show the increase of chronic infectious-inflammatory diseases, characterized by flaccid, constantly recurring course, torpid to adequate etiotopic therapy. They are caused by conventionally-pathogenic or opportunistic microbes, often with atypical biological properties, having multiple resistance to antibiotics. About 30 new pathogenic microorganisms were revealed for the last 20-30 years, including HIV-infection agent. The number of patients with allergic and autoimmune diseases increased, thus resulting in high urgency of this problem in gerontology. Decrease of immunologic reactivity, observed practically in all parts of the world, but mostly manifested in Russia, is one of the causes of infectious pathology, including pathology of inner organs, manifestation of allergic and autoimmune diseases. General practitioners, gerontologists understand that to cope with the increased rate of infectious, allergic or autoimmune diseases only by antibiotics or anti-inflammatory medicines is next to impossible. It's clear now that the use of only chemotherapeutic drugs in treatment of elderly and therapeutic patients is a mistake. Immunocorrective medicines, which stimulate reparative processes, allow to accelerate the processes of involution and shorten the general period of treatment. Antibiotic inhibits the agent multiplication, but its complete elimination from the body is a result of immune factors activity. In elderly patients with inner organ pathology and chronic pathology on the background of the suppressed immunoreactivity the effect of antibiotics, as well as antifungal, antiviral and other chemotherapeutic medicines is ineffective or of low effect. Optimal clinical effect in elderly patients can obviously be achieved only if there is synergism in the activity of the body protective forces and antimicrobial drugs. Thus, immunoreactivity dysfunction has a significant part in the pathogenesis of inner organ diseases in elderly patients with the disturbance of immunological status. So in complex of medical means, indicated for this pathology, adequate immunotherapy plays a special role, and the main problem is the choice of particular drugs.
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PMID:[Immunomodulators and cytokines in the treatment of internal diseases, associated with immunologic status disturbance in elderly patients]. 1555 4

Optimal generation of cytotoxic T cell (CTL) responses continues to be a challenge in the production of vaccines against pathogens such as HIV-1, in part because it is difficult to introduce soluble protein antigens (Ag) into the MHC class I pathway. Using heat-killed Brucella abortus (HKBA) as an adjuvant and ovalbumin (ova) protein as an Ag, we demonstrated that a high dose of Ag was required for systemic and effective CTL. In an adoptive transfer model, primary and secondary ova-specific OT-1 CD8 cell expansion by HKBA plus high dose of ova were partially CD4 T cell-dependent. Interestingly, primary stimulation with HKBA plus ova allowed effective secondary stimulation with ova alone that was equivalent to HKBA plus ova in terms of IFN-gamma production from Ag-specific CD8 cells. Thus a combination of adequate Ag dose, and selection of appropriate adjuvants can meet the threshold not only for primary effective CTL responses to soluble protein Ags but for secondary CTL responses following stimulation with protein Ag alone.
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PMID:Programming of CTL with heat-killed Brucella abortus and antigen allows soluble antigen alone to generate effective secondary CTL. 1570 79

Dendritic cells (DCs) loaded with viral peptides are a potential form of immunotherapy of human immunodeficiency virus type 1 (HIV-1) infection. We show that DCs derived from blood monocytes of subjects with chronic HIV-1 infection on combination antiretroviral drug therapy have increases in expression of HLA, T-cell coreceptor, and T-cell activation molecules in response to the DC maturation factor CD40L comparable to those from uninfected persons. Mature DCs (mDCs) loaded with HLA A*0201-restricted viral peptides of the optimal length (9-mer) were more efficient at activating antiviral CD8(+) T cells than were immature DCs or peptide alone. Optimal presentation of these exogenous peptides required uptake and vesicular trafficking and was comparable in DCs derived from HIV-1-infected and uninfected persons. Furthermore, DCs from HIV-1-infected and uninfected persons had similar capacities to process viral peptides with C-terminal and N-terminal extensions through their proteasomal and cytosolic pathways, respectively. We conclude that DCs derived from HIV-1-infected persons have similar abilities to process exogenous peptides for presentation to CD8(+) T cells as those from uninfected persons. This conclusion supports the use of DCs loaded with synthetic peptides in immunotherapy of HIV-1 infection.
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PMID:Processing and presentation of exogenous HLA class I peptides by dendritic cells from human immunodeficiency virus type 1-infected persons. 1570 25

Cryptococcal meningitis is a common opportunistic infection in AIDS patients, particularly in Southeast Asia and Africa. Cases also occur in patients with other forms of immunosupression and in apparently immunocompetent individuals. Mortality from HIV-associated cryptococcal meningitis remains high (10-30%), even in developed countries, because of the inadequacy of current antifungal drugs and the complication of raised intracranial pressure. In cohorts of HIV-infected patients from sub-Saharan Africa, cryptococcosis has accounted for 13-44% of all deaths. Optimal current therapy is with amphotericin B 0.7-1 mg/kg/day plus flucytosine 100 mg/kg/day for 2 weeks, followed by fluconazole 400 mg/day for 8 weeks and 200 mg/day thereafter. Saline loading reduces amphotericin B nephrotoxicity. If there is no contraindication on CT head scan, repeat lumbar puncture with drainage of cerebrospinal fluid (CSF) is recommended for patients with very raised CSF opening pressure. Expansion of antiretroviral programmes raises the prospect of transforming the long-term prognosis of these patients, provided that they survive the acute phase of the illness. Studies are needed to define more fungicidal drug regimens and to improve the treatment of raised intracranial pressure.
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PMID:Cryptococcal meningitis. 1583 17

The vast majority of HIV-infected women are of childbearing potential, so issues surrounding reproduction and mother-to-child transmission of the virus are critical in the management of this population. Optimal antiretroviral management of pregnant women is a major global issue since antiretroviral regimens offered to pregnant women to decrease mother-to-child transmission in many countries are often not highly active against HIV. The subsequent emergence of resistant virus can have long-term sequelae for the mother, child, and ultimately, other exposed individuals. The efficacy of antiretroviral therapy appears similar in men and women, although women may experience higher toxicity profiles, which may, in turn, be related to the higher antiretroviral concentrations shown in pharmacokinetic studies. Further investigation into gender-related issues, including sex-associated antiretroviral toxicities, unique pharmacokinetic profiles and optimal antiretroviral management during pregnancy is needed.
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PMID:Gender-specific considerations in the antiretroviral management of HIV-infected women. 1591 79

Antiretroviral treatments have transformed the prognosis for patients with HIV infection. However, because the treatment is only virostatic and has substantial side effects, especially in the long term, it should not be proposed to all HIV-infected patients but only to symptomatic patients or asymptomatic patients with immune deficiency (CD4 cell count < 350/mm3). The aim of antiretrovirals is to lower the viral load to undetectable levels for prolonged periods and thus enable immune reconstitution and prevent selection of resistant mutants. In initiating treatment, the preferred options are a combination of 2 HIV nucleoside reverse transcriptase inhibitors associated with either a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor, the latter with a low dose of ritonavir. Optimal compliance is the key to successful treatment and requires that the aims of the antiretroviral therapy be clearly explained to the patient. Treatment failure usually occurs in two types of situations. Failure after an initial regimen is often related to poor compliance and sometimes to interactions between drugs. Conversely, in patients for whom several regimens have failed, the accumulation of resistant mutations compromises the antiretroviral activity. Genotype resistance tests help in the choice of a new treatment regimen that should ideally include at least 2 active molecules. In these situations the new antiviral drugs with novel mechanisms of action, such as the entrance inhibitors, are clearly of interest.
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PMID:[Treatment of the human immunodeficiency virus in adults in 2005]. 1602 66

Assay protocols of three rapid human immunodeficiency virus (HIV) assays, OraQuick-1/2, SeroStrip-1/2, and Determine-1/2, were modified to detect recent HIV seroconversion using a higher dilution of serum specimens. Optimal predilution of specimens resulted in negative test results during early periods of seroconversion (about 6 months), when antibody levels were low. A total of 269 seropositive specimens from routine HIV type 1 testing and from commercial sources (low-titer and seroconversion panels) were tested, and results were recorded as negative (score=0) or positive using intensity scores from 0.5 (weak positive) to 4 (strongly positive). The same specimens were previously tested by a less sensitive (LS) enzyme immunoassay (EIA), Abbott 3A 11-LS, and were classified as recent or long-term infections based on the standardized optical density (SOD) cutoff of 0.75. Overall concordance of >94% was observed between 3A 11-LS and modified rapid tests (RT-LSs) for detecting and distinguishing recent HIV seroconversion from long-term HIV infection (kappa statistics=0.894 to 0.901). Moreover, intensity scores on RT-LSs correlated well with median 3A 11-LS SOD values (R(2)>0.98). Our results indicate that rapid HIV tests can be modified to detect recent seroconversion with results comparable to those from less sensitive EIA.
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PMID:Modification of rapid human immunodeficiency virus (HIV) antibody assay protocols for detecting recent HIV seroconversion. 1608 8

Transgenic HIV-1-derived lentiviral particles are at the forefront of current gene therapy and tissue engineering initiatives, which will require optimal protocols for large-scale production of clinical-grade therapeutic lentiviruses. Production of latest-generation self-inactivating lentiviral particles requires cotransfection of mammalian production cell lines with two helper plasmids along with the lentivector, whose transgene-encoding expression cassette is the only genetic information stably transduced into target chromosomes. Capitalizing on a recently designed lentiviral expression vector family, we conducted rigorous analysis of production-relevant parameters including transfection, cell density, media composition, temperature, relative (helper) vector concentrations and genetic configuration. Comparative analysis of lentiviral particle performance (VP) was based on the viral titer (reflecting the number of transduction-competent lentiviral particles) relative to the number of lentiviral particles produced (correlating with p24 production levels) (VP=titer/viral particle number). Optimal lentiviral production parameters, resulting in up to 132-fold greater VP compared to standard protocols, required (i) CaPO4-based transfection (ii) of helper plasmids and lentivector at a fixed concentration ratio (helper plasmid I:helper plasmid II:lentivector=1:1:2) (iii) into 1x10(5) human embryonic kidney cells/cm2 (HEK293-T) (iv) cultivated at 37 degrees C (v) in Advanced D-MEM medium supplemented with (vi) 2% fetal calf serum, (vii) and a culture additive containing 0.01 mM cholesterol, 0.01 mM egg's lecithin and 1x chemically defined lipid concentrate. (viii) Furthermore, constitutive transgene expression units placed in a forward polyadenylation site (pA)-free orientation relative to the lentivector backbone resulted in optimal transgene transduction/expression. Our studies suggest that detailed knowledge of lentivector design and the production of lentiviral particles will advance large-scale manufacturing of clinically relevant lentiviruses for future gene therapy applications.
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PMID:Detailed design and comparative analysis of protocols for optimized production of high-performance HIV-1-derived lentiviral particles. 1610 93

Optimal perioperative care of the immunocompromised patient requires an understanding of the consequences of disease-specific pharmacologic therapies. The toxicity profile of these therapies can strongly influence the decision algorithms for delivering care in the perioperative period. In this manuscript, the investigators describe the potential effects of drugs commonly used for treatment of patients with cancer, HIV, or transplanted organs, and the impact of these drugs on the care of these patients in the perioperative setting. The article addresses such topics as cardiotoxicity, pulmonary toxicity, hepatotoxicity, genitourinary toxicity, neurotoxicity, myelosuppression, cutaneous toxicity, mitochondrial toxicity, lipodystrophy, hypersensitivity, and liver dysfunction. The article also describes the use of corticosteroids, calcineurin inhibitors, sirolimus, and antimetabolites.
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PMID:Perioperative management of special populations: immunocompromised host (cancer, HIV, transplantation). 1632 7

Good nutrition is key to a healthy lifestyle, regardless of whether one is living with HIV/AIDS. Optimal nutrition can help boost immune function, maximize the effectiveness of antiretroviral therapy, reduce the risk of chronic illnesses such as diabetes and cardiovascular disease, and contribute to a better overall quality of life. In the early years of the AIDS epidemic, many people with HIV were dealing with wasting and opportunistic infections (OIs) linked to unsafe food or water. While these problems are less common today in developed countries with widespread access to highly active antiretroviral therapy (HAART), many HIV positive people have traded these concerns for worries about body shape changes, elevated blood lipids, and other metabolic complications associated with antiretroviral therapy. Fortunately, maintaining a healthy diet can help address these problems. As HIV positive people live longer thanks to effective treatment, good nutrition can also help prevent problems (such as bone loss) associated with normal aging. But there is no single, optimal eating regimen appropriate for every person living with HIV/AIDS. Instead, HIV positive people should adopt a sensible balanced diet and consult an experienced nutrition specialist for individualized recommendations.
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PMID:Nutrition and HIV. 1661 Jan 16


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