RESUMO
The pandemic of HIV/AIDS continues to grow daily. Incident cases among women, intravenous drug users and ethnic minorities comprise the fastest growing segment of the HIV-infected population, and the number of HIV-infected individuals over the age of 50 is growing rapidly. Today, the central nervous system and the immune system are seen as main targets of HIV infection. Significant progress in the knowledge and treatment of AIDS has been obtained in recent years. The neurological manifestations directly related to HIV are acute viral meningitis, chronic meningitis, HIV-associated dementia (HAD), vacuolar myelopathy, and involvement of the peripheral nervous system.
Assuntos
Viroses do Sistema Nervoso Central/virologia , Infecções por HIV/complicações , HIV-1 , Complexo Relacionado com a AIDS/tratamento farmacológico , Complexo Relacionado com a AIDS/virologia , Antirretrovirais/uso terapêutico , Viroses do Sistema Nervoso Central/tratamento farmacológico , Viroses do Sistema Nervoso Central/metabolismo , Quimiocinas/imunologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Humanos , Meningite Viral/virologia , Pessoa de Meia-Idade , Fatores de Risco , Carga ViralRESUMO
The pandemic of HIV/AIDS continues to grow daily. Incident cases among women, intravenous drug users and ethnic minorities comprise the fastest growing segment of the HIV-infected population, and the number of HIV-infected individuals over the age of 50 is growing rapidly. Today, the central nervous system and the immune system are seen as main targets of HIV infection. Significant progress in the knowledge and treatment of AIDS has been obtained in recent years. The neurological manifestations directly related to HIV are acute viral meningitis, chronic meningitis, HIV-associated dementia (HAD), vacuolar myelopathy, and involvement of the peripheral nervous system.
Assuntos
Humanos , Pessoa de Meia-Idade , Viroses do Sistema Nervoso Central/virologia , Infecções por HIV/complicações , HIV-1 , Complexo Relacionado com a AIDS/tratamento farmacológico , Complexo Relacionado com a AIDS/virologia , Antirretrovirais/uso terapêutico , Viroses do Sistema Nervoso Central/tratamento farmacológico , Viroses do Sistema Nervoso Central/metabolismo , Quimiocinas/imunologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Meningite Viral/virologia , Fatores de Risco , Carga ViralRESUMO
This article looks at the history, development, progress and research of the Human Immunodeficiency Virus (HIV) which causes AIDS. The author reports of the ongoing research into a vaccine for HIV, he examines the viral life cycle and indicates the points at which the virus can be attacked, and classifies antiviral strategies
Assuntos
HIV , Infecções por HIV/classificação , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/história , Infecções por HIV/terapia , HIV-2/análise , HIV-2/classificação , HIV-2/crescimento & desenvolvimento , HIV-2/isolamento & purificação , HIV-2/patogenicidade , HIV-1/análise , HIV-1/classificação , HIV-1/crescimento & desenvolvimento , HIV-1/isolamento & purificação , HIV-1/patogenicidade , Sistema Imunitário/patologia , HIV , Complexo Relacionado com a AIDS/diagnóstico , Complexo Relacionado com a AIDS/tratamento farmacológico , Complexo Relacionado com a AIDS/etnologia , Complexo Relacionado com a AIDS/etiologia , Complexo Relacionado com a AIDS/história , Complexo Relacionado com a AIDS/terapia , Complexo Relacionado com a AIDS/transmissão , Vacinas/administração & dosagem , Vacinas/efeitos adversos , Vacinas/análise , Vacinas/classificação , Vacinas/diagnóstico , Vacinas/imunologia , Vacinas/farmacologia , Vacinas Virais/administração & dosagem , Vacinas Virais/efeitos adversos , Vacinas Virais/classificação , Vacinas Virais/diagnóstico , Vacinas Virais/farmacologia , Vacinas Virais/uso terapêutico , Soropositividade para HIV , Produtos do Gene tat/análise , Produtos do Gene tat/classificação , Produtos do Gene tat/diagnóstico , Produtos do Gene tat/uso terapêuticoRESUMO
Ten patients with CDC stage III of infection by HIV were treated with AZT at doses of 300 mg/day (100 mg tid). There were 5 males and 5 females, the median age being 40.5 yr' (range 26-46). Seventy percent of them had transfusion-associated HIV infection and the rest had been infected by the sexual route. A positive clinical response was observed in 100% of the group after 16-24 weeks of treatment: the Karnofsky performance status increased from 64% to 94% (p less than 0.01), the white blood cell count raised from 3.7 to 6.0 K/microL (p less than 0.01), the number of helper lymphocytes (CD4+) also raised significantly from 248.2 to 470.7/uL (p less than .01). Only two patients required red blood cells transfusions. The life expectancy at 82 weeks was 90%. Toxicity was both moderate and transitory. It is concluded that low doses of AZT (300 mg/day) produce similar clinical results as doses of 1200-1500 mg/day. A larger study is needed to support our preliminary findings.
Assuntos
Complexo Relacionado com a AIDS/tratamento farmacológico , Zidovudina/uso terapêutico , Adulto , Peso Corporal/efeitos dos fármacos , Linfócitos T CD4-Positivos , Dispepsia/induzido quimicamente , Feminino , Cefaleia/induzido quimicamente , Humanos , Contagem de Leucócitos/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Zidovudina/administração & dosagem , Zidovudina/efeitos adversosRESUMO
Thirty-five children with symptomatic human immunodeficiency virus infection were enrolled in a 12-week, three-center phase I study of intravenous and oral zidovudine therapy. At enrollment the children ranged in age from 5 months to 13 years, with a median age of 3 1/2 years. Twenty-one children (60%) had acquired immunodeficiency syndrome and 14 (40%) had the related complex; 20 children had less than 0.5 10(9) CD4+ lymphocytes per liter (less than 500 cells/mm3) at entry. Zidovudine was administered in one of three escalating dose regimens. One or two months of intravenous treatment with zidovudine every 6 hours was followed by orally administered drug on the same schedule; zidovudine was infused at 80, 120, or 160 mg/m2/dose, and the oral dose was one and one-half times the intravenous dosage. Adverse events were similar to those observed in adults. Neutropenia (absolute neutrophil count less than 0.75 10(9)/L (750 cells/mm3] occurred in nine patients. The median neutrophil count fell from 2.50 10(9)/L at entry to 1.72 10(9)/L at the end of the study. Anemia requiring transfusion occurred in seven 10(9)/L at the end of the study. Anemia requiring transfusion occurred in seven patients; the median hemoglobin level among nontransfused patients decreased from an entry value of 108 to 105 gm/L (10.8 to 10.5 gm/dl). Dosage adjustments were made in 15 patients, in 12 because of anemia or neutropenia. No patients required permanent discontinuation of zidovudine because of toxic effects. Positive effects included a faster-than-anticipated rate of weight gain, decreased hepatosplenomegaly, and lowering of the total IgG and IgM concentrations toward more normal values. Zidovudine appears to be safe and to have manageable toxic effects in children.