Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Cancer Chemother; 8:305-32 1986. Unique Identifier : AIDSLINE ICDB/87636524 Chachoua A; Oratz R; Green M; Muggia FM; Dept. of Medicine, New York Univ. Medical Center, 550 First; Avenue, New York, NY 10016
Abstract:
The focus of current investigations concerning acquired immune deficiency syndrome (AIDS) is on the development of effective antiviral agents, on immune-modifying strategies, and on anti-HTLV-III vaccines. Several studies have been in progress on the treatment of the malignancies, particularly Kaposi's sarcoma (KS), and the opportunistic infections that complicate this disease. Current research in the treatment of specific aspects of AIDS is addressed in this chapter under the following headings: epidemiology, etiology and pathogenesis, clinical features--opportunistic infections (cytomegalovirus; cryptosporidiosis; Pneumocystis carinni pneumonia; cryptococcosis; other infections), general therapeutic considerations, antiviral chemotherapy (ribavirin; phosphonoformate; suramin; antimoniotungstate; azidothymidine; other antivirals and combinations), immune modulation, AIDS vaccine, and AIDS-related neoplasias. Therapeutic trials in the treatment of epidemic KS have ranged from aggressive combination chemotherapy, such as ABV (doxorubicin, bleomycin, and vinblastine) and ABV + ADV (actinomycin D, DTIC, and vincristine), for patients with visceral involvement and systemic symptoms to less toxic single agent chemotherapy, such as VP-16, for patients with less advanced disease. All regimens had considerable antitumor activity, but the median duration of effect was not longer than 1 yr and there was no reversal of immune depression. Studies are underway with ICRF-187 (an iv form of its insoluble enantiomer ICRF-159) and vinblastine, given as continuous infusion. Treatment of epidemic KS with interferons resulted in a wide range of response rates, in inconsistent effects on immune function, and in significant toxicity. Results of treatment with VP-16 and alpha2-interferon administered sequentially or concurrently have not been encouraging. Other neoplasias complicating AIDS include primarily lymphomas. Rates of response of the lymphomas to various combination chemotherapies and/or radiation range from 30 to 50%; relapse rates are high, with median survival ranging from 5 to 8 mo. Since 1980-1981 there have been increases in the incidences of squamous carcinomas of the oral cavity and anorectum in homosexual males. (111 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*DRUG THERAPY/ETIOLOGY/ IMMUNOLOGY Adjuvants, Immunologic/THERAPEUTIC USE Antimony/THERAPEUTIC USE Antiviral Agents/*THERAPEUTIC USE Human HIV/IMMUNOLOGY Phosphonoacetic Acid/ANALOGS & DERIVATIVES/THERAPEUTIC USE Ribavirin/THERAPEUTIC USE Risk Suramin/THERAPEUTIC USE Thymidine/*ANALOGS & DERIVATIVES/THERAPEUTIC USE Tungsten/THERAPEUTIC USE Viral Vaccines/ADMINISTRATION & DOSAGE JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
