Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
APPROACHES TO THERAPY OF AIDS
Aids and Infections of Homosexual Men. Second Edition. Ma P and Armstrong D, eds. Boston, Butterworths, p. 433-45 1989.. Unique Identifier : AIDSLINE ICDB/90659653 Siegal FP; Section of Hematology Res., Div. of Hematology/Oncology, Long; Island Jewish Medical Center, New Hyde Park, NY
Abstract:
HIV exerts profound effects on the complex systems of host defense at almost all levels of function. Although its most obvious, and perhaps principal, target is the helper T-lymphocyte population expressing the T4 marker, other cells are involved. Since AIDS, as defined by the CDC, represents the end stage of what is clearly a protracted decline of the immune system, treatment of AIDS should begin well in advance of the development of any secondary complications, at a time when infection with the AIDS agent has already had a demonstrable effect on the immune system. Such treatment, still largely hypothetical, would prevent the progressive decline of immune function that ultimately leads to a probably irreversible immunodeficient state. Approaches to therapy are discussed, including antiviral agents, requisites of a useful antiretroviral agent, antiviral drugs in clinical trials (HPA-23 [antimoniotungstate], ribavirin, zidovudine [AZT, Retrovir], ansamycin, phosphonoformic acid [Foscarnet], and suramin), immunomodulating agents (anti-inflammatory drugs, interleukin-2, interferons, and cyclosporin A), and therapeutic maneuvers. It seems unlikely that therapy for AIDS will succeed until ways are found to turn off the effects of the AIDS virus. As active antiviral agents are developed, synergistic combinations of drugs most likely will be needed to achieve long-term suppression, and they will have to be studied in carefully controlled multicenter trials. Perhaps more important than the regimens developed will be the timing of their deployment. Stabilizing a declining patient should be far easier than trying to reconstitute an individual with end-stage immunodeficiency. If relatively nontoxic drugs can be found, administering them to those in the early stages of HIV infection might be effective in preventing the development of severe immune deficiency and conceivably could prevent, or at least reduce, the probability of transmission of the virus. (40 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*THERAPY Adjuvants, Immunologic/THERAPEUTIC USE Antiviral Agents/THERAPEUTIC USE Biological Response Modifiers/THERAPEUTIC USE Clinical Trials Combined Modality Therapy *Homosexuality Human HIV/DRUG EFFECTS/*PATHOGENICITY Male Opportunistic Infections/THERAPY CLINICAL TRIAL MONOGRAPH REVIEW REVIEW, TUTORIAL 900430
M9040658
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
