Antiretroviral treatment. NLM AIDSLINE Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

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Antiretroviral treatment.

Int Conf AIDS. 1993 Jun 6-11;9(1):10 (abstract no. PS-03-2). Unique Identifier : AIDSLINE MED/93333215
Lange JM; Global Programme on AIDS, Geneva, Switzerland.

Abstract: It has been difficult to establish the best time to initiate antiretroviral treatment in order to maximize efficacy and the duration of the response. The issue has become complicated by the emergence of didanosine (ddI) as an alternative to zidovudine ZDV) monotherapy and by reports on superior surrogate marker responses with combinations of nucleosides. The newer nucleoside analogue reverse transcriptase inhibitors stavudine (d4T) and 3TC will enter efficacy trials, as monotherapy and in combination with other antiretroviral agents. Preliminary data regarding the efficacy of the Tat-antagonist Ro24-7429 and several protease inhibitors--drugs that, contrary to the reverse transcriptase inhibitors, affect HIV replication in chronically infected cells--should become available soon. Earlier pessimism about the future of non-nucleoside reverse transcriptase inhibitors--based on the extremely rapid emergence of drug resistance to these agents--has been mitigated by several developments: a) it may be possible to give dosages of some of these drugs that lead to plasma concentrations that exceed the 50% inhibitory concentration for resistant virus; b) a resistance-conferring mutation to one antiretroviral agent may restore sensitivity to another; c) in vitro findings indicate that certain combinations of mutations for drug resistance (to ZDV, ddI and a non-nucleoside) may negatively affect virus viability. Beside antiviral resistance, virus cytopathicity is being increasingly recognized as an important determinant of the response to antiretroviral therapy. Effective treatment of individuals harbouring syncytium-inducing HIV variants is major challenge for the future. On a global scale, the greatest challenge, however, is to develop locally effective and safe virucides that can be utilized intravaginally to prevent sexual transmission of HIV and other STDs.
Keywords: *Acquired Immunodeficiency Syndrome/DRUG THERAPY *Antiviral Agents/THERAPEUTIC USEKWDacquiredimmunodeficiencysyndrome/drugtherapyKWDantiviralagents/therapeuticuse
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M93B5832

Copyright © 1993 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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