Sexually transmitted diseases (STDs), formerly known as venereal diseases, are diseases that are spread from person to person through sexual activity. There are over 20 diseases that can be transmitted sexually; they may be caused by bacteria, viruses, or parasites (see below for information on specific STDs).
Using a blood test to monitor concentrations of antiretroviral drugs may be a clinical tool whose time has come. With the growing awareness of the toxicities and low tolerability of currently available anti-HIV drugs, a method for optimizing their use has become increasingly attractive.
In this article, Dr. Walker describes a symposium that occurred at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), which took place in September 1999 in San Francisco. ICAAC is the largest annual international conference on infectious diseases for researchers andphysicians; coverage of the 40th ICAAC will appear in the upcoming Winter issue of BETA
Highly active antiretroviral therapy (HAART) has radically changed the face of HIV disease in economically developed countries. However, after the initial hope for a "cure," we are sobering to the realization that HAART, effective and important as it is, will not eradicate HIV.
The Second International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV attracted 373 delegates, compared with 230 at last year’s meeting in San Diego. Twenty-two countries were represented, up from 16 last year, and 133 abstracts submitted, compared with 67 last year--all reflections of the increasing concern with the emerging metabolic and body fat syndrome(s), usually referred to as "lipodystrophy."
By the time most of you are reading this, the XIII International AIDS Conference in Durban, South Africa, will have just concluded. A particular anticipation, as well as controversy, has surrounded this conference, and much has been said both positively and critically in the months leading up to it. People and groups ranging from small grassroots and nongovernmental organizations to major media (e.g., both ABC's "Nightline" and CBS's "60 Minutes" covered AIDS in Africa) and leaders of nations have addressed HIV and its global impact, with diverse emotions but few proposed solutions.
At the close of this past decade, an estimated 33.6 million men, women, and children worldwide were infected with the human immunodeficiency virus (HIV). This virus, unknown until 17 years ago, now dominates national and international affairs. The HIV/AIDS epidemic is now acknowledged to be a contributing factor to changing national economies, to population displacement, and most recently, to national and international security.
Microbicides 2000, a conference held March 13-16 in Alexandria, VA, signaled the rising interest in topical microbicides to prevent sexual transmission of HIV infection, other sexually transmitted diseases (STDs), pregnancy, or all three. Over 600 people, nearly half of them from outside the U.S., attended the three-day conference.
This report includes highlights from the 3rd International Workshop on Salvage Therapy for HIV Infection held April 12-14, 2000, in Chicago, and the 10th International Symposium on Viral Hepatitis and Liver Disease held April 9-13, 2000, in Atlanta.
NRTIs including ddI, d4T, lodenosine, and adefovir work against HIV by disrupting the function of the virus's reverse transcriptase enzyme, which converts the HIV gene set into a DNA form that inserts itself into human cell genomes. Nucleoside analog drugs are essentially defective versions of natural nucleosides (precursor compounds).
My grandfather started practicing medicine in the 1920s before the days of specialists, before the days of HIV/AIDS, and well before the advent of highly active antiretroviral therapy (HAART). However, in some ways I think he would have had an easier time answering callers' questions than I do.
In a season that will likely see few drug candidates appearing on the market, Abbott Laboratories' lopinavir (more commonly known as ABT-378) may be the next drug to receive approval from the U.S. Food and Drug Administration (FDA).
Of 33.6 million people living with HIV/AIDS around the world today, 14.8 million are women; Of 5 million adults newly infected in 1999, 2.3 million are women; Of the 2.1 million people who had died of AIDS by 1999, 1.1 million were women
The rate of HIV infection in the United States has increased among women and individuals of color, while decreasing among White men. Women and individuals of color now represent 67% of people newly diagnosed with AIDS, 62% of individuals living with AIDS, and 69% of newly reported diagnoses of HIV infection.
The International AIDS Society-USA (IAS) recently published new guidelines recommending antiviral resistance testing in certain situations. Such testing, which helps determine if the strains of HIV in a person's body are susceptible to various antiviral drugs, were recommended to guide the choice of a new drug regimen after treatment failure and to guide the treatment of pregnant women with HIV.
One of the more heated HIV-related debates to develop this year relates to a very old issue: whether or not HIV causes AIDS (see the "Special Report on HIV & AIDS"). While supporters of the ill-informed "AIDS is a hoax" concept remain relatively scarce in North America and Europe, this may not be the case in sub-Saharan Africa, where resources to deal with HIV/AIDS are few and where the dissidents' viewpoint may be favorably received for political and financial reasons.
A spate of articles appearing recently in the general media have tackled the issue of HIV's causal role in AIDS from a number of directions. Despite the fact that this issue was resolved years ago in the scientific arena, a few so-called HIV/AIDS denialists (including journalists such as Celia Farber, who has written about AIDS for the magazines Spin and Gear, and groups such as ACT UP San Francisco) continue to charge that AIDS-related illnesses are the exclusive result of such factors as malnutrition, poverty, and illicit drug use (i.e., not HIV).
It seems that the so-called experts on AIDS have done a poor job of convincing the public that HIV is the sole and unequivocal cause of this dread disease. The case should be an easy one. After all, close to 40 million people worldwide are known to be infected with HIV, and AIDS is projected to become the world's leading cause of death within the next five years.
The recent surge of publicity denying HIV's causal role in AIDS begs an examination of the relationship between a specific microorganism and a specific disease. The question is this: What scientific proof is required to establish cause and effect?
The 39th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) this past September marked an historic turning point in the history of HIV medicine. Four years ago, the 11th International Conference on AIDS in Vancouver, Canada, Testing! Testsaluted the debut of the new treatment paradigm.
In recent years, excitement about the benefits of combination anti-HIV therapy has been tempered by a growing awareness of the problems that accompany the use of anti-HIV drugs. In addition to drug resistance and the difficulty of adhering to complex regimens, side effects associated with highly active antiretroviral therapy (HAART) have become a major concern.
While the never-skip-a-dose wisdom still holds, in a few settings researchers and doctors today are closely supervising HIV positive subjects who have halted their antiretroviral therapy. The theory is that alternating periods of HAART treatment with regulated withdrawals of drug therapy may serve as a means of inducing immune system control of HIV.
Use of highly active antiretroviral therapy (HAART) has resulted in clearly decreased morbidity and mortality for persons living with HIV/AIDS. For these reasons everyone who meets the criteria for treatment with these regimens must have access to them. Once an individual has access to HAART, it is also critically important that she or he adhere closely to the regimen in order to maximally benefit.
Entry inhibitors, a prominent new class of antiretroviral drugs, were a focus of numerous presentations at the 7th Conference on Retroviruses and Opportunistic Infections (CROI), with several groups reporting pre-clinical and clinical data on candidates.
Approximately 3,200 physicians and researchers attended the 7th Conference on Retroviruses and Opportunistic Infections (CROI) held January 30-February 2, 2000, in San Francisco. The annual CROI is the most important conference held in North America that addresses clinical and basic science research in HIV/AIDS.
Drug Interaction Studies; Side Effects and Toxicities Associated with Anti-HIV Drugs; Other selected findings about anti-HIV drug side effects and fat redistribution
Several studies examined the effects on fat redistribution and metabolic changes after switching from a PI-based HAART combination to one without a PI. Overall, the results were mixed, with some possible trends towards some improvements in certain studies. Longer follow-up will be necessary to derive any definitive conclusions.
Perfect adherence to dosing of HAART for one year led to a viral load undetectability rate of 85% (limit of detection 50 copies/mL) to 100% (limit of detection 400 copies/mL), according to Margaret Fischl, MD, of the University of Miami.
In January, a panel of researchers released newly updated Department of Health and Human Service (DHHS) Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents; the initial guidelines were published in 1998.
Tenofovir DF (TDF) is an experimental nucleotide reverse transcriptase inhibitor being developed by Gilead Sciences of Foster City, CA. Nucleotide reverse transcriptase inhibitors are similar to nucleoside analog (NRTI) drugs such as d4T (Zerit) but do not require the same degree of processing within cells to become active (see full explanation below)
All listings are taken from Trials Search, an online database of open clinical trials for HIV-infected individuals. Trials Search, a comprehensive source for clinical trial information, is available at http://hivinsite.ucsf.edu/tsearch. The Community Consortium of the University of California at San Francisco (UCSF) Positive Health Program at San Francisco General Hospital Medical Center provides this free service.
This information is designed to support, not replace, the relationship that exists between you and your doctor.