AIDS Clinical Review 2000/2001

by Volberding; Paul A.

• ISBN13: 9780824704339
• ISBN10: 0824704339
• Format: Hardcover
• Copyright: 2000-09-01
• Publisher: CRC Press

Summary

The latest in the crucial series documenting scientific discoveries at the forefront of HIV and AIDS research! This volume updates the most important and controversial issues facing physicians, nurses, microbiologists, pharmacists, and epidemiologists who deal directly with patients suffering from HIV and AIDS, focusing on specific areas in which important new advances have occurred in diagnosis, therapy, and prevention of infection and related complications. Outlines new disease management strategies being tested in prospective clinical trials and observational studies! Combining elements of virology, epidemiology, immunology, oncology, endocrinology, neurology, psychiatry, and the behavioral sciences, AIDS Clinical Review 2000/2001 clarifies substantive advancements in vaccine development, realistically assessing potential efficacy and limitations explores short-term antiretroviral therapy for dramatically reducing the rate of vertical transmission from mother to child evaluates the efficacy of antiretroviral prophylaxis for workers who experience high-risk exposure to HIV-infected blood discusses preservation of HIV specific immunity when antiretroviral therapy is initiated early in the course of acute infection considers complex drug interactions that occur when drugs are used in combination highlights cytokine and other immune-based therapies suggests chronic hepatitis may ultimately be more fatal than HIV for coinfected patients and more! Including results recently presented at scientific meetings but not yet published in peer-reviewed journals, AIDS Clinical Review 2000/2001 is essential reading for infectious disease specialists, epidemiologists, virologists, immunologists, pharmacologists, microbiologists, hematologists, hepatologists, oncologists, neurologists, medical students in these disciplines, and all medical professionals involved in both AIDS research and clinical practice.

Author Biography

Judith A. Aberg, M.D.: Director of HIV Services, AIDS Clinical Trials Unit, Washington University School of Medicine, St. Louis, Missouri Mary A. Albrecht, M.D.: Assistant Professor of Medicine, Harvard Medical School, and Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts Francesca Aweeka, Pharm.D.: Associate Clinical Professor of Pharmacy, Department of Clinical Pharmacy, San Francisco General Hospital, University of California, San Francisco Aurelio Cafaro, M.D.: Senior Investigator, Laboratory of Virology, Istituto Superiore di Sanita, Rome, Italy David D. Celentano, Sc.D., M.H.S.: Professor, Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland Raymond T. Chung, M.D.: Assistant Professor of Medicine and Medical Director, Liver Transplant Program, GI Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts Thomas J. Coates, Ph.D.: Professor of Medicine and Epidemiology, Department of Medicine, and Director, University of California, AIDS Research Institute, San Francisco, California Anke A. Ehrhardt, Ph.D.: Professor of Medical Psychology and Director, Psychiatry and HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Barbara Ensoli, M.D., Ph.D.: Chief, Retrovirus Division, Laboratory of Virology, Istituto Superiore di Sanita, Rome, Italy Rita Fahrner, R.N., M.S., N.P.: Clinical Nurse Specialist, San Francisco General Hospital Occupational Health Service, and Assistant Clinical Professor, Department of Physiological Nursing, University of California Lisa M. Frenkel, M.D.: Associate Professor, Departments of Pediatrics and Laboratory Medicine, University of Washington and Children's Hospital and Regional Medical Center, Seattle Arthur Y. Kim, M.D.: Fellow in Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston Bradley W. Kosel, Pharm.D.: Clinical Pharmacology Research Fellow, Drug Research Unit, San Francisco General Hospital, and Department of Clinical Pharmacology, University of California Michael M. Lederman, M.D.: Professor, Division of Infectious Diseases, Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio Ann J. Melvin, M.D.: Assistant Professor, Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle Bruce Polsky, M.D.: Chief, Division of Infectious Diseases, Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York Hernan Valdez, M.D.: Assistant Professor, Division of Infectious Diseases, Department of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Ohio Bruce D. Walker, M.D.: Professor of Medicine, Harvard Medical School; Director, Partners AIDS Research Center, Massachusetts General Hospital; and Brigham and Women's Hospital, Boston

Table of Contents

Preface	iii
Contributors	xi
Human Immunodeficiency Virus Prevention: Applying the Lessons Learned	1	(22)
Thomas J. Coates
Anke A. Ehrhardt
David D. Celentano
Intervention Strategies: Levels of Interventions	4	(9)
Where are the Needs?	13	(3)
What Can We Recommend Now?	16	(1)
Conclusion	17	(6)
References	17	(6)
Novel Strategies Toward the Development of an Effective Vaccine to Prevent Human Immunodeficiency Virus Infection or Acquired Immunodeficiency Virus	23	(40)
Barbara Ensoli
Aurelio Cafaro
How AIDS Vaccine Strategies Have Evolved from Sterilizing Immunity to the Control of Infection	25	(4)
Live Attenuated Vaccines: Concepts to Learn	29	(1)
Novel Strategies	30	(13)
Conclusions and Perspectives	43	(20)
References	46	(17)
Pediatric Human Immunodeficiency Virus Type 1 Infection: Updates on Prevention and Management	63	(22)
Ann J. Melvin
Lisa M. Frenkel
Introduction	65	(1)
Maternal and Obstetrical Factors Associated with Perinatal HIV-1 Transmission	66	(9)
Antiretroviral Therapy for HIV-1-Infected Children	75	(2)
Summary	77	(8)
References	77	(8)
Risk of Human Immunodeficiency Virus Infection in Health Care Workers	85	(16)
Rita Fahrner
Introduction	87	(1)
Anecdotal Case Reports of Occupational HIV Infection	88	(3)
Prospective Cohort Studies	91	(1)
Prevention	92	(2)
Management of Occupational Exposure	94	(2)
HIV-Infected Health Care Workers: Risks to Patients	96	(1)
Conclusion	97	(4)
References	98	(3)
Can Immune Responses to Human Immunodeficiency Virus Be Preserved, Enhanced, or Restored?	101	(14)
Bruce D. Walker
Introduction	103	(1)
Components of Protective Immunity in HIV Infection	104	(2)
Why Does the Immune System Fail to Control HIV?	106	(1)
Effects of Highly Active Antiretroviral Therapy (HAART) on HIV-Specific Immune Responses	106	(1)
Rebuilding the Immune System in Chronic HIV Infection	107	(1)
Critical Need for Immunotherapy plus HAART in Augmenting Immunity to HIV	108	(1)
Approaches to Immune Enhancement in HIV Infection	109	(1)
Conclusions and Future Directions	110	(5)
References	111	(4)
Reconstitution of Immunity Against Opportunistic Infections in the Era of Potent Antiretroviral Therapy	115	(24)
Judith A. Aberg
Introduction	117	(1)
PCP	118	(5)
MAC	123	(3)
CMV	126	(3)
Toxoplasmosis	129	(1)
Systemic Mycoses	130	(1)
Summary	130	(9)
References	131	(8)
Salvage Therapy for Patients Failing their Current Antiretroviral Regimen	139	(54)
Mary A. Albrecht
Background	141	(3)
Defining Virologic Failure	144	(1)
When to Switch Therapy	145	(1)
Devising Salvage Therapy	146	(4)
Salvage Therapy in Patients Failing PI-Containing Regimens: Clinical Trial Results	150	(9)
Role of Intensification Strategies	159	(2)
Predictors of Treatment Response	161	(8)
Role of Genotypic and Phenotypic Resistance Assays in Devising Salvage Therapy	169	(7)
Structured Treatment Interruptions	176	(1)
Multidrug Rescue Regimens	177	(2)
Conclusions	179	(14)
References	180	(13)
Drug Interactions of Antiretroviral Agents	193	(36)
Bradley W. Kosel
Francesca Aweeka
Overview	195	(2)
Interpretation of Drug Concentrations	197	(1)
Interaction Types	197	(1)
Inhibitor and/or Inducer	198	(2)
Nucleoside Reverse Transcriptase Inhibitors	200	(4)
PI Combinations	204	(5)
NNRTI and PI Combinations	209	(5)
Management of Non-ARV Drug Interactions	214	(6)
Conclusion	220	(9)
References	221	(8)
Rationale for Immune-Based Therapies for Human Immunodeficiency Virus Type 1 Infection	229	(34)
Michael M. Lederman
Hernan Valdez
Rationale for Immune-Based Therapies	231	(2)
Host-Directed Therapies	233	(4)
Cytokines and Growth Factors	237	(5)
Enhancement of HIV-1 Specific Immune Responses	242	(7)
Conclusion	249	(14)
References	250	(13)
Human Immunodeficiency Virus and Hepatitis B and C Coinfection: Pathogenic Interactions, Natural History, and Therapy	263	(44)
Arthur Y. Kim
Raymond T. Chung
Bruce Polsky
Introduction	265	(1)
HIV and HBV	266	(4)
HIV and HCV	270	(16)
Conclusion	286	(21)
References	286	(21)
Index	307