Recent Advancements in HIV/AIDS Treatment

By Kutzer, Dolores; Hicks, Megan; Hlebik, Erin; Infantino, Jeremy | Drug Topics, April 14, 2008 | Go to article overview

Recent Advancements in HIV/AIDS Treatment


Kutzer, Dolores; Hicks, Megan; Hlebik, Erin; Infantino, Jeremy, Drug Topics


This article titled "Recent advancements in HIV/AIDS treatment" includes review of the pathogenesis and clinical presentation of an HIV infection, review of methods of detection and diagnosis, and latest medications approved for the treatment of HIV/AIDS such as: tipranavir, fosamprenavir, darunavir, atazanavir, enfuvirtide, raltegravir, emtricitabine, and maraviroc. Discussion includes indications, pharmacokinetics, precautions, adverse effects, drug interactions, dosage and availability, and patient counseling.

Since the first reported case in 1982, HIV infections have been noted in staggering numbers. There are an estimated one million individuals currendy living with HIV/AIDS in the United States, with approximately 40,000 new infections occurring each year. Most new infections are attributed to men who have sex with men (MSM). However, the numbers of heterosexual transmission and those occurring in young adults and adolescents are also on the rise.

The most common methods of transmission is through contact between infected bodily fluids and the mucosal surfaces lining the intestinal tract and the genitalia and the sharing of needles for intravenous drug abuse. Factors that increase the risk of transmission include having a high viral load or an advanced infection (AIDS), if vaginal or rectal bleeding occurs during sexual intercourse, if a male is uncircumcised, co-infection with other sexually transmitted infections (STIs), menstruation, and hormonal imbalances.

Pathogenesis: HIV is a positive sense, single stranded RNA retrovirus. It possesses an indolent and complicated infectious cycle. Infections result in a destruction of CD4 lymphocytes and cell-mediated immunity.

After the virus gains entry into the body, it binds to host CD4 cells and chemokine co-receptors by utilizing a glycoprotein located on its outer surface (gpI60). The gp!60 is comprised of two smaller units (gp4l and gp!20). Gp 120 has a higher affinity for the CD4 cell receptors, playing a significant role in the initial internalization of the virus. Chemokines (CCR5 and CXCR4) help to further promote internalization.

Since HIV is a RNA virus, it must convert its RNA into viral DNA. To do this, the virus carries an essential RNA-dependent DNA polymerase enzyme called reverse transcriptase (RT). RT is rather inaccurate, creating many errors which promote viral mutation. The new viral DNA enters the nucleus to incorporate into the host DNA using the enzyme DNA integrase. Integration is random, creating cell abnormalities that lead to apoptosis. After integration is complete, the virus utilizes the host cell to duplicate its newly formed DNA and produce viral proteins, RNA, and surface glycoproteins.

Viral RNA, proteins, and other necessities are packaged together under the host cell membrane. This package then buds off from the host cell, using the membrane to form its own and take on host characteristics. Once free from the host cell, the new viron uses HIV protease to create mature proteins and an infectious virus.

Clinical Presentation: Most patients present with acute mononucleosis-like signs and symptoms two to six weeks after exposure including: fever, weight loss, night sweats, aseptic meningitis, nausea, vomiting, diarrhea, fatigue, sore throat, and myalgias. Symptoms usually resolve after two weeks.

Resolution of the initial signs and symptoms marks die start of the clinically latent period. However, viral replication is never fully suppressed or eliminated and the immune system over time slowly declines. Steady decline in CD4 levels is the most clinically measurable component of immune system decline. The viral load will reach a set-point after a drop in plasma viral counts, which may remain relatively constant for years. High viral loads constitute a poor prognosis and more rapid development of AIDS.

During the clinically latent period, patients experience mild and nonspecific symptoms that come and go over the course of several months or years. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Recent Advancements in HIV/AIDS Treatment
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.