[THE DYNAMICS OF THE INCIDENCE OF OPPORTUNISTIC INFECTIONS AND SOMATIC DISEASES HIV-INFECTED PATIENTS WHO RECEIVED INPATIENT TREATMENT IN 2006-2011].

To the article a brief historical review and modern data are driven about the state of HIV-infection in the Odessa area, morbidity of HIV is analysed--the infected patients, passing treatment in stationary section of the Odessa regional centre from a prophylaxis and fight against AIDS during the last six year, drawn conclusion about efficiency of introduction of potent antiretroviral therapy.

Antiretroviral therapy: current drugs.

The rapid advances in drug discovery and the development of antiretroviral therapy is unprecedented in the history of modern medicine. The administration of chronic combination antiretroviral therapy targeting different stages of the human immunodeficiency virus' replicative life cycle allows for durable and maximal suppression of plasma viremia. This suppression has resulted in dramatic improvement of patient survival. This article reviews the history of antiretroviral drug development and discusses the clinical pharmacology, efficacy, and toxicities of the antiretroviral agents most commonly used in clinical practice to date.

Resistência a antirretrovirais nas gestantes infectadas pelo HIV: revisão sistemática / Antiretroviral resistance in HIV-infected pregnant women: systematic review

A Aids é uma das doenças mais importantes do mundo, sendo a transmissão vertical um dos problemas mais temidos e combatidos. Com a introdução da terapia antirretroviral, a taxa de transmissão é reduzida para menos de 1%. Alguns estudos dizem que a resistência materna é algo grave, pois o feto nasceria com uma cepa resistente, mas evidências científicas não comprovam isso. Observa-se que cada país tem uma forma padrão utilizada no manejo das gestantes infectadas pelo HIV, levando-se em consideração, por exemplo, a carga viral, período gestacional, ou uso prévio de terapia medicamentosa. Mesmo com recomendações padronizadas a resistência pode aparecer, sendo a resistência à nevirapina a mais comum, por esse motivo inúmeros estudos vêm mostrando medidas alternativas para evitar esse evento que tanto amedronta os clínicos.(AU)

AIDS is one of the most important diseases in the world, and the vertical transmission is the problem more feared and fought. By the introduction of antiretroviral therapy, the vertical transmission rate is reduced to less than 1%. Some studies say the maternal resistance is something serious, because the fetus would be born with a resistant strain, but scientific evidence does not prove it. It is observed that each country has a standard form used in the management of HIV infected pregnant women, taking into consideration, for example, the viral load, pregnancy period or previous use of drug therapy. Even with standardized recommendations, the resistance may appear, and resistance to nevirapine the most common, for this reason many studies have shown alternative measures to prevent this event that both frightens the clinicians.(AU)

The history of antiretroviral therapy and of its implementation in resource-limited areas of the world.

HIV/AIDS not only represents the most severe epidemic in modern times, but also the greatest public health challenge in history. The response of the scientific community has been impressive and in just a few years, turned an inevitably fatal disease into a chronic manageable although not yet curable condition. The development of antiretroviral therapy is not only the history of scientific advancements: it is the result of the passionate 'alliance' towards a common goal between researchers, doctors and nurses, pharmaceutical industries, regulators, public health officials and the community of HIV-infected patients, which is rather unique in the history of medicine. In addition, the rapid and progressive development of antiretroviral therapy has not only proven to be life-saving for many millions but has been instrumental in unveiling the inequities in access to health between rich and poor countries of the world. Optimal benefits indeed, are not accessible to all people living with HIV, with challenges to coverage and sustainability in low and middle income countries. This paper will review the progress made, starting from the initial despairing times, till the current battle towards universal access to treatment and care for all people living with HIV.

HIV-associated neurocognitive disorders: a historical review.

BACKGROUND: The central nervous system represents a major target of the human immunodeficiency virus (HIV), and the neurocognitive impairments associated with the disease represent a major cause of disability. REVIEW SUMMARY: The HIV-associated neurocognitive disorders are presented from a historical point of view. The evolution of our knowledge and understanding of these primary complications of HIV infection is reviewed, starting with nomenclature and clinical staging and continuing with therapeutic options. CONCLUSIONS: Although considerable progress has been made in the research of HIV-associated neurocognitive disorders, they continue to represent a clinical challenge for neurologists. Because the evolution and the clinical manifestations of HIV infection have changed with the introduction of antiretroviral therapy and the life expectancy has increased, the problems in these patients are complex and need neurologists with a thorough knowledge in HIV infection.

A brief history of antiretroviral therapy of HIV infection: success and challenges.

Unprecedented efforts in the fields of biology, pharmacology and clinical care have contributed to progressively turn HIV infection from an inevitably fatal condition into a chronic manageable disease, at least in the countries where HIV infected people have full access to the potent antiretroviral drug combinations that allow a marked and sustained control of viral replication. However, since currently used treatments are unable to eradicate HIV from infected individuals, therapy must be lifelong, with the potential for short- and long-term, known and unknown, side effects, and high costs for health care systems. In addition, different patterns of unexpected systemic complications involving heart, bone, kidney and other organs are emerging. Although their pathogenesis is still under debate, they are likely to originate from chronic inflammation and immune dysfunction associated to HIV infection. A final consideration regards the dishomogenous pattern of HIV disease worldwide. In fact, access to HIV diagnosis, treatment and care are seriously limited in the geographical areas that are most affected, like Africa, which sustains 70% of the global burden of the infection. This is one of the greatest challenges that international institutions are asked to face today.

[History and the development of the studies on HIV and AIDS]. / Historia i rozwój badan nad HIV i AIDS.

The article describes the progress of medical knowledge which has been observed since the finding and discovery of the first case of the immune deficiency syndrome in the world in 1981. During this period the methods of diagnosis and treatment of HIV/AIDS has changed significantly. The progress in this area of examinations which is presently achieved allows unambiguous diagnosis of the virus and the disease. The recognition of the pathogenesis of the HIV and AIDS enabled the beginning of the studies on the medicines having antiretroviral properties. The utilization of the potential of the currently used medicines inhibits the progress of the disease and, in consequence, the elongation of the patients' life span. However, despite excessive clinical experiments in numerous research centres world-wide, until now there has not been found an effective medicine which could totally eradicate this virus from the body nor the vaccine which could prevent the further spread of this virus in the world.

Twenty-five years of translational medicine in antiretroviral therapy: promises to keep.

The year 2010 marks the 25th anniversary of modern antiretroviral drug discovery and development. In the early 1980s, AIDS was almost always a lethal disease with an appalling clinical course characterized by severe opportunistic infections and unusual forms of cancer. Since that time, starting with zidovudine (AZT) and related 2',3'-dideoxynucleosides, the causative retrovirus, now called HIV-1, went from being an untreatable infectious agent to being the target of highly active antiretroviral therapy (HAART). This degree of progress refuted early prophesies of therapeutic futility and represents a striking example of translational medicine. Here I review foundational discoveries and events in HIV-1/AIDS research and explore lessons for future translational medicine efforts.

Special anniversary review: twenty-five years of human immunodeficiency virus research: successes and challenges.

During 25 years of research since HIV-1 was first identified in Paris, there have been great advances in our understanding of the virus and of the immune system. Practical advances include the early development of diagnostic tests of infection that made blood donation safe, and since 1996, combination anti-retroviral therapy that has great reduced incidence of AIDS in HIV-infected people who have access to the drugs. HIV prevention through behavioural change has been successful, and we do not yet have any safe and efficacious microbicides or vaccines.

Adherence as therapeutic citizenship: impact of the history of access to antiretroviral drugs on adherence to treatment.

A dramatic increase in the use of antiretroviral drugs in Africa has increased focus on adherence to treatment, which has so far been equivalent if not superior to that in northern contexts. The reasons for this exceptional adherence are poorly understood. In this paper, we examine adherence in the historical and ethnographic context of access to treatment in Burkina Faso, Côte d'Ivoire and Mali. Living where there is no social security and minimal, if any, medical care, individuals diagnosed with HIV are faced with the threat of illness, death, ostracism and destitution, and were obliged to negotiate conflicting networks of obligation, reciprocity, and value. HIV and AIDS programmes value efforts to address social, and indeed biological, vulnerability. In contrast, kinship-based social relationships may value individuals in other ways. These conflicting moral economies often intersect in the worlds of people living with HIV. HIV status can be used to claim resources from the public or non-governmental organization programmes. This may interfere with social networks that are the most stable source of material and emotional support. Self-help and empowerment techniques provided effective tools for people living with HIV to fashion themselves into effective advocates. In the early years of the use of antiretroviral therapy (ART), access to treatment was thus mediated by confessional practices and forms of social triage. We introduce the term 'therapeutic citizenship' to describe the way in which people living with HIV appropriate ART as a set of rights and responsibilities to negotiate these at times conflicting moral economies. Exemplary adherence should be viewed through the lens of therapeutic citizenship.

A historical sketch of the discovery and development of HIV-1 integrase inhibitors.

The long process of HIV-1 integrase inhibitor discovery and development can be attributed to both the complexity of HIV-1 integration and poor 'integration' of these researches into mainstream investigations on antiretroviral therapy in the mid-1990s. Of note, some fungal extracts investigated during this period contain the beta-hydroxyketo group, later recognised to be a key structural requirement for keto-enol acids (also referred to as diketo acids) and other integrase inhibitors. This review reconstructs (in the general context of the history of AIDS research) the principal steps that led to the integrase inhibitors currently in clinical trials, and discusses possible future directions.