HIV Protease Inhibitors: Effect on the Opportunistic Protozoan Parasites

Alfonso, Yenisey; Monzote, Lianet

doi:10.2174/1874104501105010040

Cited by 30 publications

(13 citation statements)

References 84 publications

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“…This may be due to the fact that opportunistic parasites are known to resolve spontaneously with immune restoration among HIV/AIDS patients on ART [9,10]. The association of these parasite for lower 200 cells/mm 3 CD4 count was in line with that of Varasani (97.8%), India (83%), in selected ART centers of Adama, Afar and Dire-Dawa (62.5%), in different part of Ethiopia (76.9%) and Hawassa (72%) [16,17,21,23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Patients enrolling into ART programmes with very low CD4 cell counts have heightened risk of morbidity and mortality before ART [8]. There is evidence that the control of these opportunistic parasitic infections in HIV-positive persons under HAART is also induced by the inhibition of the aspartylprotease of the parasites and by the reconstitution of the immune system of the patient [9,10]. However, patients in resource limited settings typically start ART programmes with advanced symptomatic disease and very low blood CD4 cell counts which predisposes them to high rates of both clinical and subclinical opportunistic infections [8].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia

et al. 2013

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BackgroundIntestinal parasites are a major concern in most developing countries where HIV/AIDS case are concentrate and almost 80% of AIDS patients die of AIDS-related infections. In the absence of ART, HIV/AIDS patients in developing countries unfortunately continue to suffer from the consequences of opportunistic parasites. But this prevalence has dramatically decreased in countries where antiretroviral agents are widely available. Therefore, the aim of this study was to assess the prevalence of intestinal parasite and risk factor among pre- ART and on ART adult HIV/ AIDS patients attending ART clinic in Dessie hospital.MethodsA comparative cross-sectional study was conducted among pre-ART and on ART adult HIV/AIDS patients of Dessie Hospital. A total of 272 (136 from each group) study subjects were selected by using systematic random sampling. Stool sample was collected and processed using direct wet mount, formol-ether concentration technique and modified Ziehl-Neelson staining techniques. A structured questionnaire was used to collect data on Sociodemographic & associated risk factors. Data was entered and analyzed by using SPSS 16 software and logistic regressions were applied to assess any association between explanatory factors and outcome variables.ResultsThe overall prevalence of IP in pre-ART and on-ART was 39% and 17.6%, respectively with significant decrease of intestinal parasite in the ART era (p < 0.001). All Cryptosporidium spps infections were found in the pre-ART patients and significantly associated for lower CD4 <200cells/mm3. Absence of toilet (AOR = 7.57; 95% CI = 1.3,44.22), source of water (AOR = 6.03; 95% CI = 1.14,31.98), living condition (AOR = 13.29, 95% CI = 5.14, 34.35); WHO stage (AOR = 6.06; 95% CI = 2.49,14.74) and ART status (AOR = 7.55; 95% CI = 3.24,17.59) have significant association with prevalence of intestinal parasite.ConclusionThe overall prevalence of IP was differ by ART status and opportunistic parasite like cryptosporidium spps were found in low CD4 counts in ART naive patients. This study identified some environmental and some clinical finding as determinant factor for IP infections. Therefore, public health measures and adherence to ART should be strengthened to improve the quality of life of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia

et al. 2013

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“…The use of highly active antiretroviral therapy (HAART) in HIVinfected patients is associated with dramatic improvement of cryptosporidial diarrhea. Improvement is likely to result from immune reconstitution as well as inhibition of the parasite proteases (Alfonso and Monzote 2011).…”

Section: Intestinal Coccidiamentioning

confidence: 99%

Understanding drug resistance in human intestinal protozoa

El-Taweel

2015

Parasitol Res

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Infections with intestinal protozoa continue to be a major health problem in many areas of the world. The widespread use of a limited number of therapeutic agents for their management and control raises concerns about development of drug resistance. Generally, the use of any antimicrobial agent should be accompanied by meticulous monitoring of its efficacy and measures to minimize resistance formation. Evidence for the occurrence of drug resistance in different intestinal protozoa comes from case studies and clinical trials, sometimes with a limited number of patients. Large-scale field-based assessment of drug resistance and drug sensitivity testing of clinical isolates are needed. Furthermore, the association of drug resistance with certain geographic isolates or genotypes deserves consideration. Drug resistance has been triggered in vitro and has been linked to modification of pyruvate:ferredoxin oxidoreductase, nitroreductases, antioxidant defense, or cytoskeletal system. Further mechanistic studies will have important implications in the development of second generation therapeutic agents.

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“…In patients co-infected with HIV and malaria or leishmaniasis, the damage to the immune system is cumulative. In this regard, it is interesting to note that a number of protease inhibitors currently in use in the therapy of AIDS showed activity in vitro against Plasmodium, Leishmania and other parasitic protozoa (for a thorough review, see [239]). Affecting both viral and protozoal proteases, in HIV/parasite coinfected patients these drugs achieve the double goal of contributing to the efficiency of the host immune system and of interfering with parasite virulence and survival.…”

Section: Discussionmentioning

confidence: 99%

New Chemotherapeutic Strategies Against Malaria, Leishmaniasis and Trypanosomiases

Zucca¹,

Scutera²,

Savoia³

2013

Current Medicinal Chemistry

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Due to the persistent lack of suitable vaccines, chemotherapy remains the only option for the treatment of patients infected by protozoan parasites. However, most available antiparasitic drugs have serious disadvantages, ranging from high cost and poor compliance to high toxicity and rapid induction of resistance. In recent decades basic research laboratories identified a considerable number of promising new molecules, but their development has not been pursued in depth by pharmaceutical firms because of poor prospects of economic return. The establishment of adequately funded public-private partnerships is currently reversing the trend. This review deals with new drugs against Plasmodium, Leishmania and Trypanosoma parasites, focusing on the molecules that are in the most advanced stage of development. The purpose of this article is to provide the reader with a panoramic view of the updated literature on the challenges and strategies of contemporary antiprotozoal drug research, paying the due attention to the already published reviews.

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HIV Protease Inhibitors: Effect on the Opportunistic Protozoan Parasites

Cited by 30 publications

References 84 publications

Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia

Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia

Understanding drug resistance in human intestinal protozoa

New Chemotherapeutic Strategies Against Malaria, Leishmaniasis and Trypanosomiases

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