Thirty years of the human immunodeficiency virus epidemic and beyond

Abstract

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus (HIV) as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressing social and psychological factors involved in the care of individuals continue to be important considerations.

An oral formulation of efavirenz‐loaded lactoferrin nanoparticles with improved biodistribution and pharmacokinetic profile

“…Progression to AIDS is determined primarily on the basis of a low CD4 count, which may eventually lead to immunological failure [2,3]. The Food and Drug Administration (FDA), USA has approved six classes of drugs for treatment of HIV infection: (1) non-nucleoside reverse transcriptase inhibitors (NNRTIs), (2) nucleoside reverse transcriptase inhibitors (NRTIs), (3) integrase inhibitors, (4) protease inhibitors (PIs), (5) fusion inhibitors and (6) co-receptor antagonists [4]. Treatment of AIDS started with mono-drug therapy in the late 1990s, subsequently shifted to combination therapy with two drugs, and is currently triple-drug combination therapy.…”

Outcomes of Total Knee Arthroplasty in Human Immunodeficiency Virus-Positive Patients

“…Human immunodeficiency virus (HIV) infection is a widespread public health problem that has evolved from a "death sentence" to a manageable, chronic illness over the past 30 years. 17 Advances in HAART have changed the landscape of HIV treatment, enabling HIVþ patients to achieve longevity. 1, 18,19 The increased life expectancy, combined with an increased risk for bone and joint disorders, will lead to a greater demand for TKA within this population.…”

Perfil genômico da resposta ao HIV-1 e implicações para a vacina terapêutica com células dendríticas contra o HIV-1.

“…Nessas últimas três décadas de epidemia, avanços científicos contribuíram para um melhor entendimento da resposta imune do hospedeiro, fornecendo assim subsídios para o desenvolvimento de potentes agentes antirretrovirais (YOUNAI, 2013). E mesmo que o número de indivíduos infectados tenha permanecido elevado, o advento da terapia antirretroviral levou à uma diminuição da mortalidade e morbidade da doença (VAN VAERENBERGH, 2001).…”

“…Os antirretrovirais aprovados e comercialmente disponíveis agem em estágios da replicação do HIV e consistem em: inibidores nucleosídeos e nucleotídeos para transcriptase reversa; inibidores não-nucleosídeos da transcriptase reversa; inibidores de protease; inibidores de fusão; inibidores de integrase; inibidores de entrada (antagonista de CCR5) e agentes combinados(CHEN; HOY; LEWIN, 2007;YOUNAI, 2013). Na maioria dos indivíduos infectados pelo HIV-1 a administração de ART resulta no aumento da contagem de células TCD4+ e na redução da viremia plasmática que podem ser mantidos durante anos (CHEN et al, 2007;FINZI;SILICIANO, 1998).…”

“…Nossos dados sugerem que uma triagem baseada na genética poderia auxiliar na predição da capacidade estimulatória da DC e no sucesso da imunoterapia em pacientes HIV+. No Brasil, de acordo com o último boletim epidemiológico há atualmente 734 mil pessoas vivendo com HIV/AIDS (BRASIL, 2013;YOUNAI, 2013).…”