China
Africa
Explore chapters and articles related to this topic
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
This drug is a non-nucleoside reverse transcriptase inhibitor that is indicated for the treatment of HIV-1 infection in combination with at least two other active antiretroviral agents. Delavirdine lowers viral titer in an attempt to minimize HIV comorbidities (e.g., Kaposi’s sarcoma). It is an FDA pregnancy category C drug in the old system. The registry is actively collecting patients exposed to this drug during pregnancy. Currently, only 10 infants have been born following first trimester exposure, one of whom had a birth defect that was corrected surgically.
Antiviral Agents and Rational Drug Design
Published in Nathan Keighley, Miraculous Medicines and the Chemistry of Drug Design, 2020
The enzyme reverse transcriptase is a DNA polymerase exclusively associated with the virus, but caution should nevertheless be taken to ensure that there is no inhibitory effect on cellular DNA polymerases when designing nucleoside reverse transcriptase inhibitors. These molecules mimic the nucleoside structure and become phosphorylated to the active drug, as explained in the previous example, acyclovir. The important difference here though is that the phosphorylation steps must all be carried out by cellular enzymes because, unlike Herpesvirus, HIV does not have the necessary kinase enzyme.
Infectious Diseases
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) target reverse transcriptase. Integrase inhibitors target integrase and protease inhibitors target protease. There are also therapies that aim to prevent the fusion of HIV to immune cells (fusion inhibitors).
Mild hearing loss in C57BL6/J mice after exposure to antiretroviral compounds during gestation and nursing
Published in International Journal of Audiology, 2023
J. Riley DeBacker, Bo Hua Hu, Eric C. Bielefeld
In an effort to curb the spread of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), the World Health Organisation (WHO) works with local governments and researchers to find new ways to implement HIV prevention and transmission control measures. A specific focus of recent prevention efforts has been vertical transmission, where the virus is passed from mother to child during pregnancy and childbirth. The WHO recommends that all people with HIV initiate and maintain lifelong antiretroviral therapy and specifically highlights pregnant and breastfeeding women as a target population. To minimise the risk of transmission, the WHO recommends treating HIV-positive mothers with highly-active antiretroviral therapy (HAART) during pregnancy and breastfeeding (Beyrer 2016). Initial HAART treatment regimens usually include two nucleoside reverse transcriptase inhibitors and one or more additional drugs. The goal is stopping viral replication, reducing the viral load, and increasing the number of CD4 cells. This helps to prevent the transmission of HIV and often reduces the severity of complications, ultimately increasing survival rate (Poorolajal et al. 2016; Sebitloane and Moodley 2017).
Developments in pharmacotherapeutic agents for hepatitis B – how close are we to a functional cure?
Published in Expert Opinion on Pharmacotherapy, 2023
Naoshin Khan, Mohamed Ramzi Almajed, Mary Grace Fitzmaurice, Syed-Mohammed Jafri
Nucleos(t)ide analogs resemble naturally occurring nucleos(t)ides to cause termination of emerging DNA chains. They are also known as reverse transcriptase inhibitors (NRTIs) that inhibit viral replication either by competitive inhibition of the viral polymerase or by DNA chain termination [11]. Treatment with these agents is life-long given that after 5 years of treatment, minimal reduction in HBsAg was seen. The effectiveness of nucleos(t)ide analogs depends on the viral status of the patient. In HBeAg-positive patients, serologic response is only seen in those patients with elevated ALT. HBV DNA will decrease independent of ALT levels and HBV genotype [12]. However, with higher viral load, prolonged therapy with these agents is typically needed as DNA remains detectable after one to two years of treatment. In HBeAg-negative patients, due to varying responses, therapy is reserved for patients with persistently elevated ALT, often with findings of substantial inflammation or cirrhosis on imaging.
Influence of HIV on in-hospital outcomes in patients with atrial fibrillation
Published in Acta Cardiologica, 2023
Daniel Antwi-Amoabeng, Joban Ghuman, Sunil Sathappan, Bryce D. Beutler, Mark B. Ulanja, Mihir Dave, Omar Canaday
In the early years of the epidemic, HIV/AIDS was considered a death sentence; the median life expectancy for an individual diagnosed with AIDS was 1–2 years [13]. Fortunately, progress in HIV/AIDS management since the early 1980s has been nothing short of astounding. The first antiretroviral agent, zidovudine (AZT)—a nucleoside reverse transcriptase inhibitor—was approved by the Food and Drug Administration in 1987 and represented a quantum leap forward in HIV treatment, marking a transition from supportive care to targeted therapy [14]. Protease and non-nucleoside reverse transcriptase inhibitors were approved in 1995 and 1996, respectively, and significantly prolonged the lives of affected individuals [15]. Further progress was achieved with the introduction of entry and integrase inhibitors in the first decade of the 2000s. As of this writing, the projected life expectancy for a young adult diagnosed with HIV who receives highly-active antiretroviral therapy (HAART) is ∼53 years—less than a decade shorter than the average life expectancy of the general population[16].