Antiretroviral therapy in AIDS

Article Abstract:

Human immunodeficiency virus (HIV), the causative agent of AIDS, belongs to a class known as retroviruses. New antiretroviral drugs are being used to combat the AIDS virus. The first of these agents to be used to treat HIV infection is zidovudine (AZT). One concern regarding the use of AZT has been the emergence of AZT-resistant strains of HIV, particularly in patients who have been using the drug for six months or more. Consequently, other drugs that act by different mechanisms are being investigated. HIV infects cells by binding to a target cell protein called CD4. Efforts have been made to create CD4 derivatives to which HIV would preferentially bind, rather than infecting cells. However, this is still experimental, and to some degree theoretical. A group of molecules in the anionic polysaccharides category is being studied for their potential ability to block the reproduction of HIV, but results thus far show that these have little clinical effect. No other disease has resulted in such a rapid progression from laboratory studies to clinical trials. When AZT was given to far larger groups of people than those initially targeted, epidemiologic studies showed increases in overall AIDS survival. The improved survival was nearly offset by the toxicity of the drug, but recent studies have shown that a lower dose of AZT than originally prescribed is as effective, with considerably fewer toxic effects. Drugs similar to AZT, including ddC, ddA, and ddI, are undergoing trials. Like AZT, they show antiviral activity, but each has its own associated toxic side effects. Future research will focus on the reproductive pattern of HIV and on drugs that inhibit the various steps of this reproduction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Zidovudine, HTLV infections, panel discussion

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Induction of adrenal suppression by megestrol acetate in patients with AIDS

Article Abstract:

The use of megestrol acetate in AIDS patients may have the adverse side effect of suppressing adrenal activity. This hormonally derived compound is used to induce weight gain in AIDS patients. Three AIDS patients treated with megestrol acetate gained 9, 7.5, and 16 pounds, respectively, in 3 months. However, adrenal hormonal levels dropped significantly. Cortisol levels dropped 10-fold and ACTH levels dropped 2.5-fold to subnormal levels. In one of these patients who also had diabetes, insulin requirements increased 10-fold. A separate case study patient who suspended treatment with this drug had clinical symptoms ranging from exhaustion to low blood pressure. This patient also had nearly non-existent cortisol levels indicating poor adrenal function. Symptoms of disease associated with low adrenal hormonal activity may be expected with the use of megestrol acetate and particularly when treatment is withdrawn.

Physiological aspects, Megestrol acetate, Cachexia, Megestrol, Adrenal glands

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Using multiple drugs in combination helps patients with advanced AIDS

Article Abstract:

Highly active antiretroviral therapy (HAART) appears to benefit AIDS patients who are very ill, according to a study of 528 patients with advanced AIDS. HAART usually involves taking three or four AIDS drugs that affect the virus in different ways.

Anti-HIV agents

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