1.  Title: Chronic viral hepatitis may diminish the gains of HIV antiretroviral therapy in sub-Saharan Africa. Author: Cooper CL; Mills E; Wabwire BO; Ford N; Olupot-Olupot P Source: International Journal of Infectious Diseases. 2009 May;13(3):302-6. Abstract: There is a heavy burden of HIV-hepatitis B virus (HBV) and HIV-hepatitis C virus (HCV) co-infection in many regions of the developing world. An often unmentioned illness, issues of poverty, socio-economic status, nutrition, access to medical care, and mistrust of Western-style medicine conspire to reduce the opportunity to receive clinical work-up and treatment for chronic viral hepatitis. We discuss key issues specific to the treatment of viral hepatitis and obstacles to success with this endeavor in the context of HIV co-infection in Africa. We predict that provision of viral hepatitis antiviral therapy will become a more pressing issue as more HIV-infected patients receive lifesaving combination antiretroviral therapy only to succumb thereafter from viral hepatitis-induced liver disease. Given the lessons learned from combination antiretroviral rollout in sub-Saharan Africa, establishing expertise and infrastructure for viral hepatitis care and antiviral therapy is relevant. Failure to act now may diminish the milestones and the gains made with antiretroviral therapy in the developing world. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | SIDE EFFECTS | HEPATIC EFFECTS | TOXICITY | HEPATITIS | ANTIVIRAL DRUGS | OBSTACLES | SCREENING | Africa | Developing Countries | HIV | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Drugs | Organization and Administration | Examinations and Diagnoses Document Number: 342111 |
| 2. Title: Contraception and HIV infection in women. Author: Heikinheimo O; Lahteenmaki P Source: Human Reproduction Update. 2009 Mar-Apr;15(2):165-76. Abstract: BACKGROUND: More than 15 million women, many of reproductive age, were infected with human immunodeficiency virus (HIV) at the end of 2007. As the HIV epidemic evolves, heterosexual intercourse is increasingly risky: the risk of infection in exposed young women is 4- to 7-fold higher than in young men and nearly half a million newborns annually have HIV. This review aims to show the effect of contraceptive choices on risk of HIV and on the course of disease in women with HIV. METHODS: Relevant citations were selected by agreement between the authors after a search of MEDLINE using the terms HIV/AIDS and contraception. RESULTS: Risk of transmission of HIV varies from 1 in 200 to 1 in 10 000 coital incidents, depending in part on the integrity of the vaginal epithelium. Consistent use of male condoms has been proven to reduce horizontal transmission of HIV by 80% among HIV-serodiscordant couples. Hormonal contraception may increase the risk of HIV acquisition in high-risk women such as commercial sex workers, but not in women at low risk of HIV. While hormonal contraception did not affect progression of disease in two cohort studies involving 370 women, in a randomized trial among women not receiving antiretroviral medication, clinical disease accelerated in the oral contraception group (13.2/100 woman-years) compared with the copper intrauterine devices group (8.6/100 woman-years; hazard ratio, 1.5; 95% confidence interval, 1.04-2.1). Hormonal contraception does not interfere with antiviral drug effectiveness. CONCLUSIONS: All the available reversible contraceptive methods can generally be used by women at risk of HIV infection and by HIV-infected women. Further studies are needed to investigate the safety and efficiency of hormonal contraception in women living with HIV/AIDS. Language: English Keywords: FINLAND | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | HIV INFECTIONS | CONDOM USE | CONTRACEPTIVE AGENTS, FEMALE | HORMONES | IUD, COPPER RELEASING | ANTIVIRAL DRUGS | DRUG INTERACTIONS | Developed Countries | Europe, Northern | Europe | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Risk Reduction Behavior | Behavior | Contraceptive Agents | Contraception | Family Planning | Endocrine System | Physiology | Biology | IUD | Contraceptive Methods | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330966 |
| 3. Peer Reviewed Title: Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study. Author: Lingappa JR; Kahle E; Mugo N; Mujugira A; Magaret A Source: PloS One. 2009;4(4):e5272. Abstract: BACKGROUND: The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. METHODS: HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. RESULTS: Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (<5%), except for Trichomonas vaginalis in 14% of HIV-1 infected women. Median baseline CD4 count for HIV-1 infected participants was 462cells/mcL and median HIV-1 plasma RNA was 4.2 log(10) copies/mL. After adjusting for age and African region, correlates of HIV-1 RNA level included male gender (+0.24 log(10) copies/mL; p<0.001) and CD4 count (-0.25 and -0.55 log(10) copies/mL for CD4 350-499 and >500 relative to <350, respectively, p<0.001). CONCLUSIONS: The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT00194519. Language: English Keywords: AFRICA | RESEARCH REPORT | CLINICAL TRIALS | SEXUAL PARTNERS | HETEROSEXUALS | HERPES GENITALIS | ANTIVIRAL DRUGS | HIV PREVENTION | HIV TRANSMISSION | RISK FACTORS | Developing Countries | Clinical Research | Research Methodology | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases Document Number: 342450 |
| 4. Peer Reviewed Title: Effect of aciclovir on HIV-1 acquisition in herpes simplex virus 2 seropositive women and men who have sex with men: a randomised, double-blind, placebo-controlled trial. Author: Celum C; Wald A; Hughes J; Sanchez J; Reid S Source: Lancet. 2008 Jun 21-27;371(9630):2109-2119. Abstract: Across many observational studies, herpes simplex virus type 2 (HSV-2) infection is associated with two-fold to three-fold increased risk for HIV-1 infection. We investigated whether HSV-2 suppression with aciclovir would reduce the risk of HIV-1 acquisition. We undertook a double-blind, randomised, placebo-controlled phase III trial in HIV-negative, HSV-2 seropositive women in Africa and men who have sex with men (MSM) from sites in Peru and the USA. Participants were randomly assigned by block randomisation to twice daily aciclovir 400 mg (n=1637) or matching placebo (n=1640) for 12-18 months, and were seen monthly for dispensation of study drug, adherence counselling and measurement by pill count and self-reporting, and risk reduction counselling, and every 3 months for genital examination and HIV testing. The primary outcome was HIV-1 acquisition and secondary was incidence of genital ulcers. Analysis was by intention to treat. This study is registered with Clinicaltrials.gov, number NCT00076232. 3172 participants (1358 women, 1814 MSM) were included in the primary dataset (1581 in aciclovir group, 1591 in control group). The incidence of HIV-1 was 3.9 per 100 person-years in the aciclovir group (75 events in 1935 person-years of follow-up) and 3.3 per 100 person-years in the placebo group (64 events in 1969 person-years of follow-up; hazard ratio 1.16 [95% CI 0.83-1.62]). Incidence of genital ulcers on examination was reduced by 47% (relative risk 0.53 [0.46-0.62]) and HSV-2 positive genital ulcers by 63% (0.37 [0.31-0.45]) in the aciclovir group. Adherence to dispensed study drug was 94% in the aciclovir group and 94% in the placebo group, and 85% of expected doses in the aciclovir group and 86% in the placebo group. Retention was 85% at 18 months in both groups (1028 of 1212 in aciclovir group, 1030 of 1208 in placebo group). We recorded no serious events related to the study drug. Our results show that suppressive therapy with standard doses of aciclovir is not effective in reduction of HIV-1 acquisition in HSV-2 seropositive women and MSM. Novel strategies are needed to interrupt interactions between HSV-2 and HIV-1. (author's) Language: English Keywords: SOUTH AFRICA | ZIMBABWE | ZAMBIA | UNITED STATES OF AMERICA | PERU | RESEARCH REPORT | DOUBLE-BLIND STUDIES | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | WOMEN | MEN HAVING SEX WITH MEN | HERPES GENITALIS | HIV INFECTIONS | ANTIVIRAL DRUGS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Developed Countries | North America | Americas | South America, Western | South America | Latin America | Studies | Research Methodology | Clinical Research | Viral Diseases | Diseases | Demographic Factors | Population | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 327473 |
| 5. Peer Reviewed Title: Suppressive acyclovir therapy reduces HIV cervicovaginal shedding in HIV- and HSV-2-infected women, Chiang Rai, Thailand. Author: Dunne EF; Whitehead S; Sternberg M; Thepamnuay S; Leelawiwat W Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49(1):77-83. Abstract: BACKGROUND: Herpes simplex virus type 2 infection is important in the HIV epidemic and may contribute to increased HIV transmission. We evaluated the effect of suppressive acyclovir therapy on cervicovaginal HIV-1 shedding. METHODS: HIV-1- and herpes simplex virus type 2-coinfected women aged 18-49 years with CD4 counts >200 cells/microL were enrolled in a randomized crossover trial of suppressive acyclovir therapy (NCT00362596, http://www.clinicaltrials.gov). For each woman, monthly plasma and weekly cervicovaginal lavage specimens were collected; the mean of the monthly median cervicovaginal lavage HIV-1 viral load and plasma HIV-1 viral load was compared. RESULTS: Sixty-seven women were enrolled; at baseline, median CD4 count was 366 cells/microL, and median HIV-1 plasma viral load was 4.6 log10 copies/mL. The mean cervicovaginal lavage HIV-1 viral load was 1.9 (SD 0.8) log10 copies/mL during the acyclovir month and 2.2 (SD 0.7) log10 copies/mL during the placebo month (P < 0.0001); the mean decrease in HIV was 0.3 log10 copies/mL. The mean plasma HIV viral load during the acyclovir month (3.78 log10 copies/mL) was reduced compared with the placebo month (4.26 log10 copies/mL, P < 0.001). CONCLUSIONS: Acyclovir reduced HIV genital shedding and plasma viral load among HIV-1- and herpes simplex virus type 2-coinfected women. Further data from clinical trials will examine the effect of suppressive therapy on HIV transmission. Language: English Keywords: THAILAND | RESEARCH REPORT | CERVICAL EFFECTS | ANTIVIRAL DRUGS | HIV INFECTIONS | HERPES GENITALIS | Developing Countries | Asia, Southeastern | Asia | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 328260 |
| 6. Peer Reviewed Title: An international, randomized, double-blind, placebo-controlled, study of valacyclovir for the suppression of herpes simplex virus type 2 genital herpes in newly diagnosed patients. Author: Fife KH; Warren TJ; Justus SE; Heitman CK Source: Sexually Transmitted Diseases. 2008 Jul;35(7):668-73. Abstract: BACKGROUND: Antiviral suppressive therapy of genital herpes is often initiated based on the established pattern of recurrences in an individual. Because most persons with first episode herpes simplex virus type 2 (HSV-2) infection experience recurrences and because viral shedding occurs frequently in the first year after infection, we examined the strategy of initiating suppressive therapy shortly after diagnosis of genital HSV-2 infection. SUBJECTS AND METHODS: From June 16, 2004 to July 26, 2006, 384 subjects from 74 sites in the United States, Canada, Argentina, Brazil, and Chile who were newly diagnosed with a first recognized episode of genital herpes at the time of the screening visit or within 3 months before the screening visit were randomized (2:1) to receive valacyclovir 1 g once daily or placebo for 24 weeks. Subjects were instructed to return to clinic during suspected genital herpes outbreaks for clinician confirmation of recurrences. RESULTS: Valacyclovir significantly prolonged the time to first recurrence of HSV-2 genital herpes in newly diagnosed subjects compared with placebo, with approximately 43% of subjects on placebo and 71% of subjects on valacyclovir recurrence-free at 24 weeks (P <0.001). Valacyclovir significantly reduced the mean number of genital HSV-2 recurrences per month occurring during the 24-week study period (0.11 for valacyclovir, 0.48 for placebo, P <0.001). Adverse events were comparable in the valacyclovir and placebo arms. CONCLUSION: Valacyclovir 1 g once daily administered for 24 weeks was well-tolerated and effective in suppressing genital herpes recurrences in immunocompetent newly diagnosed persons without an established recurrence pattern. Language: English Keywords: BRAZIL | UNITED STATES OF AMERICA | CHILE | ARGENTINA | CANADA | RESEARCH REPORT | CLIENTS | HERPES GENITALIS | TREATMENT | SCREENING | EXAMINATIONS AND DIAGNOSES | ANTIVIRAL DRUGS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Developed Countries | North America | South America, Southern | North America, Northern | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 328375 |
| 7. Title: The emerging field of HCV drug resistance. Author: Koev G; Kati W Source: Expert Opinion on Investigational Drugs. 2008;17(3):303-319. Abstract: With 170 million people infected worldwide and an inadequate current standard of care, hepatitis C virus (HCV) infection represents a major unmet medical need. Multiple companies are working on the discovery and development of specific HCV antiviral drugs, including inhibitors of HCV polymerase, protease and NS5A. Because of the error-prone nature of viral RNA replication, resistance mutants will develop that could present a potentially significant challenge to developing antiviral treatment regimens. Here, we review the major classes currently in preclinical and clinical development and the resistance mutations specific for each class that have been identified from cell culture and/or in vivo studies. We have analyzed currently available scientific literature to create a comprehensive review of the current state of the art in the field of HCV resistance to specific antiviral agents, in vitro and in vivo. Most specific HCV inhibitors described in the literature can select resistant viral variants in cell culture and in the clinic. Interplay of a mutant's fitness and its level of resistance will determine its clinical importance. Combinations of non-cross-resistant classes of drugs will be key to successful antiviral therapy. The number of drugs in a combination as well as the optimal duration of antiviral treatment, are important issues that need to be addressed in future studies. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | DATA ANALYSIS | HEPATITIS | DRUG RESISTANCE | RESEARCH AND DEVELOPMENT | ANTIVIRAL DRUGS | Developed Countries | North America | Americas | Research Methodology | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Technology | Economic Factors | Drugs Document Number: 325225 |
| 8. Title: Herpes simplex virus type 2: epidemiology and management options in developing countries. Author: Paz-Bailey G; Ramaswamy M; Hawkes SJ; Geretti AM Source: Postgraduate Medical Journal. 2008 Jun;84(992):299-306. Abstract: Genital herpes simplex virus type 2 (HSV2) is highly prevalent worldwide and an increasingly important cause of genital ulcer disease (GUD). Continued HSV2 transmission is facilitated by the large number of undiagnosed cases, the frequency of atypical disease and the occurrence of asymptomatic shedding. The lack of easy, affordable diagnostic methods and specific antiviral treatment in countries with low and middle income is of great concern, given the ability of GUD to enhance HIV transmission and acquisition. With rising HSV2 prevalence contributing to an increase in the proportion of GUD attributed to genital herpes in high-HIV prevalence settings, a safe and effective HSV vaccine is urgently needed. Meanwhile, multifaceted interventions are required to improve recognition of genital herpes, to prevent its spread and also to prevent its potential to promote HIV transmission in developing countries. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EPIDEMIOLOGIC METHODS | TARGET POPULATION | PREVALENCE | HERPES GENITALIS | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | COST EFFECTIVENESS | ANTIVIRAL DRUGS | HIV TRANSMISSION | VACCINES | Research Methodology | Program Design | Programs | Organization and Administration | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Drugs | Treatment | HIV Infections | Viral Diseases Document Number: 329292 |
9.  Title: Acyclovir susceptibility of herpes simplex virus isolates at King Chulalongkorn Memorial Hospital, Bangkok. Author: Sangdara A; Bhattarakosol P Source: Journal of the Medical Association of Thailand. 2008 Jun;91(6):908-912. Abstract: To determine the ACV susceptibility in Thai HSV clinical isolates, one hundred thirty HSV isolates from the Virology Laboratory Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand had typing done by immunofluoresent assay using monoclonal antibody specific to either HSV-1 or HSV-2. Their sensitivity to ACV (IC50) was determined by plaque reduction assay. The IC50 of 77 HSV-1 isolates ranged from 0.07-0.97 µg/ml and that of 53 HSV-2 isolates was 0.13-1.66 µg/ml. The standard HSV-1 (KOS) and HSV-2 (Baylor 186) were included in each run. The mean + standard deviation (SD) of ACV IC50 among HSV-1 and HSV-2 isolates were 0.38 + 0.23 and 0.50 + 0.32 µg/ml while that of standard HSV-1 and HSV-2 were 0.45 + 0.13 and 0.57 + 0.04 µg/ml. Statistically significant difference between IC50 of HSV-1 and HSV-2 isolates was indicated (p = 0.02). The conclusion was that no ACVr HSV has been detected and ACV susceptibility of HSV-2 has more resistance than that of HSV-1. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | LABORATORY PROCEDURES | HERPES GENITALIS | ANTIVIRAL DRUGS | DRUG RESISTANCE | Developing Countries | Asia, Southeastern | Asia | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Drugs | Treatment Document Number: 327451 |
| 10. Title: Emerging drugs for hepatitis C. Author: Soriano V; Madejon A; Vispo E; Labarga P; Garcia-Samaniego J Source: Expert Opinion on Emerging Drugs. 2008 Mar;13(1):1-19. Abstract: Chronic hepatitis C virus (HCV) infection remains a global health threat with approximately 200 million carriers worldwide. Current treatment consists of the use of peginterferon (pegIFN)/ribavirin (RBV) for 24 or 48 weeks depending on HCV genotype. Serious side effects and the fact that less than half of patients infected with HCV genotypes 1 and 4 (which are the most common) accomplish sustained virological response with this medication warrant the need for novel anti-HCV therapies. The objective was the description of specifically targeted antiviral therapies for hepatitis C (STAT-C) designed to inhibit the serine protease and the RNA-dependent HCV-RNA polymerase. The method used was a review of available data reported in peer-reviewed journals and medical conferences. Early preclinical studies using these compounds produced encouraging results, but the initial enthusiasm has been hampered by toxicity issues and rapid selection of resistance. Therefore, combination therapy with a backbone of pegUFN/RBV, or perhaps in the future using several of these small molecules, preferable having district modes of action and resistance profiles, will be required. (author's) Language: English Keywords: PROGRESS REPORT | LITERATURE REVIEW | EVALUATION | TARGET POPULATION | HEPATITIS | ANTIVIRAL DRUGS | TREATMENT | SIDE EFFECTS | ADMINISTRATION AND DOSAGE | GENETICS | TOXICITY | Program Design | Programs | Organization and Administration | Viral Diseases | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Physiology Document Number: 325182 |
| 11. Peer Reviewed Title: Surfactants as microbicides and contraceptive agents: a systematic in vitro study. Author: Vieira OV; Hartmann DO; Cardoso CM; Oberdoerfer D; Baptista M; Santos MA; Almeida L; Ramalho-Santos J; Vaz WL Source: PLoS One. 2008;3(8):e2913. Abstract: BACKGROUND: The urgent need for cheap and easy-to-use protection against both unwanted pregnancies and sexually transmitted diseases has stimulated considerable interest in the use of surfactants as microbicides, anti-viral, and contraceptive agents in recent years. In the present study we report a systematic in vitro evaluation of the microbicidal, anti-viral and contraceptive potential of cationic, anionic, zwitterionic, and non-ionic surfactants. METHODOLOGY/PRINCIPAL FINDINGS: Toxicity was evaluated in mammalian columnar epithelial (MDCK) cells, human sperm cells, Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Streptococcus agalactiae and Enterococcus faecalis. The inhibition of adenovirus and lentivirus infection of MDCK cells was also tested. A homologous series of cationic surfactants, alkyl-N,N,N-trimethylammonium bromides (C(n)TAB), with varying alkyl chains were shown to be bactericidal and fungicidal at doses that were related to the surfactant critical micelle concentrations (CMC), all of them at concentrations significantly below the CMC. In general, bacteria were more susceptible to this surfactant group than C. albicans and this organism, in turn, was more susceptible than MDCK cells. This suggests that the C(n)TAB may be useful as vaginal disinfectants only in so far as bacterial and fungal infections are concerned. None of the surfactants examined, including those that have been used in pre-clinical studies, showed inhibition of adenovirus or lentivirus infection of MDCK cells or spermicidal activity at doses that were sub-toxic to MDCK cells. CONCLUSIONS/SIGNIFICANCE: The results of this study lead us to propose that systematic analysis of surfactant toxicity, such as we report in the present work, be made a mandatory pre-condition for the use of these substances in pre-clinical animal and/or human studies. Language: English Keywords: PORTUGAL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | LABORATORY ANIMALS | IN VITRO | MICROBICIDES | VAGINAL GEL | SEXUALLY TRANSMITTED DISEASE PREVENTION | VAGINAL FOAM | BACTERIAL AND FUNGAL DISEASES | ANTIVIRAL DRUGS | Europe, Southwestern | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 329236 |
| 12. Title: Avian influenza: Critical program issues. Author: Yansen S; Safi B; Nuzzo J; Barnett D Source: Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health [INFO], 2008 Feb 21. [2] p. (Global Health Technical BriefsUSAID Grant No. GPH-A-00-02-00003-00) http://www.maqweb.org/techbriefs/spanish/stb46avianflu.pdf (Spanish) Abstract: While the spread of avian influenza (H5N1) virus from person-to-person is currently rare and unsustained, H5N1 continues to pose a significant threat to public health and economies worldwide. All evidence to date indicates that close contact with dead or sick birds is the principal source of human infection with H5N1. Key protective practices endorsed by international agencies include washing (proper hygiene), separating chickens/birds, reporting dead or sick chickens/birds, and cooking poultry properly. Strategic AI communication can effectively increase awareness of AI risks, means of transmission, and promote sustained behavior change when carefully delivered. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | INFLUENZA | COMMUNICABLE DISEASE CONTROL | HYGIENE | INFECTION TRANSMISSION | BEHAVIOR CHANGE COMMUNICATION | ANTIVIRAL DRUGS | VACCINES | POLITICAL FACTORS | USAID | Administrative Personnel | Organization and Administration | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Public Health | Infections | Behavior Change | Behavior | Communication Programs | Communication | Drugs | Treatment | Medical Procedures | Medicine | Sociocultural Factors | Government Agencies | Organizations Document Number: 326800 |
| 13. Title: The ethics of rationing antiretroviral treatment. Author: Chakrabartty A Source: Indian Journal of Medical Ethics. 2007 Jul-Sep;4(3):135; discussion 136-7. Abstract: In a super specialty government medical centre, antiretroviral treatment (ART) is provided to People Living with HIV and AIDS (PLHAs). Each month, on an average, 100 PLHAs come to the centre for ART. A clinician heads this ART centre in a medical college. The rule of thumb is that all PLHAs who are willing to receive ART undergo certain blood tests. On the basis of the test results, the clinician identifies PLHAs who are "fit" for the course of drugs. The clinician offers ART to such cases on a "first-come first-priority" basis. For various reasons, a significant proportion of PLHAs default in adhering to the therapy. Therefore, counselling is provided at the medical centre to each case selected for ART. One PLHA, Mr K, started ART on June 2003 at this clinic. After six months of his ART course, he had to visit his home in Bihar for four months. He requested the clinic to provide him with enough drugs for this duration. The clinic refused, saying that it was against government policy. As a result, while he was away, his ART could not be continued. He returned after four months to the clinic to restart his treatment. Due to the significant gap in treatment, the clinic requested him to undergo tests for resistance. He was initially very reluctant, but after repeated requests and consultations with the clinicians, he took the tests. The tests fortunately showed that he had not developed resistance. His ART drug was restarted. However, soon after the treatment was resumed, he was summoned back to his home in Bihar to attend to his wife's illness. The treatment again had to be discontinued. This time, he was away for five months. On his return, when he reported to the clinic, he again went through the tests for resistance. This time, he had developed resistance to the first-line ART he was receiving. When he was informed about second-line ART, he made a claim for it from the clinic. He was told that according to government policy, all government clinics provide only first-line ART, and if he wanted second-line ART he would have to buy it from the market. He was not financially capable of buying medicines from the market for the long-term treatment he needed. K believes that he has a right to receive second-line drugs from the government. He also believes that he developed resistance because of the government's faulty policy of not providing him with drugs to take with him when he visited his hometown. He has decided to go to the courts to force the government to respect his right to get full treatment and to change the government policy of not giving medicines when someone is travelling. He is also planning to approach the Human Rights Commission to get redress for the violation of his human rights. (excerpt) Language: English Keywords: INDIA | CRITIQUE | RECOMMENDATIONS | CASE STUDIES | PERSONS LIVING WITH HIV/AIDS | POLICYMAKERS | ETHICS | ANTIVIRAL DRUGS | RESOURCE ALLOCATION | HEALTH POLICY | HUMAN RIGHTS | DECISION MAKING | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Administrative Personnel | Organization and Administration | Sociocultural Factors | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Health | Financial Activities | Economic Factors | Policy | Political Factors | Behavior | Program Evaluation | Programs Document Number: 328773 |
| 14. Title: [Diagnosis and treatment of human papillomavirus] Diagnostico y terapia del virus papiloma humano. Author: Concha Rogazy M Source: Revista Chilena de Infectiologia. 2007 Jun;24(3):209-214. Abstract: The identification and treatment of human papillomavirus (HPV) infections and HPV-associated neoplasm are complex. Difficulties in diagnosis and treatment of HPV-associated diseases arise from inabilities to detect HPV efficiently, the lack of specific antiviral drugs active against HPV and the high rates of recurrence and persistence of HPV infections after treatment. We present a review of therapies for HPV infections. Language: Spanish Keywords: GLOBAL | HPV | TREATMENT | EXAMINATIONS AND DIAGNOSES | ANTIVIRAL DRUGS | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 324802 |
| 15. Peer Reviewed Title: Genital herpes. Author: Gupta R; Warren T; Wald A Source: Lancet. 2007 Dec;370(9605):2127-2137. Abstract: Genital herpes is the main cause of genital ulcers worldwide; the prevalence of herpes simplex virus (HSV) type 2 infections in the general population ranges from 10% to 60%. Most genital herpes is caused by HSV-2, although HSV-1 accounts for about half of new cases in developed countries. The risk of HIV acquisition is three times higher in people with HSV-2. Neonatal herpes is an uncommon but serious complication of genital herpes. Most genital HSV-2 infections are unrecognised and undiagnosed; infected individuals, even with mild symptoms, shed HSV, and can infect sexual partners. Since clinical diagnosis is neither sensitive nor specific, virological and type-specific serological tests should be used routinely. Oral antiviral drugs for HSV infections are safe and effective and can be used both to treat episodes and to prevent recurrences. Antiviral treatment of the infected partners and condom use reduce the risk of sexual transmission of HSV-2. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | SEXUAL PARTNERS | HERPES GENITALIS | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | NEONATAL DISEASES AND ABNORMALITIES | SEROCONVERSION | LABORATORY EXAMINATIONS AND DIAGNOSES | ANTIVIRAL DRUGS | CONDOM USE | INFECTION TRANSMISSION | Developed Countries | North America | Americas | Research Methodology | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Transmission | Immunity | Immune System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Risk Reduction Behavior Document Number: 323239 |
| 16. Peer Reviewed Title: Genital herpes in Africa: Time to rethink treatment. Author: O’Farrell N; Moodley P; Sturm AW Source: Lancet. 2007 Dec;370(9605):2164-2166. Abstract: That genital ulcer disease increases the risk of HIV infection was first identified in Africa in the mid-1980s, and several studies have since confirmed this association. Bacterial genital ulcer diseases such as chancroid, syphilis, or donovanosis were initially thought to be responsible for the link with HIV. As the incidence of these bacterial diseases has diminished, genital herpes has been identified as having an increasing role in HIV transmission at the population level because of its growing prevalence. In a meta-analysis, the population-attributable risk percentage of HIV transmissions due to herpes simplex virus type 2 (HSV2) infection (that causes genital herpes) was estimated to be 19% in populations which had a 22% HSV2 antibody positive prevalence; this risk rose to 47% in populations with 80% HSV2 antibody positive prevalence. The importance of HSV2 in Africa has been reinforced by evidence that both men and women have high HSV2 antibody levels. (excerpt) Language: English Keywords: AFRICA | PROGRESS REPORT | EPIDEMIOLOGIC METHODS | HEALTH PERSONNEL | HERPES GENITALIS | HIV TRANSMISSION | RISK FACTORS | TREATMENT | ANTIVIRAL DRUGS | SIGNS AND SYMPTOMS | SEX EDUCATION | TRAINING ACTIVITIES | POLITICAL FACTORS | Developing Countries | Research Methodology | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Biology | Medical Procedures | Medicine | Health Services | Drugs | Education | Training Programs | Sociocultural Factors Document Number: 323241 |
| 17. Peer Reviewed Title: Pregnancy in effectiveness trials of HIV prevention agents. Author: Raymond EG; Taylor D; Cates W Jr; Tolley EE; Borasky D Source: Sexually Transmitted Diseases. 2007 Dec;34(12):1035-1039 . Abstract: Despite remarkable progress over the past several decades in understanding the biology and epidemiology of the HIV pandemic, the virus continues to spread relentlessly. Diverse prevention approaches are desperately needed to reverse this trend. For many women, products that can be used without the cooperation of male partners are critical. Multiple such products are currently being tested in large-scale effectiveness trials, and many more are in earlier stages of development. These products include physical and chemical barriers to viral entry, vaginal pH buffers, an antiherpes drug, antiretroviral drugs, and other agents. Some of these products may have contraceptive as well as anti-infective activity. The basic design of HIV prevention trials is standard: HIV-negative women at risk for HIV infection are randomly assigned to use either the study product or a placebo according to a specified schedule (e.g., daily or before each coital act) and then are followed to assess HIV incidence. Most HIV prevention trials are conducted in resource-poor settings in Africa and Asia where HIV incidence is high. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CLINICAL TRIALS | PREGNANT WOMEN | PREGNANCY | HIV PREVENTION | DRUGS | SAFETY | VAGINAL SPERMICIDES | MICROBICIDES | ANTIVIRAL DRUGS | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Contraceptive Methods | Contraception | Family Planning Document Number: 322525 |
| 18. Peer Reviewed Title: Genital herpes and its management. Author: Sen P; Barton SE Source: BMJ. British Medical Journal. 2007 May 19;334(7602):1048-1052. Abstract: Genital herpes is an important public health disease and is the leading cause of genital ulcer disease worldwide. We present the latest evidence based guidelines from the British Association for Sexual Health and HIV (BASHH), the Centers for Disease Control and Prevention (CDC), and other expert committees to provide an up to date account of genital infection with herpes simplex virus (HSV), its clinical features and diagnosis, and a practical approach to management of affected patients. Treatment regimens have largely been based on evidence obtained from randomised controlled trials, while certain new diagnostic tests are limited by lower levels of evidence obtained only from descriptive or case studies. (excerpt) Language: English Keywords: UNITED KINGDOM | LITERATURE REVIEW | CLIENTS | HERPES GENITALIS | PREVALENCE | PUBLIC HEALTH | COUNSELING | ANTIVIRAL DRUGS | ADMINISTRATION AND DOSAGE | PREGNANCY | CESAREAN SECTION | HIV INFECTIONS | Europe, Western | Europe | Developed Countries | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Research Methodology | Health | Clinic Activities | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Reproduction | Obstetrical Surgery | Surgery | Viral Diseases Document Number: 313532 |
| 19. Title: New antiviral agents. Author: Abdel-Haq N; Chearskul P; Al-Tatari H; Asmar B Source: Indian Journal of Pediatrics. 2006 Apr;73(4):313-321. Abstract: During the last three decades, a better understanding of viral replication and disease states caused by viral infections have led to the development of newer antiviral agents with enhanced activity and better tolerability. This review focuses on newer systemic and topical antiviral agents that are used in treatment of herpes viruses including herpes simplex type-1 (HSV-1) and type-2 (HSV-2), varicella-zoster virus (VZV) and cytomegalovirus CMV) as well as the human papilloma virus (HPV). Included in this article are the agents famciclovir, penciclovir, valganciclovir, imiquimod, docosanole and brivudin. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | TARGET POPULATION | ANTIVIRAL DRUGS | VIRAL DISEASES | ADMINISTRATION AND DOSAGE | SIDE EFFECTS | CONTRAINDICATIONS | SEXUALLY TRANSMITTED DISEASES | HERPES GENITALIS | North America | Americas | Developed Countries | Research Methodology | Program Design | Programs | Organization and Administration | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Reproductive Tract Infections | Infections Document Number: 299922 |
| 20. Title: Ritonavir - fluticasone interaction causing Cushing syndrome in HIV-infected children and adolescents. Author: Arrington-Sanders R; Hutton N; Siberry GK Source: Pediatric Infectious Disease Journal. 2006 Nov;25(11):1044-1048. Abstract: Ritonavir, a potent inhibitor of CYP3A4 enzyme, can lead to high systemic concentrations of fluticasone when these 2 drugs are coadministered. Exogenous Cushing syndrome (CS) in HIV-infected patients receiving ritonavir and fluticasone has been reported frequently in adults but not in children. Three patients, all receiving ritonavir--fluticasone, developed weight gain and altered fat distribution concerning for either lipodystrophy or CS. Three patients were initially identified by their clinicians as having weight gain and altered fat distribution concerning for either lipodystrophy or CS. All 3 patients were receiving fluticasone and ritonavir, leading to concern about a potential medication interaction. After suspecting exogenous CS, all patient medication lists were reviewed to identify all children prescribed ritonavir--fluticasone. Blood adrenocorticotropic hormone (ACTH) and cortisol were obtained during routine clinic visits. Medication history, laboratory data and physical examination findings were abstracted from medical records. Seventeen (9%) of 189 patients in this pediatric HIV clinic had been prescribed ritonavir--fluticasone. Of 7 patients still taking ritonavir--fluticasone, CS features were present in 4 (57%) patients, including the 3 patients initially suspected of CS or lipodystrophy. Five (71%) patients, including all 4 with CS features, had low serum concentrations: median cortisol < 0.2 µg/dL (normal, < 0.2 µg/dL). Three of these 5 had ACTH measured, all of which were low: median ACTH 3.0 pmol/L (range, 2.2 -- < 5.0 pmol/L). One patient taking ritonavir--fluticasone had suppressed cortisol but no CS features. The 2 patients with normal serum cortisol and ACTH values had persistent HIV viremia and were suspected of medication nonadherence. Clinical and laboratory abnormalities generally normalized in affected patients within 3 months after discontinuation of fluticasone alone (2) and ritonavir--fluticasone (3). Pediatric HIV physicians frequently prescribe fluticasone and ritonavir together. The combination can cause CS and adrenal suppression in children, potentially leading to misdiagnosis of lipodystrophy syndrome and to increased risk of adrenal crisis during acute illness. Alternatives to fluticasone should be used for treating children receiving ritonavir. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | LABORATORY EXAMINATIONS AND DIAGNOSES | TREATMENT | DRUG INTERACTIONS | ANTIVIRAL DRUGS | ASTHMA | North America | Americas | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Pulmonary Effects | Physiology | Biology Document Number: 309620 |
| 21. Title: Guidelines on co-trimoxazole prophylaxis for HIV-related infections among children, adolescents and adults. Recommendations for a public health approach. Author: Bpharm MS; Chimzizi R; Chotpitayasunondh T; Crowley S; Duncombe C Author: World Health Organization [WHO] Source: Geneva, Switzerland, World Health Organization [WHO], 2006. 61 p. Abstract: In high-income countries, co-trimoxazole prophylaxis among children (both those exposed to HIV and those living with HIV) and adults and adolescents living with HIV has been the standard of care for many years. WHO and UNAIDS have not produced guidelines for national programmes in resource-limited settings. In the absence of clear guidelines, countries and programmes have been slow in adopting co-trimoxazole prophylaxis, a life-saving, simple and inexpensive intervention. The objective of these guidelines is to provide global technical and operational recommendations for the use of co-trimoxazole prophylaxis in HIV-exposed children, children living with HIV and adolescents and adults living with HIV in the context of scaling up HIV care in resource-limited settings. This publication is primarily intended for use by national HIV/AIDS programme managers, managers of nongovernmental organizations delivering HIV/AIDS care services and other policymakers who are involved in planning HIV/AIDS care strategies in resource-limited countries. It should also be useful to clinicians in resource-limited settings. (excerpt) Language: English Keywords: DEVELOPED COUNTRIES | MANUAL | PERSONS LIVING WITH HIV/AIDS | CHILD | INFANT | ADOLESCENTS | ADULTS | PREGNANT WOMEN | HIV INFECTIONS | MALARIA | ANTIVIRAL DRUGS | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | PERSONNEL MANAGEMENT | NONGOVERNMENTAL ORGANIZATIONS | RECOMMENDATIONS | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Management | Organization and Administration | Organizations | Political Factors | Sociocultural Factors Document Number: 322022 |
| 22. Title: Stampidine: a selective oculo-genital microbicide. Author: D'Cruz OJ; Uckun FM Source: Journal of Antimicrobial Chemotherapy. 2005;56:10-19. Abstract: Adenoviruses (ADVs) are causative agents of severe and extremely contagious ocular and genital infections associated with conjunctivitis, genital ulcers and urethritis. Yet, no functional antiviral compounds are currently available against adenoviral infections. We discovered halogen-substituted phenyl phosphoramidate derivatives of stavudine (STV/d4T) as a new class of dual-function anti-human immunodeficiency virus (HIV) agents with potent and selective anti-ADV activity. The lead compound, stampidine [5'-(4-bromophenyl methoxyalaninylphosphate)-2’,3’-didehydro-3’-deoxythymidine], was the most potent non-toxic dual-function antiviral agent. Stampidine displayed remarkable in vitro and in vivo anti-HIV activity against drug-sensitive and drug-resistant HIV strains. Stampidine was non-cytotoxic and nonirritating tomucosalepithelial cells. Several preclinical studies conducted thus far, suggest that stampidine has clinical potential as a dual-function topical agent for the prevention and/or effective treatment of oculo-genital ADV/HIV infections. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | PERSONS LIVING WITH HIV/AIDS | VIRAL DISEASES | ANTIVIRAL DRUGS | OPHTHALMOLOGICAL EFFECTS | UROGENITAL EFFECTS | North America | Americas | Developed Countries | Persons Living With HIV/AIDS | HIV Infections | Diseases | Drugs | Treatment | Physiology | Biology | Urogenital System Document Number: 285287 |
| 23. Title: Patient and partner perceptions about preventing genital herpes transmission. Author: Gilbert L; Scanlon K; Peterson R; Ebel C Source: Herpes. 2005 Dec;12(3):60-65. Abstract: Research over the past decade has provided a new understanding of genital herpes transmission and measures that can reduce transmission risk. It is unclear, however, how those affected by genital herpes access and interpret this information to make decisions about risk behaviours. This study measured how people with genital herpes and their partners perceived prevention methods, barriers and facilitating factors, and information sources. Formative evaluation was conducted, and survey data were collected from visitors to four websites (n = 1849). Results suggest that the prevention messages of refraining from sex during disease outbreaks and condom use have had the greatest reach. Misconceptions about the potential role of suppressive antiviral therapy for genital herpes prevention persist among a substantial percentage of respondents. Accurate information concerning transmission between outbreaks, the effectiveness of condoms and the role of antiviral medication is critical in preventing the spread of genital herpes. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE EVALUATION | SURVEYS | FOCUS GROUPS | CLIENTS | CONDOM USE | ANTIVIRAL DRUGS | TRANSMISSION | INFECTION PREVENTION | WOMEN | HERPES GENITALIS | Developed Countries | North America | Americas | Evaluation | Sampling Studies | Studies | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Risk Reduction Behavior | Behavior | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections Document Number: 285777 |
| 24. Title: Design of a small-molecule entry inhibitor with activity against primary measles virus strains. Author: Plemper RK; Doyle J; Sun A; Prussia A; Cheng LT Source: Antimicrobial Agents and Chemotherapy. 2005 Sep;49(9):3755-3761. Abstract: The incidence of measles virus (MV) infection has been significantly reduced in many nations through extensive vaccination; however, the virus still causes significant morbidity and mortality in developing countries. Measles outbreaks also occur in some developed countries that have failed to maintain high vaccine coverage rates. While vaccination is essential in preventing the spread of measles, case management would greatly benefit from the use of therapeutic agents to lower morbidity. Thus, the development of new therapeutic strategies is desirable. We previously reported the generation of a panel of small-molecule MV entry inhibitors. Here we show that our initial lead compound, although providing proof of concept for our approach, has a short half-life (< 16 h) under physiological conditions. In order to combine potent antiviral activity with increased compound stability, a targeted library of candidate molecules designed on the structural basis of the first lead has been synthesized and tested against MV. We have identified an improved lead with low toxicity and high stability (half-life >> 16 h) that prevents viral entry and hence infection. This compound shows high MV specificity and strong activity (50% inhibitory concentration = 0.6 to 3.0 µM, depending on the MV genotype) against a panel of wild-type MV strains representative of viruses that are currently endemic in the field. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | MEASLES | GENETICS | VACCINES | PREVENTION AND CONTROL | ANTIVIRAL DRUGS | CYTOLOGY | TOXICITY | North America | Americas | Developed Countries | Viral Diseases | Diseases | Biology | Drugs | Treatment | Physiology Document Number: 284800 |
| 25. Peer Reviewed Title: Care of patients with chronic hepatitis B and HIV co-infection: recommendations from an HIV-HBV International Panel. Author: Soriano V; Puoti M; Bonacini M; Brook G; Cargnel A Source: AIDS. 2005;19:221-240. Abstract: Liver disease caused by chronic hepatitis B virus (HBV) infection is currently an important cause of morbidity and mortality among HIV-infected patients in the western world, where classical opportunistic complications of severe immunodeficiency have declined dramatically as a result of the widespread use of potent antiretroviral therapies. Over the past few years, several consensus reports have addressed the issue of viral hepatitis and HIV co-infection. However, as a result of the larger impact of hepatitis C virus (HCV), they have focused mainly on HIV and HCV co-infection, whereas only a few reports have devoted particular attention to hepatitis B. There are several reasons to highlight HBV in HIV positive individuals. (excerpt) Language: English Keywords: DEVELOPED COUNTRIES | RECOMMENDATIONS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HEPATITIS | HIV INFECTIONS | TREATMENT | LIVER DYSFUNCTION | HEPATIC EFFECTS | ANTIRETROVIRAL DRUGS | ANTIVIRAL DRUGS | ADMINISTRATION AND DOSAGE | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Physiology | Biology | Drugs Document Number: 281562 |
| 26. Title: Varicella immunization and herpes zoster. Author: Volpi A Source: Herpes. 2005 Dec;12(3):59. Abstract: Herpes Zoster (Shingles) -- the clinical manifestation of latent varicella zoster virus (VZV) reactivation -- can occur several decades after primary infection and has a profound effect on quality of life and healthcare expenditure. An early study estimated there were 3.4 herpes zoster cases per 1000 population per year, with a direct relationship to age: the incidence by the 8th decade of life was 10/1000 per year. The annual incidence of herpes zoster is reported to be 2.9/1000 in the USA, 4.6/1000 in Iceland, 4/1000 in Italy and 4.8/1000 in France. In the Italian survey, about half of the cases occurred in people over 65 years old; over three quarters in people older than 50. Over time, there is no indication that herpes zoster incidence is decreasing. Indeed, a higher number of cases might be expected in future, because of increasing numbers of immunocompromised patients and longevity. Management of this disease and its most prominent complication in the elderly, post-herpetic neuralgia (PHN), frequently remains suboptimal. (excerpt) Language: English Keywords: ITALY | RESEARCH REPORT | IMMUNIZATION | SEXUALLY TRANSMITTED DISEASES | IMMUNITY | VACCINES | ANTIVIRAL DRUGS | Europe, Southern | Europe | Developed Countries | Primary Health Care | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Immune System | Physiology | Biology | Medical Procedures | Medicine | Drugs | Treatment Document Number: 285973 |
| 27. Title: Breastfeeding and HIV transmission -- a meta analysis. Source: AIDS Scan. 2004 Jul;2(5):[1] p.. Abstract: Up to half of infants infected with HIV in nine major studies of mother to child HIV transmission contracted the virus through breastfeeding, and the risk of infection did not fall throughout the breastfeeding period, according to a meta-analysis published in the June 15th edition of the Journal of Infectious Diseases. In an accompanying editorial experts from the US Centers for Disease Control emphasise that antiretroviral treatment should be targeted at breastfeeding mothers with adavanced HIV infection as a key element in the package of measures designed to reduce mother to child HIV transmission. Male infants and children of mothers with low CD4 cell counts (< 200 cell/mm3) were at greater risk of infection through breastfeeding, suggesting that substantial efforts will be needed to identify mothers with advanced HIV disease who would benefit from antiretroviral treatment. The reasons for the greater vulnerability of male children is still unclear. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT | BREASTFEEDING | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | TREATMENT | ANTIVIRAL DRUGS | SEX FACTORS | HIV | COMMUNICABLE DISEASES | Developed Countries | North America | Americas | Parents | Family Relationships | Family Characteristics | Family and Household | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Drugs | Infections Document Number: 273295 |
| 28. Title: In this month's issue, let us discuss the utility of CD4 cell count in aiding diagnosis in HIV positive patients with pulmonary manifestation. Source: AIDS Scan. 2004 Jul;2(5):[1] p.. Abstract: In patients not treated with highly active antiretroviral drugs, the CD4 cell count is an excellent indicator of an HIV-infected patient's risk of developing a specific opportunistic infection or neoplasm, presumably because it reflects the stage of HIV disease and degree of immunocompromise. Each of the HIV-related respiratory illnesses typically develops at or below a characteristic CD4 cell count range and uncommonly or rarely occurs above these ranges. Respiratory illnesses such as upper respiratory tract infections, sinusitis, pharyngitis, acute bronchitis, obstructive airway disease, bacterial pneumonia, TB, non-Hodgkin's lymphoma, pulmonary embolus, and bronchogenic carcinoma can occur in immunocompetent persons. Many of these diseases, however, are more common in HIV-infected persons than in immunocompetent ones. These diseases have occurred in HIV-infected patients at all CD4 cell count ranges. As the CD4 cell count declines, the incidence of many of these diseases increases. For example, there is a higher incidence of bacterial pneumonia in HIV-infected patients with a CD4 cell count <250 cells/mm3 compared with patients with a CD4 cell count >250 cells/mm3. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | EXAMINATIONS AND DIAGNOSES | RESPIRATORY INFECTIONS | ANTIVIRAL DRUGS | RISK FACTORS | Developed Countries | North America | Americas | HIV Infections | Viral Diseases | Diseases | Infections | Drugs | Treatment | Biology Document Number: 273296 |
| 29. Title: Nigeria: rapid assessment of HIV / AIDS care in the public and private sectors. Author: Abt Associates. Partners for Health Reform Plus; John Snow [JSI]. DELIVER; Futures Group. POLICY Project Source: Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus Project, 2004 Aug. [71] p. (USAID Contract No. HRN-C-00-00-00019-00) Abstract: This assessment report documents the Nigerian experience in HIV/AIDS treatment in both the public and private sectors. Nigeria accounts for approximately 20 percent of West Africa’s population and is ranked fourth in the world in total number of reported AIDS cases. The impact of the epidemic on the social and economic development of Nigeria has been substantial. HIV/AIDS has contributed to the decrease in life expectancy, increase in the number of deaths in young adults, and increase in the number of orphans in the country. Since 1999, the Nigerian government has placed high priority on HIV/AIDS prevention, treatment, care, and support activities, supported by significant donor efforts for AIDS prevention and control. This assessment was commissioned by United States Agency for International Development (USAID)/Nigeria to gain an in-depth understanding of the current status, challenges, and cost of providing HIV/AIDS services in the public and private sectors in Nigeria. It was a joint undertaking of USAID, the Federal Ministry of Health, and the National Institute of Medical Research. (author's) Language: English Keywords: NIGERIA | EVALUATION REPORT | AIDS PREVENTION | HIV PREVENTION | EPIDEMICS | ANTIRETROVIRAL THERAPY | ANTIVIRAL DRUGS | GOVERNMENT PROGRAMS | PRIVATE SECTOR | PUBLIC SECTOR | EQUIPMENT AND SUPPLIES | IMPLEMENTATION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Drugs | Treatment | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors Document Number: 278373 |
| 30. Title: MSF AIDS treatment experience: rapid expansion, emerging challenges. Briefing document. Author: Médecins Sans Frontières. Campaign for Access to Essential Medicines Source: Geneva, Switzerland, Médecins Sans Frontières, Campaign for Access to Essential Medicines, 2004 Jul. [10] p. Abstract: The AIDS treatment emergency was defined at the XIV International AIDS Conference in Barcelona two years ago: six million people were in urgent clinical need of antiretroviral (ARV) therapy, but a mere fraction had access to it. International activism and medical action had begun to highlight the feasibility of ARV treatment in resource-limited settings, and governments and international institutions came under pressure to confront the daily catastrophe of the AIDS pandemic and commit to mobilising a serious response. The World Health Organization (WHO) subsequently announced the goal of ensuring treatment for at least three million people by 2005. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | PERSONS LIVING WITH HIV/AIDS | LOW INCOME POPULATION | AIDS | TREATMENT | ANTIVIRAL DRUGS | NONGOVERNMENTAL ORGANIZATIONS | POVERTY | HIV Infections | Viral Diseases | Diseases | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Drugs | Organizations Document Number: 195605 |
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