Human immunodeficiency virus (HIV) entry inhibitors (CCR5 specific blockers) in development: are they the next novel therapies?

Since the introduction of the nucleoside reverse transcriptase inhibitor zidovudine in 1987, the number of the available antiretroviral medications has grown to about 20. Despite the efficacy of these medications, treatment-limiting adverse events are frequent. During the last several years, a new class of antiretroviral drugs often referred to as entry inhibitors, specifically the CCR5 blockers, have moved from the basic science laboratories and are now in the clinical phases of drug development.

The 2004 International AIDS Conference and how to globally counter HIV/AIDS.

This article reports noteworthy HIV/AIDS clinical trials presented at the XVth International AIDS Conference, Bangkok, July 2004, and also outlines goals of comprehensive prevention, care, treatment, and monitoring plans. The Bangkok conference theme was "Access for All." Outlined are goals of comprehensive prevention, care, and treatment programs: increased education and prevention efforts, greater involvement of national health authorities, reduction of new HIV infections, increased use of voluntary counseling and testing, increased acceptance and use of condoms, acceptance of an individual's right to be protected against HIV infection during sexual activity, increased support of NGOs, reduction of sexual partners, increased sexual fidelity, availability of antiretroviral medication, prevention of mother-to-child transmission, reduction of AIDS deaths, improved surveillance of sexually transmitted infections, improved blood supply security, increased coordination with tuberculosis and malaria treatment, equity for urban and rural persons, increased orphan services, reduction of orphan rate, greater involvement of local leaders, increased media involvement, reducing HIV/AIDS discussion taboo, reduced injecting drug user needle sharing, and continuing education for health care professionals.

Human immunodeficiency virus: scientific challenges impeding candidate vaccines.

Most initial work with HIV vaccines was directed at developing vaccines that elicited neutralizing antibodies. These neutralizing antibodies have been narrow in the focus of their action and specific almost entirely to the strain of the innoculating virus. Additionally, controversy has been reported about both the design of assay systems to measure the neutralization of such isolates and interpretation of the results.

The concept of structured treatment interruptions in the management of patients with human immunodeficiency virus (HIV) disease: where are we currently?

The failure to achieve viral eradication with currently available antiretroviral agents has spawned new approaches to limiting drug exposure. Highly active antiretroviral therapy (HAART) lowers morbidity and mortality of HIV disease but cannot eradicate the virus from the body. Structured treatment interruptions (STIs) have been proposed as a strategy to minimize the toxicities of HAART while providing a mechanism to enhance HIV-specific immunity.

HIV resistance and tolerability issues in antiretroviral therapy.

The therapeutic regimens used to treat patients with HIV disease involve a considerable pill burden. Patient adherence to dosing schedules and other factors have been implicated in the therapeutic failure of antiretroviral agents. Alternative medical approaches to HIV disease are problematic for clinicians and scientists because many of these herbal compounds have not been assessed in well-designed research trials.

20 years since human immunodeficiency virus discovery: considerations for the next decade.

The year 2003 marks the 20th anniversary of the discovery of the human immunodeficiency virus type 1 (HIV-1). Among infectious disease-causing agents, HIV-1 is now the number one killer worldwide. Approximately 70% of the cases in the world are in sub-Saharan Africa, where in some regions, the seroprevalence of HIV-1 among adults exceeds 25%.

The evolving role of antiretroviral drug resistance testing in HIV-infected individuals.

Scientific advances have made HIV resistance testing routinely available to clinicians and other HIV caregivers. However, interpretation of HIV resistance results is complicated by the lack of knowledge of the clinical consequences of specific genotypic and phenotypic results for most antiretroviral agents. Limitations of viral genotype and phenotype HIV resistance testing include factors such as lack of uniform quality assurance, turn around time, cost, and insensitivity to those mutant strains present in less than 20% to 30% of the viral population.

Promising microbicide approach for prevention of human immunodeficiency virus transmission needs more support.

The human immunodeficiency virus (HIV) is the number one killer worldwide among infectious disease-causing agents. Because of the speed at which the epidemic has spread, it is crucial for the global community to expand female-controlled preventive options such as the use of microbicides. Much of microbicide research explores how HIV crosses the mucous membranes of the female genital tract and how the virus can be blocked at that point.

Human immunodeficiency viruses and drug therapy: resistance and implications for antiretroviral therapy.

Through a concerted effort to combat the human immunodeficiency virus (HIV) epidemic, researchers have made significant strides in molecular biology, virology, and immunology, which have resulted in an increased understanding of the complexities of this infection. The biggest obstacle to the success of current HIV therapy, however, is the emergence of viral resistance. Viral resistance is caused by mutations in the HIV-1 genome coding for structural changes in the target enzymes that can affect the binding or activity of the inhibitors.