BETA : bulletin of experimental treatments for AIDS : a publication of the San Francisco AIDS Foundation最新文献

The antiretroviral drug pipeline was last reviewed in BETA three years ago (see "The HIV/AIDS drug pipeline: a status report" in the Summer/Autumn 2002 issue). That report called on pharmaceutical companies to "ensure a steadier stream of innovative and affordable approaches to managing HIV infection." Is this goal being achieved?

Neurological complications are common in HIV disease. The spectrum of neurological disorders is broad and involves the central nervous system, or CNS (brain and spinal cord) and the peripheral nervous system, or PNS (nerves outside the brain and spinal cord, and related muscle). Neurological disorders related to HIV often result in reduced quality of life and shortened survival, especially in people with more advanced HIV disease. Nevertheless, some neurological conditions are mild, readily treatable, or reversible. Several have become less common since the introduction of highly active antiretroviral therapy (HAART). And, despite the fact that many anti-HIV drugs are unable to cross the blood-brain barrier and penetrate the brain, recent data published in the Journal of Acquired Immune Deficiency Syndromes support the claim that HAART can improve some neurocognitive functioning.

Symptoms occur across the trajectory of HIV disease and can diminish the quality of life of women living with the virus. Untreated symptoms may also influence medication adherence and lead to complications of HIV and coexisting illnesses. Symptom management can address these concerns. A variety of self-care approaches should be incorporated into any plan of treatment, which ideally should be based on a partnership between the woman with HIV and her health-care providers. This article will address a range of issues concerning symptoms in women with HIV both in the U.S. and worldwide.

Immune reconstitution, or the reversal of HIV-related immune system decline, is one of the primary goals of highly active antiretroviral therapy (HAART). Reconstitution involves an increase in functional CD4 cells to guide the immune response against pathogens such as HIV, resulting in the suppression of viral load and other beneficial outcomes. However, immune reconstitution may trigger an inflammatory reaction in some people soon after they begin anti-HIV therapy and show signs of immunological improvement. Known as immune reconstitution syndrome (IRS) or immune reconstitution inflammatory syndrome (IRIS), this set of symptoms often resembles an AIDS-defining illness or other condition seen in people with HIV. While in most cases the symptoms of IRIS resolve after a few weeks, the syndrome may be severe or mistaken for true disease progression, and should be properly diagnosed and treated.

The subject of HIV/AIDS as it relates to fertility and conception has begun to generate interest among biological and sociobehavioral researchers. As a result, a better understanding of the fertility-related intentions and desires of HIV positive individuals, as well as advancing knowledge regarding reproductive technologies, now offer the hope of parenthood to childless couples.

The term "hormone" broadly refers to any type of chemical messenger, but is most often used to denote chemicals produced by the endocrine glands. Hormones play a key role in maintaining homeostasis (a steady state of equilibrium) and regulating many bodily processes--everything from growth and metabolism to sexual function and reproduction. Over- or underproduction of endocrine hormones can contribute to a wide variety of medical conditions. Diseases such as HIV that affect the whole body can interfere with proper endocrine function, and hormones, in turn, can affect HIV disease progression.

Depression is one of the most prevalent and undertreated complications of HIV disease. Despite the improvements in health related to highly active antiretroviral therapy (HAART), women and men with HIV continue to be at risk for depression. Untreated depression not only can affect quality of life, but it also may compromise HAART adherence, weaken immune functioning, exacerbate chronic pain, and contribute to substance use. Depression might also lead to sexual risk-taking behavior in some people with HIV, potentially contributing to HIV transmission. This article will address a range of questions concerning HIV-related depression. Why is depression so common in people with HIV? Is it seen more frequently in those with HIV disease than in uninfected individuals? If so, why? And if depression is so common, why is it typically overlooked by HIV clinicians? Finally, is depression treated differently in people with HIV, and what specific types of therapy or medications are most useful?