HIV AIDS future or investigational therapies: Difference between revisions

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__NOTOC__
{{AIDS}}
{{AIDS}}
{{CMG}} '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
{{CMG}}; '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] ; {{Ammu}}
 
==Overview==
==Overview==
Research to improve current treatments includes decreasing side effects of current drugs, further simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage drug resistance. A number of studies have shown that measures to prevent opportunistic infections can be beneficial when treating patients with HIV infection or AIDS. [[Vaccination]]against [[hepatitis]] A and B is advised for patients who are not infected with these viruses and are at risk of becoming infected.<ref name=Laurence>{{
Research to improve current treatments includes decreasing side effects of current drugs, further simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage [[drug resistance]].
 
==AIDS Future or Investigational Therapies==
 
A number of studies have shown that measures to prevent [[opportunistic infection]]s can be beneficial when treating patients with HIV infection or AIDS. [[Vaccination]] against [[hepatitis]] A and B is advised for patients who are not infected with these viruses and are at risk of becoming infected.<ref name=Laurence>{{


  cite journal
  cite journal
Line 10: Line 16:
  | pmid=16433468
  | pmid=16433468


}}</ref> Patients with substantial immunosuppression are also advised to receive prophylactic therapy for [[Pneumocystis jiroveci pneumonia]] (PCP), and many patients may benefit from prophylactic therapy for [[toxoplasmosis]] and [[Cryptococcus]] [[meningitis]] as well.<ref name=PEPpocketguide>{{
}}</ref> Patients with substantial [[immunosuppression]] are also advised to receive prophylactic therapy for [[Pneumocystis jiroveci pneumonia]] (PCP), and many patients may benefit from prophylactic therapy for [[toxoplasmosis]] and [[Cryptococcus]] [[meningitis]] as well.<ref name=PEPpocketguide>{{


  cite web
  cite web
Line 19: Line 25:
  | accessdate = 2007-02-05
  | accessdate = 2007-02-05


}}</ref>
}}</ref> Daily multivitamin and mineral supplements have been found to reduce HIV disease progression among men and women. This could become an important low-cost intervention provided during early HIV disease to prolong the time before antiretroviral therapy is required.<ref name=Fawzi>{{
 
Daily multivitamin and mineral supplements have been found to reduce HIV disease progression among men and women. This could become an important low-cost intervention provided during early HIV disease to prolong the time before antiretroviral therapy is required.<ref name=Fawzi>{{


  cite journal
  cite journal
Line 52: Line 56:


}}</ref> It has been postulated that only a vaccine can halt the pandemic because a vaccine would possibly cost less, thus being affordable for developing countries, and would not require daily treatments.<ref name=Ferrantelli/> However, after over 20&nbsp;years of research, HIV-1 remains a difficult target for a vaccine.<ref name=Ferrantelli/>
}}</ref> It has been postulated that only a vaccine can halt the pandemic because a vaccine would possibly cost less, thus being affordable for developing countries, and would not require daily treatments.<ref name=Ferrantelli/> However, after over 20&nbsp;years of research, HIV-1 remains a difficult target for a vaccine.<ref name=Ferrantelli/>
==Future of Investigational Therapies==
Extensive clinical trials are going on in various stages to find a possible cure for AIDS
*A number of investigational drugs are in trial to find an effective cure<ref name=AIDSinfo>{{cite web | title = AIDSinfo.nih.gov - HIV/AIDS Clinical Trials
| url =http://aidsinfo.nih.gov/clinical-trials }}</ref>
{|
! style="width: 400px;background: #4479BA" colspan=2|{{fontcolor|#FFF| '''Investigational drugs'''}}
|-
|
{| style="border: 2px solid #DCDCDC; font-size: 90%; width:200px;"
|-
|  style="width: 120px; background: #F5F5F5"|
*Adaptavir
|-
|  style="width: 120px;background: #DCDCDC"|
*AMD-070
|-
|  style="width: 120px;background: #F5F5F5"|
*Amdoxovir
|-
|  style="width: 120px;background: #DCDCDC"|
*Cabotegravir
|-
|  style="width: 120px;background: #F5F5F5"|
*Carbopol 974P
|-
|  style="width: 120px;background: #DCDCDC"|
*Carrageenan
|-
|  style="width: 120px;background: #F5F5F5"|
*Cenicriviroc
|-
|  style="width: 120px;background: #DCDCDC"|
*Dapivirine
|-
|  style="width: 120px;background: #F5F5F5"|
*Dexelvucitabine
|-
|  style="width: 120px;background: #DCDCDC"|
*Elvitegravir
|-
|  style="width: 120px;background: #F5F5F5"|
*Elvucitabine
|-
|  style="width: 120px;background: #DCDCDC"|
*Fostemsavir
|-
|  style="width: 120px;background: #F5F5F5"|
*Ibalizumab
|-
|  style="width: 120px;background: #DCDCDC"|
*INCB-9471
|}
|
{|style="border: 2px solid #DCDCDC; font-size: 90%; width:200px; float:center"
|-
|  style="width: 120px;background: #F5F5F5"|
*Lersivirine
|-
|  style="width: 120px;background: #DCDCDC"|
*MPC-4326
|-
|  style="width: 120px;background: #F5F5F5"|
*OBP-601
|-
|  style="width: 120px;background: #DCDCDC"|
*PRO-140
|-
|  style="width: 120px;background: #F5F5F5"|
*PRO-2000
|-
|  style="width: 120px;background: #DCDCDC"|
*Racivir
|-
|  style="width: 120px;background: #F5F5F5"|
*Rintatolimod
|-
|  style="width: 120px;background: #DCDCDC"|
*SB-728-T
|-
|  style="width: 120px;background: #F5F5F5"|
*SPL-7013
|-
|  style="width: 120px;background: #DCDCDC"|
*Tenofovir Alafenamide
|-
|  style="width: 120px;background: #F5F5F5"|
*Tucaresol
|-
|  style="width: 120px;background: #DCDCDC"|
*Valproic Acid
|-
|  style="width: 120px;background: #F5F5F5"|
*Vicriviroc
|-
|  style="width: 120px;background: #DCDCDC"|
*Vorinostat
|}
|}
===Investigational approaches===
==== Anti-viral hyperactivation limiting therapeutics ====
[[AV-HALT]]s (AntiViral HyperActivation Limiting Therapeutics  or '''virostatics''') combine immunomodulating and antiviral properties to inhibit a specific antiviral target while also limiting the hyper-elevated state of immune system activation driving disease progression.<ref name="pmid15990570">{{cite journal |author=Lori F, Foli A, Groff A, Lova L, Whitman L, Bakare N, Pollard RB, Lisziewicz J |title=Optimal suppression of HIV replication by low-dose hydroxyurea through the combination of antiviral and cytostatic ('virostatic') mechanisms |journal=AIDS |volume=19 |issue=11 |pages=1173–81 |year=2005 |month=July |pmid=15990570 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0269-9370&volume=19&issue=11&spage=1173 |accessdate=2012-03-10}}</ref>
====Recent developments====
IMOD (short for "Immuno-Modulator Drug") is the name of a new herbal drug developed by scientists in Iran, which has been reported to rein the AIDS virus and boost the body’s immune system.  Its efficiency and safety have not yet been confirmed by the mainstream scientific community.
====Synergistic enhancers ====
[[Synergistic enhancer (antiretroviral)|Synergistic enhancers]] either do not possess antiretroviral properties alone or are inadequate or impractical for monotherapy, but when they are taken concurrently with antiretroviral drugs they enhance the effect of that drug (often by altering the metabolism of the other antiretroviral). This group include [[ritonavir]].
'''Example:''' [[Ritonavir]] is an antiretroviral drug which belongs to the class of [[protease inhibitors]]. It can however be administered at a "baby" dosage to reduce the liver metabolism of other antiretroviral drugs. This principle was first exploited in the drug [[Kaletra]] (Abbott), which is a combination of ritonavir with the protease inhibitor [[lopinavir]] at a ratio ([[v/v]]) of 1:5. Ritonavir is also used as an enhancer of other [[protease inhibitors]] such as [[saquinavir]] and [[atazanavir]], and of the investigational [[integrase inhibitor]], GS-9137. Other synergistic enhancers are being investigated for this purpose.
==HIV Vaccine==
To learn more about HIV vaccine [[HIV vaccine|click here.]]


==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}
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{{WH}}
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Latest revision as of 22:12, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Ujjwal Rastogi, MBBS ; Ammu Susheela, M.D. [2]

Overview

Research to improve current treatments includes decreasing side effects of current drugs, further simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage drug resistance.

AIDS Future or Investigational Therapies

A number of studies have shown that measures to prevent opportunistic infections can be beneficial when treating patients with HIV infection or AIDS. Vaccination against hepatitis A and B is advised for patients who are not infected with these viruses and are at risk of becoming infected.[1] Patients with substantial immunosuppression are also advised to receive prophylactic therapy for Pneumocystis jiroveci pneumonia (PCP), and many patients may benefit from prophylactic therapy for toxoplasmosis and Cryptococcus meningitis as well.[2] Daily multivitamin and mineral supplements have been found to reduce HIV disease progression among men and women. This could become an important low-cost intervention provided during early HIV disease to prolong the time before antiretroviral therapy is required.[3] Some individual nutrients have also been tried.[4][5] Anti-retroviral drugs are expensive, and the majority of the world's infected individuals do not have access to medications and treatments for HIV and AIDS.[6] It has been postulated that only a vaccine can halt the pandemic because a vaccine would possibly cost less, thus being affordable for developing countries, and would not require daily treatments.[6] However, after over 20 years of research, HIV-1 remains a difficult target for a vaccine.[6]

Future of Investigational Therapies

Extensive clinical trials are going on in various stages to find a possible cure for AIDS

  • A number of investigational drugs are in trial to find an effective cure[7]
Investigational drugs
  • Adaptavir
  • AMD-070
  • Amdoxovir
  • Cabotegravir
  • Carbopol 974P
  • Carrageenan
  • Cenicriviroc
  • Dapivirine
  • Dexelvucitabine
  • Elvitegravir
  • Elvucitabine
  • Fostemsavir
  • Ibalizumab
  • INCB-9471
  • Lersivirine
  • MPC-4326
  • OBP-601
  • PRO-140
  • PRO-2000
  • Racivir
  • Rintatolimod
  • SB-728-T
  • SPL-7013
  • Tenofovir Alafenamide
  • Tucaresol
  • Valproic Acid
  • Vicriviroc
  • Vorinostat

Investigational approaches

Anti-viral hyperactivation limiting therapeutics

AV-HALTs (AntiViral HyperActivation Limiting Therapeutics or virostatics) combine immunomodulating and antiviral properties to inhibit a specific antiviral target while also limiting the hyper-elevated state of immune system activation driving disease progression.[8]

Recent developments

IMOD (short for "Immuno-Modulator Drug") is the name of a new herbal drug developed by scientists in Iran, which has been reported to rein the AIDS virus and boost the body’s immune system. Its efficiency and safety have not yet been confirmed by the mainstream scientific community.

Synergistic enhancers

Synergistic enhancers either do not possess antiretroviral properties alone or are inadequate or impractical for monotherapy, but when they are taken concurrently with antiretroviral drugs they enhance the effect of that drug (often by altering the metabolism of the other antiretroviral). This group include ritonavir.

Example: Ritonavir is an antiretroviral drug which belongs to the class of protease inhibitors. It can however be administered at a "baby" dosage to reduce the liver metabolism of other antiretroviral drugs. This principle was first exploited in the drug Kaletra (Abbott), which is a combination of ritonavir with the protease inhibitor lopinavir at a ratio (v/v) of 1:5. Ritonavir is also used as an enhancer of other protease inhibitors such as saquinavir and atazanavir, and of the investigational integrase inhibitor, GS-9137. Other synergistic enhancers are being investigated for this purpose.

HIV Vaccine

To learn more about HIV vaccine click here.

Reference

  1. Laurence J (2006). "Hepatitis A and B virus immunization in HIV-infected persons". AIDS Reader. 16 (1): 15&ndash, 17. PMID 16433468.
  2. "Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America". Department of Health and Human Services. 2007-02-02. Retrieved 2007-02-05.
  3. Fawzi W, Msamanga G, Spiegelman D, Hunter DJ (2005). "Studies of vitamins and minerals and HIV transmission and disease progression". J. Nutrition. 135 (4): 938&ndash, 944. PMID 15795466.
  4. (Selenium:) Hurwitz BE, Klaus JR, Llabre MM, Gonzalez A, Lawrence PJ, Maher KJ, Greeson JM, Baum MK, Shor-Posner G, Skyler JS, Schneiderman N (2007). "Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial". Arch Intern Med. 167 (2): 148&ndash, 155. PMID 17242315.
  5. (Vitamin C:) Cathcart RR (1984). "Vitamin C in the Treatment of Acquired Immune Deficiency Syndrome". Medical Hypotheses. 14 (4): 423–433. doi:10.1016/0306-9877(84)90149-X. PMID 6238227.
  6. 6.0 6.1 6.2 Ferrantelli F, Cafaro A, Ensoli B (2004). "Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccines". Curr Opin Biotechnol. 15 (6): 543&ndash, 556. PMID 15560981.
  7. "AIDSinfo.nih.gov - HIV/AIDS Clinical Trials".
  8. Lori F, Foli A, Groff A, Lova L, Whitman L, Bakare N, Pollard RB, Lisziewicz J (2005). "Optimal suppression of HIV replication by low-dose hydroxyurea through the combination of antiviral and cytostatic ('virostatic') mechanisms". AIDS. 19 (11): 1173–81. PMID 15990570. Retrieved 2012-03-10. Unknown parameter |month= ignored (help)

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