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Encyclopedia > Antiretroviral drug

Antiretroviral drugs are medications for the treatment of infection by retroviruses, primarily HIV. Different classes of antiretroviral drugs act at different stages of the HIV life cycle. Combination of several (typically three or four) antiretroviral drugs is known as Highly Active Anti-Retroviral Therapy (HAART). Spicerhaart is the UKs largest independent estate agency group, based in Colchester, Essex[1]. Spicerhaart currently trade under the following brands: Spicer McColl Darlows Felicity J Lord Haart James Jardine Company website ^ Company milestones. ... Genera Alpharetrovirus Betaretrovirus Gammaretrovirus Deltaretrovirus Epsilonretrovirus Lentivirus Spumavirus A retrovirus is any virus belonging to the viral family Retroviridae. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ...


Organizations such as the United States National Institutes of Health recommend offering antiretroviral treatment to all patients with AIDS. However, because of the complexity of selecting and following a regimen, the severity of the side effects, and the importance of compliance to prevent viral resistance, such organizations emphasize the importance of involving patients in therapy choices and recommend analyzing the risks and the potential benefits to patients without symptoms.[1] National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical research. ... For other uses, see AIDS (disambiguation). ... In the context of virology, resistance or drug resistance refers to the lack of response of a population of viruses to an antiviral drug or treatment. ...

Contents

Classes of antiretroviral drugs

Antiretroviral drugs are broadly classified by the phase of the retrovirus life-cycle that the drug inhibits. There are thus six broad classifications of antiretroviral drugs in development, though only the first three classes currently have licensed examples:

  • Reverse transcriptase inhibitors (RTIs) target construction of viral DNA by inhibiting activity of reverse transcriptase. There are two subtypes of RTIs with different mechanisms of action: nucleoside-analogue RTIs are incorporated into the viral DNA leading to chain termination, while non-nucleoside-analogue RTIs distort the binding potential of the reverse transcriptase enzyme.
  • Protease inhibitors (PIs) target viral assembly by inhibiting the activity of protease, an enzyme used by HIV to cleave nascent proteins for final assembly of new virons.
  • Fusion inhibitors block HIV from fusing with a cell's membrane to enter and infect it. There is currently only one FDA-approved drug in this class, enfuvirtide, marketed as Fuzeon.
  • Integrase inhibitors inhibit the enzyme integrase, which is responsible for integration of viral DNA into the DNA of the infected cell. There are several integrase inhibitors currently under clinical trial, and raltegravir became the first to receive FDA approval in October 2007.
  • Entry inhibitors block HIV-1 from the host cell by binding CCR5, a molecule on the host membrane termed a co-receptor that HIV-1 normally uses for entry into the cell together with a primary receptor. Only one entry-inhibitor class drug is available, maraviroc.
  • Maturation inhibitors inhibit the last step in gag processing in which the viral capsid polyprotein is cleaved, thereby blocking the conversion of the polyprotein into the mature capsid protein (p24). Because these viral particles have a defective core, the virions released consist mainly of non-infectious particles. Bevirimat is the only drug that is currently under investigation.[2]
  • Portmanteau inhibitors A new way to combat HIV through the merging of two antiviral agents into one drug, achieving the same effect as when two or more drugs are taken separately.

This article needs to be cleaned up to conform to a higher standard of quality. ... In biochemistry, a reverse transcriptase, also known as RNA-dependent DNA polymerase, is a DNA polymerase enzyme that transcribes single-stranded RNA into double-stranded DNA. Normal transcription involves the synthesis of RNA from DNA, hence reverse transcription is the reverse of this. ... Protease inhibitors are a class of medication used to treat or prevent viral infections. ... Proteases (proteinases, peptidases, or proteolytic enzymes) are enzymes that break peptide bonds between amino acids of proteins. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... A common alternate meaning of virus is computer virus. ... A fusion inhibitor is a class of antiretroviral drugs used to treat viral infections such as HIV. It works by blocking the virus from fusing with a cells membrane to enter and infect the cell. ... Enfuvirtide is a novel antiretroviral drug used in combination therapy for the treatment of HIV-1 infection. ... Integrase inhibitors are a class of antiretroviral drug developed for the treatment of HIV infection. ... Integrase is a protein produced by a virus that enables genetic material that is helpful to the virus, proviral DNA, to be integrated into the DNA of the infected cell. ... Isentress pills Raltegravir (MK-0518, brand name IsentressTM) is an experimental antiretroviral drug from Merck & Co. ... Entry inhibitors are very much similar to Fusion inhibitors. ... CCR5, short for chemokine (C-C motif) receptor 5, is a chemokine receptor. ... Maraviroc is an chemokine receptor antagonist drug developed by the drug company Pfizer that is designed to act against HIV by interfering with the interaction between HIV and CCR5. ... The genome and proteins of HIV have been the subject of extensive research since the discovery of the virus in 1983. ... A portmanteau inhibitor is a drug which is a combination of two drug molecules, each of which is itself a type of inhibitor. ...

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. Poster at the official press conference introducing IMOD IMOD (short for Immuno-Modulator Drug) is the name of an herbal drug that Iranian scientists have claimed protects those already infected by HIV from the spread of AIDS by strengthening the immune system. ...


Fixed dose combinations

Fixed dose combinations are multiple antiretroviral drugs combined into a single pill. Fixed dose combinations of antiretrovirals are multiple antiretroviral drugs combined into a single pill, which helps reduce pill burden. ...


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). These include ritonavir. Ritonavir, for example, 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. Synergistic enhancers of antiretrovirals usually do not possess any antiretroviral properties alone, but when they are taken concurrently with antiretroviral drugs they enhance the effect of that drug. ... Ritonavir is a drug from the protease inhibitor class used to treat AIDS. It is manufactured as Norvir® by Abbott Laboratories. ... Ritonavir is a drug from the protease inhibitor class used to treat AIDS. It is manufactured as Norvir® by Abbott Laboratories. ... Antiretroviral drugs are medications for the treatment of infection by the retrovirus HIV. Different antiretroviral drugs act at various stages of the HIV life cycle. ... Lopinavir (ABT-378) is an antiretroviral of the protease inhibitor class. ... Lopinavir (ABT-378) is an antiretroviral of the protease inhibitor class. ... Antiretroviral drugs are medications for the treatment of infection by the retrovirus HIV. Different antiretroviral drugs act at various stages of the HIV life cycle. ... Saquinavir (Fortovase®, Roche) is a protease inhibitor, used as a component of HIV therapy. ... Atazanavir, trade name Reyataz®, (formerly known as BMS-232632) is an antiretroviral drug of the protease inhibitor (PI) class. ... Integrase inhibitors are a class of antiretroviral drug developed for the treatment of HIV infection. ...


Combination therapy

The life cycle of HIV can be as short as about 1.5 days: From viral entry into a cell; through replication, assembly, and release of additional viruses; to infection of other cells.[3] HIV lacks proofreading enzymes to correct errors made when it converts its RNA into DNA via reverse transcription. Its short life cycle and high error rate cause the virus to mutate very rapidly, resulting in a high genetic variability of HIV. Most of the mutations either are inferior to the parent virus (often lacking the ability to reproduce at all) or convey no advantage, but some of them have a natural selection superiority to their parent and can enable them to slip past defenses such as the human immune system and antiretroviral drugs. The more active copies of the virus, the greater the possibility that one resistant to antiretroviral drugs will be made, so antiretroviral combination therapy defends against resistance by suppressing HIV replication as much as possible. Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Neuraminidase ribbon diagram An enzyme (in Greek en = in and zyme = blend) is a protein, or protein complex, that catalyzes a chemical reaction and also controls the 3D orientation of the catalyzed substrates. ... Left: An RNA strand, with its nitrogenous bases. ... The structure of part of a DNA double helix Deoxyribonucleic acid, or DNA, is a nucleic acid molecule that contains the genetic instructions used in the development and functioning of all known living organisms. ... Reverse transcriptase is an enzyme used by all retroviruses and retrotransposons that transcribes the genetic information from the virus or retrotransposon from RNA into DNA, which can integrate into the host genome. ... This article is about mutation in biology, for other meanings see: mutation (disambiguation). ... This article is about biological infectious particles. ... For other uses, see Natural selection (disambiguation). ...


Combinations of antiretrovirals create multiple obstacles to HIV replication to keep the number of offspring low and reduce the possibility of a superior mutation. If a mutation arises that conveys resistance to one of the drugs being taken, the other drugs continue to suppress reproduction of that mutation. With rare exceptions, no individual antiretroviral drug has been demonstrated to suppress an HIV infection for long; these agents must be taken in combinations in order to have a lasting effect. As a result the standard of care is to use combinations of antiretroviral drugs. Combinations usually comprise two nucleoside-analogue RTIs and one non-nucleoside-analogue RTI or protease inhibitor.[4] This three drug combination is commonly known as a triple cocktail.[5]


Combinations of antiretrovirals are subject to positive and negative synergies, which limits the number of useful combinations. For example, ddI and AZT inhibit each other, so taking them together is less effective than taking either one separately. Other issues further limit some people's treatment options from antiretroviral drug combinations, including their complicated dosing schedules and often severe side effects. Synergy (from the Greek synergos, συνεργός meaning working together, circa 1660) refers to the phenomenon in which two or more discrete influences or agents acting together create an effect greater than that predicted by knowing only the separate effects of the individual agents. ...


In recent years drug companies have worked together to combine these complex regimens into simpler formulas, termed fixed dose combinations. For instance, two pills containing two or three medications each can be taken twice daily. This greatly increases the ease with which they can be taken, which in turn increases adherence, and thus their effectiveness over long term. Lack of adherence is a primary cause of resistance development in medication-experienced patients. Patients able to adhere at this rate and higher can maintain one regimen for up to a decade without developing resistance. This greatly increases chances of long-term survival, as it leaves more drugs available to the patient for longer periods of time. Fixed dose combinations of antiretrovirals are multiple antiretroviral drugs combined into a single pill, which helps reduce pill burden. ...


Current treatment guidelines

Antiretroviral drug treatment guidelines have changed many times. Early recommendations attempted a "hit hard, hit early" approach. A more conservative approach followed, with a starting point somewhere between 350 and 500 CD4+ T cells/mm³. The current guidelines use new criteria to consider starting HAART, as described below. However, there remain a range of views on this subject and the decision of whether to commence treatment ultimately rests with the patient and their doctor.


The current guidelines for antiretroviral therapy (ART) from the World Health Organization reflect the 2003 changes to the guidelines and recommend that in resource-limited settings (that is, developing nations), HIV-infected adults and adolescents should start ART when HIV infection has been confirmed and one of the following conditions is present [6]): “WHO” redirects here. ...

  • Clinically advanced HIV disease;
  • WHO Stage IV HIV disease, irrespective of the CD4 cell count;
  • WHO Stage III disease with consideration of using CD4 cell counts less than 350/µl to assist decision making;
  • WHO Stage I or II HIV disease with CD4 cell counts less than 200/µl.

The treatment guidelines in the USA are set by the United States Department of Health and Human Services (DHHS). The current guidelines for adults and adolescents were stated on October 6, 2005 [7]: The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ...

  • All patients with history of an AIDS-defining illness or severe symptoms of HIV infection regardless of CD4+ T cell count receive ART.
  • Antiretroviral therapy is also recommended for asymptomatic patients with less than 200 CD4+ T cells/µl.
  • Asymptomatic patients with CD4+ T cell counts of 201–350 cells/µl should be offered treatment.
  • For asymptomatic patients with CD4+ T cell of greater than 350 cells/µl and plasma HIV RNA greater than 100,000 copies/ml, most experienced clinicians defer therapy but some clinicians may consider initiating treatment.
  • Therapy should be deferred for patients with CD4+ T cell counts of greater than 350 cells/µl and plasma HIV RNA less than 100,000 copies/mL.

The preferred initial regimens are[8]:

In countries with a high rate of baseline resistance, resistance testing is recommended prior to starting treatment; or, if the initiation of treatment is urgent, then a "best guess" treatment regimen should be started which is then modified on the basis of resistance testing. In the UK, there is 11.8% medium to high level resistance at baseline to the combination of zidovudine + lamivudine + efavirenz, and 6.4% medium to high level resistance to stavudine + lamivudine + nevirapine.[9] This article needs to be cleaned up to conform to a higher standard of quality. ... Zidovudine (INN) or azidothymidine (AZT) (also called ZDV) is an antiretroviral drug, the first one approved for treatment of HIV. It is also sold under the names Retrovir® and Retrovis®, and as an ingredient in Combivir® and Trizivir®. It is an analog of thymidine. ... Lamivudine (2,3-dideoxy-3-thiacytidine, commonly called 3TC) is a potent nucleoside analog reverse transcriptase inhibitor (nRTI). ... Tenofovir disoproxil fumarate belongs to a class of antiretroviral drugs known as nucleotide analogue reverse transcriptase inhibitors (NtRTIs), which block reverse transcriptase, an enzyme crucial to viral production in HIV-infected people. ... Emtricitabine is a nucleoside reverse transcriptase inhibitor (NRTI) for the treatment of HIV infection in adults. ... Lopinavir (ABT-378) is an antiretroviral of the protease inhibitor class. ... Ritonavir is a drug from the protease inhibitor class used to treat AIDS. It is manufactured as Norvir® by Abbott Laboratories. ... Zidovudine (INN) or azidothymidine (AZT) (also called ZDV) is an antiretroviral drug, the first one approved for treatment of HIV. It is also sold under the names Retrovir® and Retrovis®, and as an ingredient in Combivir® and Trizivir®. It is an analog of thymidine. ... Lamivudine (2,3-dideoxy-3-thiacytidine, commonly called 3TC) is a potent nucleoside analog reverse transcriptase inhibitor (nRTI). ... This article needs to be cleaned up to conform to a higher standard of quality. ... Stavudine (2-3-didehydro-2-3-dideoxythymidine, d4T, brand name Zerit®) is a thymidine analogue active against HIV. It is phosphorylated by cellular kinases into active triphosphate. ... Lamivudine (2,3-dideoxy-3-thiacytidine, commonly called 3TC) is a potent nucleoside analog reverse transcriptase inhibitor (nRTI). ... This article or section contains information that has not been verified and thus might not be reliable. ...


Because HIV disease progression in children is more rapid than in adults, and laboratory parameters are less predictive of risk for disease progression, particularly for young infants, treatment recommendations from the DHHS have been more aggressive in children than in adults, the current guidelines were published November 3, 2005 [10].


In 2005, the Centers for Disease Control and Prevention in the United States recommended a 28-day HIV drug regimen for those who have been exposed to HIV (HIV Postexposure Prophylaxis [PEP])[11]. The drugs have demonstrated effectiveness in preventing the virus nearly 100% of the time in those who received treatment within the initial 24 hours of exposure. The effectiveness falls to 52% of the time in those who are treated within 72 hours; those not treated within the first 72 hours are not recommended candidates for the regimen.


Concerns

There are several concerns about antiretroviral regimens. The drugs can have serious side effects.[12] Regimens can be complicated, requiring patients to take several pills at various times during the day, although treatment regimens have been greatly simplified in recent years. If patients miss doses, drug resistance can develop.[13] Also, providing anti-retroviral treatment is costly and resource-intensive, and the majority of the world's infected individuals cannot access treatment services.


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.


Responses to treatment in older adults

As people age, their bodies aren't able to repair and rebuild damaged cells, organs or tissues as rapidly as those of younger people. Diseases like HIV that attack and destroy the body's defenses can exacerbate this slowing and increase the risk of developing additional medical problems like diabetes and high blood pressure, and more physical limitations than younger adults with HIV. In the early years of the HIV epidemic (before HAART), older adults' health deteriorated more rapidly than that of younger individuals - regardless of CD4 count. Several studies found that older adults had lower CD4 counts at diagnosis, faster progression to an AIDS diagnosis, more opportunistic infections, and a shorter survival rate than younger adults, regardless of when they were first diagnosed with HIV. Image File history File links Question_book-3. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... This article is about the disease that features high blood sugar. ... A sphygmomanometer, a device used for measuring arterial pressure. ... CD4 (cluster of differentiation 4) is a molecule that is expressed on the surface of T helper cells (as well as regulatory T cells and dendritic cells). ... For other uses, see AIDS (disambiguation). ...


Recent studies have found that a person's age doesn't interfere with the ability of HAART to reduce viral load, but there may be differences between younger and older people in how well the immune system responds to treatment. A study published in AIDS (2000) by Roberto Manfredi and Francesco Chiodo examined the effect of HAART on older people (defined as 55 or older) compared to younger people (35 or younger). The study included 21 older people (8 women, 13 men) and 84 younger people (29 women, 55 men). The researchers found that both groups responded to HAART, especially in reducing viral load. However, CD4 counts did not increase as much in the older people relative to the younger ones. On average, CD4 counts increased from 212 to 289 for older adults after one year of HAART. During the same period, CD4 counts rose from 231 to 345 for younger people. Viral load is a measure of the severity of a viral infection, and can be estimated by calculating the amount of virus in an involved body fluid, e. ...


Some people may have a very low CD4 count even though they have an undetectable viral load. This may be related to decreased activity in the thymus (the gland where CD4 cells are made). A 2001 study in AIDS conducted by researchers in Los Angeles included 80 HIV-positive veterans (13 were over 55 and 67 were younger). Although both groups of veterans showed dramatic reductions in viral load once they were on treatment, the researchers found significant differences in CD4 levels at 3, 9, 15, and 18 months. After one year on HAART, average CD4 counts increased by 50 for the older men, compared to increases of 100 for the younger ones. This difference was not related to baseline HIV viral load, coinfection with hepatitis C, or the race/ethnicity of participants. These studies represent an important first step in understanding how their age may affect older adults' response to HIV treatment, but more studies are needed to understand the long-term effects of age on HAART in older adults. Thymus, see Thyme. ... This page is for the disease. ...


Limitations of antiretroviral drug therapy

If an HIV infection becomes resistant to standard HAART, there are limited options. One option is to take larger combinations of antiretroviral drugs, an approach known as mega-HAART or salvage therapy. Salvage therapy often increases the drugs' side-effects and treatment costs. Another is to take only one or two antiretroviral drugs, specifically ones that induce HIV mutations that diminish the virulence of the infection. The most common resistance mutation to lamivudine (3TC) in particular appears to do this. Thus, 3TC can be somewhat effective even alone and when the virus is resistant to it. Image File history File links Question_book-3. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ...


If an HIV infection becomes sufficiently resistant to antiretroviral-drugs, treatment becomes more complicated and prognosis may deteriorate. Treatment options continue to improve as additional new drugs enter clinical trials. However, the limited distribution of many such drugs denies their benefits to patients in the developing world.


Drug holidays (or "structured treatment interruptions"), are intentional discontinuations of antiretroviral drug treatment. Studies of such interruptions attempt to increase the sensitivity of HIV to antiretroviral drugs. The interruptions attempt to change the selection pressure from the drug resistance back toward resistance to the human immune system, thus breeding a more drug-susceptible virus. HIV spends some of its life-cycle in a state where its DNA is entirely integrated into human DNA. Under certain conditions, drug-resistant strains of the virus can remain dormant in this state, since CD4 T-cells also are dormant when not aroused by invading organisms. The resistant strain can then reemerge when antiretroviral drugs are re-introduced. A drug holiday, sometimes referred to as a structured treatment interruption (STI) is the intentional discontinuation of a medication, usually for a short period of time. ...


Intermittent therapy is an experimental approach designed to reduce exposure to antiretroviral drugs in an effort to mitigate side-effects. Intermittent therapy differs from treatment interruptions in that it involves using a much shorter cycle of switching on and off the antiviral drugs. Studies of such approaches include schedules of Week-on, week-off (also known as "wowo") and Five-days-on, two-days-off (also known as "foto"), which skips treatment on weekends. They also seek to determine what kinds of patients are best suited for this approach. However, initial data suggest that intermittent therapy is ineffective and results in drug resistance.


It is still unclear whether suppressing or even eliminating HIV will be adequate to restore normal immune function in the long term, since HIV can damage the ability of the thymus to produce normally diverse T-cells. Also, rapid suppression of HIV and partial restoration of the immune system sometimes produces a dangerous hypersensitivity reaction, immune reconstitution inflammatory syndrome. Research continues in these areas. Thymus, see Thyme. ... Immune reconstitution inflammatory syndrome (IRIS) or immune reconstitution syndrome (IRS) is a rare condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of...


Adverse effects

Adverse effects of antiretroviral drugs vary by drug, by ethnicity, and by individual, and by interaction with other drugs, including alcohol. Hypersensitivity to some drugs may also occur in some individuals. The following list is not complete, but includes several of the common adverse effects experienced by patients taking some antiretroviral drugs: [14]

Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Alopecia is a set of disorders ranging from male and female pattern alopecia (alopecia androgenetica), to alopecia areata, which involves the loss of some of the hair from the head, alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the... This article discusses the medical condition. ... Asthenia (Greek: ασθένεια, lit. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause... // Pre-syncope is a sensation of feeling faint. ... Fanconi syndrome (also known as Fanconis syndrome) is a disorder in which the proximal tubular function of the kidney is impaired, resulting in improper reabsorption of electrolytes and nutrients back into the bloodstream. ... Flatulence is the presence of a mixture of gases known as flatus in the digestive tract of mammals expelled from the rectum. ... A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Jaundice, technically known as icterus, is yellowing of the skin, sclera (eyes) and mucous membranes caused by increased levels of bilirubin in the system. ... Hypercholesterolemia (literally: high blood cholesterol) is the presence of high levels of cholesterol in the blood [1]. It is not a disease but a metabolic derangement that can be secondary to many diseases and can contribute to many forms of disease, most notably cardiovascular disease. ... In dermatology, hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. ... Onychocryptosis, commonly known as ingrown nails (unguis incarnatus), is a common form of nail disease. ... This article is about the sleeping disorder. ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, conjunctiva (a clear covering over the sclera, or whites of the eyes) and mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in red blooded animals). ... In medicine, lipodystrophy is a condition characterized by abnormal or degernative conditions of the bodys fat tissue. ... Liver failure is the final stage of liver disease. ... Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... Severe confusion of a degree considered pathological usually refers to loss of orientation (ability to place oneself correctly in the world by time, location, and personal identity), and often memory (ability to correctly recall previous events or learn new materal). ... Mitochondrial toxicity is a condition in which the mitochondria of a bodys cells become damaged or decline significantly in number; it occurs as a side-effect of certain antiretroviral drugs used to treat human immunodeficiency virus, or HIV. While the exact causes of mitochondrial toxicity are not known, research... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... Myalgic Encephalomyelitis (M.E.), pronounced [my-aljik en-sefa-lo-mye-lytis], is also known as Post-Viral Fatigue Syndrome (PVFS) (ICD10 - G93. ... In medicine, a myopathy is a neuromuscular disease in which the muscle fibers do not function for any one of many reasons, resulting in muscular weakness. ... For other uses, see Nausea (disambiguation). ... Neutropenia (or neutropaenia, adjective neutrop(a)enic) is a hematological disorder characterized by an abnormally low number of neutrophil granulocytes (a type of white blood cell). ... The current usage of the term nightmare refers to a dream which causes the sleeper a strong unpleasant emotional response. ... Endoscopic images of a duodenal ulcer. ... Pancreatitis is inflammation of the pancreas. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep (but not directly related to the phenomenon of... Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the side-effects of systemic illness. ... A rash is a change in skin which affects its color, appearance, or texture. ... Renal failure is the condition in which the kidneys fail to function properly. ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... Stevens-Johnson syndrome (SJS) is a severe and life-threatening condition. ... Taste is one of the traditional five senses and refers to the ability to detect the flavor of foodstuffs and other substances (e. ... Emesis redirects here. ... Xeroderma literally means dry skin. It is a condition involving the integumentary system, which in most cases can safely be treated with emollients and/or moisturizers. ... Xerostomia is the medical term for a dry mouth due to a lack of saliva. ...

See also

Antiviral drugs are a class of medication used specifically for treating viral infections. ...

References

  1. ^ Panel on Clinical Practices for Treatment of HIV (2002-09-03). Guidelines for using antiretroviral agents among HIV-infected adults and adolescents. PubMed and National Institutes of Health. Retrieved on 2006-01-09.
  2. ^ Panacos Pharmaceuticals. Clinical Trial: Phase 2 Safety and Efficacy Study of Bevirimat Functional Monotherapy in HIV Treatment-Experienced Patients for 2 Weeks*. ClinicalTrials.gov. Retrieved on 2007-08-28.
  3. ^ Perelson AS, Neumann AU, Markowitz M, Leonard JM, Ho DD (1996). "HIV-1 dynamics in vivo: virion clearance rate, infected cell life-span, and viral generation time". Science 271 (5255): 1582–6. PMID 8599114. 
  4. ^ United States Department of Health and Human Services (2004). A Guide to Primary Care for People With HIV/AIDS, 2004 Edition. Retrieved on 2006-07-03.
  5. ^ http://www.fda.gov/FDAC/features/1999/499_aids.html
  6. ^ World Health Organization (2003). Scaling up retroviral therapy in resource limited settings. Retrieved on 2006-01-17.
  7. ^ Panel on Clinical Practices for Treatment of HIV Infection (October 6, 2005). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Department of Health and Human Services. Retrieved on 2006-01-17.
  8. ^ Department of Health and Human Services (August, 2006). HIV and Its Treatment: What You Should Know. Retrieved on 2006-11-04.
  9. ^ UK Group of Transmitted HIV Drug Resistance (2005). "Time trends in primary resistance to HIV drugs in the United Kingdom: multicentre observational study". Brit Med J 331 (7529): 1368–71. doi:10.1136/bmj.38665.534595.55. PMID 16299012. 
  10. ^ Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children (November 3, 2005). Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Department of Health and Human Services. Retrieved on 2006-01-17.
  11. ^ MMWR weekly (2005) Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States January 21, 54 (RR02), 1-20
  12. ^ Saitoh A, Hull AD, Franklin P, Spector SA. (2005) Myelomeningocele in an infant with intrauterine exposure to efavirenz. J Perinatol. 25, 555-556 PMID 16047034
  13. ^ Dybul M, Fauci AS, Bartlett JG, Kaplan JE, Pau AK; Panel on Clinical Practices for Treatment of HIV. (2002) Guidelines for using antiretroviral agents among HIV-infected adults and adolescents. Ann Intern Med. 137, 381-433 PMID 12617573
  14. ^ Ian McNicholl (August 2004, July 2005). Adverse Events of Antiretroviral Drugs. University of California San Francisco. Retrieved on 2006-01-07.

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Antiretroviral drug section....


  Results from FactBites:
 
Antiretroviral drug - Wikipedia, the free encyclopedia (2537 words)
Antiretroviral drugs are medications for the treatment of infection by retroviruses, primarily HIV.
Drug holidays (or "structured treatment interruptions"), are intentional discontinuations of antiretroviral drug treatment.
Antiretroviral drugs are broadly classified by the phase of the retrovirus life-cyle that the drug inhibits.
  More results at FactBites »

 
 

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