Terapêutica anti-retroviral na infecção a VIH (1ª parte)
Palavras-chave:
terapêutica combinada, resistênciaResumo
Faz-se uma breve revisão sobre a imunofisiopatologia da infecção pelo VIH. Abordam-se os fármacos que se encontram em investigação clínica mais avançada e alguns que poderão ter interesse futuro. Destacam-se os compostos actualmente disponíveis para uso clínico, tentando abordar os aspectos que na prática clínica são mais importantes. Referenciam-se ensaios clínicos quanto à eficácia nestas drogas em monoterapia ou combi nação.
Downloads
Referências
Werner A, Winskowsky G, Cichutek K et ai. Productive infection of both CD4+ and CD4- human cell lines with HIV-1, HIV-2 and SJV. AIDS 1990; 4: 537.
Ikeuchi K, Kim S, Byrn RA et al. Infection of non lymphoid cells by human immunodeficiency virus type l or type 2. J Virol 1990; 64: 4226.
Clapham PR, Weber JN, Whitby D et al. Solube CD4 blocks the infectivity of diverse strains of HIV and SIV for T cells and monocytes but not for brain and muscle cells. Nature 1989; 337 1989.
Cao Yz, Friedman-Kien, Haung YX et al. CD4-independent, productive human immunodeficiency virus type 1 infection of hepatoma cell lines in vitro. J Virol 1990; 64: 2553.
Levy JA. HIV pathogenesis and long-term survival. AIDS 1993; 7: 1401-1410.
Lafeuillade A et ai. High viral burden in Iymph nodes during early stagers of HIV infection. AIDS 1993; 7: 1527.
Howard MT, Bolognesi DP. Where has HIV been hiding? Nature 1993; 362: 292-293.
Pantaleo G et al. Nature 1993; 362: 355-358.
Nuovo GJ, Becker J, Burk MW et al. ln situ detection of PCR amplified HIV-1 nucleic acids in lymph nodes and peripheral blood in patients with asymptomatic HIV-1 infection and ad vanced stage AIDS. Journal of AIDS 1994; 7: 916-923.
Ameisen. Programmed cell death (apoptosis) and cell survival regulation: relevance to AIDS and cancer. AIDS 1994; 8: 1197- 1213.
Choremi-Papadopoulou H, Viglis V, Gargalianos P et al. Down regulation of CD28 surface antigen on CD4+ and CDS+ T Iym phocytes during HIV-1 infection.Journal of AIDS 1994: 7 245-253.
Theodore AC, Kornfeld H, Wallace RP et al. CD4 modulation of noninfected T lymphocytes by HIV-1 envelope glycoprotein gp120: contribution to the immunossupression seen in HIV-1 infection by induction of CD4 and CD3 unresponsiveness. Journal of AIDS 1994; 7: 899-907.
Embretson G et al. Nature 1993; 363: 359-362
Matsuyama T et al. Cytokines and HIV infection: is AIDS a tumor necrosis factor disease. AIDS 1991; 5: 1405-1417.
Gougeon ML, Montagnier L. Apoptosis in AIDS. Science 1993: 260(5112): 1269-1270.
Fauci AS. Immunopathogenesis of HIV infection. Journal of AIDS 1993; 6(6): 655-662.
Weiss RA. How does HIV cause AIDS7 Science 1993; 260(5112): 1273-79.
Pantalaeo G, Graziosi C, Fauci AS. New concepts in the immu nopathogenesis of human immunodeficiency virus infection. N Engl J Med 1993; 328(5): 327-335
Epstein FH. The molecular biology of human immunocleficiency virus type 1 infection. N Engl J Mecl 1991; 324(5): 308-17.
Beclnarik DP, Folks TM. Mechanisms of HIV Latency. AIDS 1992; 6: 3-16.
Yeni P. Schooley R, Hammer S. Antiretroviral and immune-based therapics: update. AIDS 1993; 7(sup 1): Sl73 -Sl84.
Schooley RT et ai. Recombinant soluble CD4 therapy in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. Ann lnt Med 1990; 112: 247-252.
Kahn JO et al. The safety and phramacokineticsod recombinam soluble CD11 ( rCD4) in subjects with the acquired immunodeficiency syndrome (AIDS) anel AIDS-related complex. Ann lnt Med 1990; 112: 254-261.
Gomatos PJ, Stamatos NM and Schooley RT. Soluble Cd4, Immu nomodulators, lmmmunotoxins and other Approaches to Anti lllV Therapy. in ele Vila ed AIDS: Etiology, Diagnosis, Treat ment anel Prevention 1992, JB Lippincott.
Capon DJ. Ward RH. Antiviral effects of CD4 derivatives. Curr Opi lmmunol 1990; 2.433.
Traunecker A, Schncicler J, Kiefer H et al. Highly efficienr neutralization of HIV recombinant CD4-immunoglobulin mole cules. Nature 1989; 339: 68.
Byrn RA. Meordenti J Lucas C et al. Biological properties of immunoadhesin. Nature 1990; 344: 667.
Matsushita S, Koito A, Maecla Y et ai. Selective killing of HJV infected cells by anti gpl20 immunotoxins. A!Ds Res Hum Retroviruses 1990; 6: 193.
Focus on Diclanosine. Drugs 1992; 44(1): 100.
Zolla-Pazner S. Gorny MK. Passive immunization for the prevention and treatment of HIV infection. AIDS 1992; 6: 1235-1248.
Allaway GP, Ryder AM. Heauclry Ga et al. Synergistic inhibiton of HIV-1 envelope mediated cell fusion by CD4-based moleculaes in combination with antibodies to gpl20 or gp41. AIDS Res Hum Retroviruses 1993; 9(7): 581-587.
Lefrere JJ., Vittecoq D. and the French Passive lmmunotherapy Collaborative Study Group; resumo 050 - 4th European Conference on Clinicai Aspects and Treatment of HIV Infection, Milão - Março 94.
Osther K et al. Passhiv-1 treatment of patients with HIV-1 infection. A preliminary report of a Phase I trial hyperimmune porcine immunoglobulin to HIV-1. AIDS 1992; 6: 1457-1465.
-1. Burger Dtvf et al. Drug interactions with zidovudine. AIDS 1993; 7 445-460.
Fischl MA. State of antiretroviral therapy with zidovudine. AIDS 1989: 3(suppl 1) Sl37-Sl41
Richman DD. Aziclothimicline anel other deoxynucleoside ana logues. in ele Vita ed AIDS: Etiology, Diagnosis, Treatment and Prevention 1992. JB Lippincott.
Wood AJJ. Therapy for human immunodeficiency virus infection. N Engl J Med 1993: 328: 1686-1695.
Gray F et al. Zidovudine therapy and HIV encephalitis: a 10- year neuropathological survey: AIDS 1994; 8: 489-494.
Hurger DM et al. Penetration of zidovudine into the cerebrospinal fluid of patients infected with HIV. AIDS 1993; 7: 1581 - 1588.
Stricker RB, Elswood BF. lmmunosupressive effect of zidovudine ( letter). Ann Int Med 1993; 118: 571-572.
-!1. Mcleod GX. I lammer SM. Immunossupressive effect of zidovudine (response). Ann lnt Med 1993; 118: 572.
Roques P. et al. Correlation between HIV provirus burden and in utero transmission. AIDS 1993: 7(sup): S39-S43.
Rouzioux C. et al. Timimg of mother-to-child HIV-1 transmission depends on maternal status. AIDS 1993; 7(sup): S49-S52.
European Collaborative Study. Caesarean section and the risk of vertical transmission of HIV. Lancet 1994; 343: 1464-1467.
Centers for Disease Control and Prevention. Zidovudine for the prevention of HIV transmission from mother to infant. MMWR 1994; 43: 285-287.
Norclic Medical Research Councils' HIV Therapy Group, Double blind close-response study of zidovudine in AIDS anel advanced HIV infection. BMJ 1992; 304: 13-17
Van Luzen Schmitzj, Schmitz H et al. Nucleoside analogues sup press viral replication in patients with high virus load in vitro but interfere with T-cell blastogenesis in earlier stages of HIV infection. Resumo 040 4th European Conference on Clinical Aspects and Treatment of HIV Infection, Milão - Março 94.
Tindall B et al. Administration of zidovudine during primary HIV- 1 infection may be associated with a less vigorous immune response. AIDS 1993; 7: 127.
Aboulker JP, Swart AM. Preliminary analysis of the Concorde trial, Lancet 1993; 341: 889-890.
Concorde coordinating comittee, Concorde: MCR/ANRS randomised double-blind controlled trial os immediate and deferred zidovudine in symptom free HIV infection. Lancet 1994: 343: 871-881.
Lipsky JJ. Concorde Lands. Lancet 1994; 343: 866-867.
Mulcler JW, Cooper DA, Mathiesen L et al. Ziclovudine twice dai ly in asymptomatic subjects with HIV infection and a high risk of progression to AIDS: a randomized, double-blind placebo controlled study. AIDS 1994; 8: 313-322.
Lenclerking WR, Gelber RD, Cotton DJ et al. Evaluation of the quality of life associated with zidovudine treatment in asymp tomatic human immunocleficieny virus infection. N Engl J Med 1994; 330(11): 738-743.
Oddone EZ, Cowper D, Hamilton JD et al. Cosi effectiveness analysis of early zidovudine treatment in HIV infected patients. BMJ 1993; 307: 1322-1325.
Cooper DA, Gatell JM, KroonS et ai. Zidovudine in Persons withA,ymp tomatic HIV Infection and CD4+ Cell Count, Greater Than 400 Per Cubic Millimeter. N Engl J Mecl 1993; 329: 297-303.
Lunclgren J, Phillips A, Peclersen C and the AIDS in Europe Study Group. Comparison of the Long-term Prognosis of AIDS Patients Treated and Not Treated with Zidovudine; resumo O35 - 4th European Conference on Clinical Aspects and Treatment of HIV lnfection, Milão - Março 94.
Mannucci MP, Gringeri G, Gatenby P. and the European-Australian Haemophilia Collaborative Study Group. Randomized Douhle-Blind, placebo-Controlled Trial os Twice-Daily Zidovdline in Asymptomatic Haemophiliacs lnfected with the Human Immunodeficiency Syndrome Virus Type l; resumo 036 - 4th European Conference on Clinical Aspects and Treatment of HIV Infection, Milão - Março 94.
Graham NMH, Zeger SL, Park LP et al. The effects on survival of early treatment of human immunodeficiency syndrome. N Engl J Med 1992: 326: 1037-1042.
Dudley MN, Graham KK, Kaul S et al. Pharmacokinetics of Stavucline in Patients with AIDS or AIDS-Related Complex, J lnf Dis 1992; 166 480-485.
Browne MJ, Mayer KH, Chafee SB et al. 2',3'-Diclehydro-2'.3' clicleoxythymidine (d4T) in Patients with AIDS or AIDS-Related Complex: A Phase 1 Trial. J lnf Dis 1993: 167: 21-29.
l. Hitchcock MJM. 2',3'-Didehydro-2',3'-dideoxythymidine (cl4Tl, an anti-HIV agent. Ant Chem & Chemot 1991: 2(3): 125-132.
Bret-smith fl. Griffith B, MellorsJ et al. Effect of d4T in HIV Vire mia. Abstract PoB301 l, Vlll lnternational Conference on AIDS, Amsterelam 1992.
Dudley MN, Horton C, Kaul S et al. Effect of Dose and Schedule on CD4 Cell lncrease with Stavudine (d4T): an lntegrated Pharma cokinetic and Pharmacoelynamic Analysis. Abstract PoB3016, VJJ International Conference cm AIDS, Amsterelam 1992.
Squires K, Sacks H, Sledz S et al. Fiindings from a Phase I Study of Stavudine (el4T). Abstract PoB3030, VIIJ International Conference on AIDS, Amsterdam 1992.
Knupp CA, Shyu WC, Dolin Retal. Pharmacokinetics of didanosine in patients with acquired immunodeficiency syndrome or acquired immunodeficiency syndrome-related complex. Clin Pharm Ther 1991: 49: 523-525.
Groopman JE, MolinaJM. Nucleoside therapy for HIV infection - some answers. many questions. N Engl J Med 1992; 327: 639- 11.
Cooley TP. Kunches LM, Saunders CA et al. Treatment of AIDS and AIDS-related Complex with 2',3'-dideoxyinosine given once daily. Rev of lnf Dis 1990: 12(suppl 5): S552-S560.
Focus on Didanosine, Drugs 1992; 44(1): 108 (tabela).
Connolly KJ, AllanJD, Fitch H et al. Phase J study of 2',3'-dideo xyinosine adminstered orally twice daily in patients with AIDS or AIDS-related complex and haematological intolerance to zielovudine. Am J Med 1991; 91: 471-478.
Smaldone L. Beltangady M, Lagakos S et al. The relative safety of didanosine and zidovudine in the ACTG 1116B/117 -Arandomized double-blind trial. Abstract PoB3007 VII International conference on AIDS, Amsterdam 1992.
McLeod G, Mayers D, McCutchan Fetal. Dideoxynucleoside resistance patterns in clinical isolares of HIV-1. Abstract ThA 1569. VII International conference on AIDS. Amsterdam 1992.
Kozal MJ. Merigan TC. Therpay of HIV-1 Infection, Curr Opin lnf Dis 1994; 7: 72-81.
!,. Merigan TC, Skowron G, Bozzette SA et al. Circulating p24 antigen levels anel responses to elideoxycitidine in human immunodeficiency virus (HIV) infections. A phase 1/11 study. Ann lnt Med 1989; 110: 189-194.
Merigna TC, Skowron G. elelC study group of the AIDS Clinicai Trials Group od the National lnstitute of Allergy and lnfectious Diseases. Safety and tolerance of clideoxycitidine as a single agent. Results of early-phase studies in patients with acquired immunodeficiency syndrome (AIDS) or advanced AlDS-rela ed complex. Am J Int Meel 1990; 88(suppl 5Bl: Sl 1-Sl 5.
Roland T, Katlama C, Berlureau P et al. Long-Term Follouw-up of Patients Treated with Lamivudine (3TC) for Asymptomatic or Milelly Symptomatic HIV Infection; resumo P263 - 4th Eu ropean Conference on Clinical Aspects anel Treatment of HIV lnfection, Milão - Março 94.
Van Leeuwen R et al. The Safety and Pharmacokinetics of a Reverse Transcriptase Inhibitor, 3TC, in Patients with HIV-1 lnfection: a Phase I Study. AIDS 1992; 6: 1471-1476.
Sommaelossi JP. Nucleosiele analogs: similarities and differencies. Clin Infec Dis 1993; 16(sup n S7-S15.
De Jong M, Vella S, Cooper D et al. Neveripine Monotherapy in Nucleoside Naive p24 Antigen Positive Patients: resumo P270
- 4th European Conference on Clinical Aspects and Treatment of HIV lnfection, Milão - Março 94.
Koup RA, Brewster F, Grob P et al. Neviripine synergistically inhibits HIV-1 replication in combination with zielovudine. interferon or CD4 immunoadhesins. AIDS 1993: 7: 1181-1184.
Staszewky S. personal communication AIDS and Medication, 3rd european Meeting on Triais, Drugs and Treatment, Berlin 1993.
Staszewky S, Vandercam B, de Vuyst H et al. Evaluation of the Efficacy and Tolerance of R 18 839, R 89439 (Loviridel anel Placebo in Patients Infected with HIV-1. An lnterim Analysis: resumo 041 - 4th European Conference on Clinical Aspects and Treatment of HIV Infection, Milão - Março 94.
De Braneler M, Staszewsky S, Roeis V et al. Double-Blind evaluatin of the Effects of R 18839. R 89439 and Placebo on immunological Parameters in Asymptomatic HIV Seropositive Subjects; resumo P266 - 4th European Conference on Clinical Aspects and Treatment of HIV Infection. Milão - Março 94.
Foscarnet Therapy in persons with AIDS: Clinical Research and Management Considerations; J of AIDS,1992; 5: suppl 1.
Focus on foscarnet. Drugs 1991; 41(1): 108-115.
Ficheiros Adicionais
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 1994 Medicina Interna
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
Acesso livre
