Acquired immunodeficiency disease

IV. TREATMENT OF ACQUIRED IMMUNODEFICIENCY DISEASE (AIDS) (continued from p. 371)... 

AIDS (acquired immunodeficiency syndrome) is the final stage of disease caused by infection with HIV. In this stage, the vims infection has severely affected the immune system, causing a depletion of CD4+ T-helper cells. AIDS is characterized by the manifestation of typical diseases caused by opportunistic infections (Pneumocystis carinii pneumonia, CMV retinitis, candidiasis of the esophagus, cerebral toxoplasmosis), neurological manifestations, cachexia, or certain tumors (Kaposi sarcoma of the skin, B-cell lymphoma). 

Viruses are small infectious agents composed of a nucleic acid genome (DNA or RNA) encased by structural proteins and in some cases a lipid envelope. They are the causative agents of a number of human infectious diseases, the most important for public health today being acquired immunodeficiency syndrome (AIDS), hepatitis, influenza, measles, and vituses causing diarrhoea (e.g., rotavirus). In addition, certain viruses contribute to the development of cancer. Antiviral drugs inhibit viral replication by specifically targeting viral enzymes or functions and are used to treat specific virus-associated diseases. 

The Orphan Drug Act of 1983 was passed to encourage die development and marketing of products used to treat rare diseases. The act defines a rare disease as a condition affecting fewer than 200,000 individuals in die United States. The National Organization of Rare Disorders reports that there are more tiian 6000 rare disorders that affect approximately 25 million individuals. Examples of rare disorders include Tourette s syndrome, ovarian cancer, acquired immunodeficiency syndrome (AIDS), Huntington s disease, and certain forms of leukemia... 

M ore than 200 viruses have been identified as capable of producing disease Acute viruses, such as the common cold, have a rapid onset and quick recovery. Chronic viral infections, such as acquired immunodeficiency syndrome (AIDS), have recurrent episodes of exacerbations (increases in severity of symptoms of the disease) and remissions (periods of partial or complete disappearance of the signs and symptoms). Display 14-1 describes the viruses discussed in this chapter. 

Haverkos HW, Pinsky PF, Drotman DP, etal Disease manifestation among homosexual men with acquired immunodeficiency syndrome a possible role of nitrites in Kaposi s sarcoma. Sex Transm Dis 12 203-208, 1985 Haverkos HW, Kopstein AN, Wilson H, et al Nitrite inhalants history, epidemiology, and possible links to AIDS. Environ Health Perspect 102 858-861, 1994 Hernandez-Avila CA, Ortega-Soto HA, Jasso A, et al Treatment of inhalant-induced psychotic disorder with carbamazepine versus haloperidol. Psychiatr Serv49 812— 815, 1998... 

Parasitic diseases, such as trypanosomiasis, malaria, and leishmaniasis, affect himdreds of millions people around the world, mainly in underdeveloped countries. They are also the most common opportunistic infections that affect patients with acquired immunodeficiency syndrome (AIDS). Globally, malaria occupies the first place, but in Latin America, Chagas disease (American Trypanosomiasis) is the most relevant parasitic disease that produces morbidity and mortahty in low-income individuals. 

Although esophageal candidiasis represents the first manifestation of HIV infection in less than 10% of cases, it is the second most common acquired immunodeficiency syndrome (AIDS)-defining disease.29 As with oropharyngeal candidiasis, the incidence of esophageal candidiasis increases with decreasing CD4 counts. 

We have discussed in a general way the nature of animal viruses in the first part of this chapter. Now we discuss in some detail the structure and molecular biology of a number of important animal viruses. Viruses will be discussed which illustrate different ways of replicating, and both RNA and DNA viruses will be covered. One group of animal viruses, those called the retroviruses, have both an RNA and a DNA phase of replication. Retroviruses are especially interesting not only because of their unusual mode of replication, but because retroviruses cause such important diseases as certain cancers and acquired immunodeficiency syndrome (AIDS). 

Similarly, under certain disease conditions, altered NA innervation and/or AR signaling capacity impairs sympathetic communication with cells of the immune system, influencing disease progression. Altered catecholamine communication with the immune system is evident in autoimmune diseases such as arthritis and multiple sclerosis [5-7] and in infectious diseases, such as leprosy and a mouse model of acquired immunodeficiency syndrome [15, 43, 44], The impact of altered NA innervation of... 

When the drug is intended to treat a life-threatening disease, such as acquired immunodeficiency syndrome (AIDS). 

The human immunodeficiency virus began to spread among the homosexual population in the United States in the late 1970s, but it was not until 1981 that physicians in New York and at the Centers for Disease Control in Atlanta recognized the new clinical syndrome (acquired immunodeficiency syndrome), alerting the world to a new and fatal infection. 

There is no good animal model for infection by HIV. The virus will infect several primates, but it does not produce active disease and it is not practical to use primates for propagation of the virus. The chimpanzee has been used in vaccine trials to determine whether neutralizing antibody is produced and whether the growth of the virus can be inhibited in vivo. More productive work has been done using the immunodeficiency viruses of the species (e.g., simian immunodeficiency virus in macaques, feline immunodeficiency virus in cats) to study pathogenesis and treatment of retroviral acquired immunodeficiencies. 

The human immunodeficiency virus (HIV) causes the immunodeficiency disease known as AIDS (acquired immune deficiency syndrome). The structure of this virus is similar to that of the influenza virus (A). 

Infection with Mycobacterium avium or Mycobacterium intracellulare occurs in patients with the acquired immunodeficiency syndrome. These organisms infrequently cause lung disease in older adults and children with normal immunity but abnormal lungs. 

The human immunodeficiency virus (HIV) is one of only a few retroviruses known to infect humans. It is estimated that approximately twenty-two million people are now infected worldwide [1]. With only a tiny number of exceptions, infection ultimately leads to the development of the lethal condition of acquired immunodeficiency syndrome, or AIDS. To date, only a handful of drugs have been shown to have any effect on the course of the disease. These are, in general, relatively ineffective at significantly prolonging life, and drug resistance develops rapidly. Equally discouraging, vaccines have not yet been developed to prevent infection. 

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