Journal ArticleDOI
Primary Human Immunodeficiency Virus Type 1 Infection: Review of Pathogenesis and Early Treatment Intervention in Humans and Animal Retrovirus Infections
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TLDR
Data from retrovirus-infected animal models treated with antiviral agents suggests that therapy at the time of viral dissemination may be an effective strategy that may modify disease progression, and clinical trials to evaluate this approach are in progress.Abstract:
Primary human immunodeficiency virus type 1 (HIV-1) infection can present clinically as the abrupt onset of a febrile illness resembling acute mononucleosis. The symptoms coincide with high titers of culturable plasma viremia, cell-associated virus, and antigenemia, which rapidly decrease coincident with the emergence of detectable HIV-specific antibody and HIV-specific cytotoxic T lymphocytes. This article reviews the human and animal model data on the virologic and immunologic events that occur during primary HIV-1 and animal retrovirus infections, evaluates the prophylactic treatment experience of retrovirus infections in the animal model, and provides a plausible rationale for treatment intervention of primary HIV-1 infection in humans. Recent work delineating the pathogenesis of primary HIV-1 infection provides insight into the major mechanisms of viral dissemination and host immune response. The results from retrovirus-infected animal models treated with antiviral agents suggests that therapy at the time of viral dissemination may be an effective strategy that may modify disease progression. Clinical trials to evaluate this approach are in progress.read more
Citations
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Journal ArticleDOI
Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents
Anthony S. Fauci,John G. Bartlett,Eric P. Goosby,M. D. Smith,H. J. Kaiser,S. W. Chang,James M. Anderson,R. Armstead,A. C. Baker,David A Barr,Samuel A. Bozzette,S. Cox,M. Delaney,Fred M. Gordin,W. Greaves,M. Harrington,J. J. Henning,Martin S. Hirsch,J. Jacobs,Richard Marlink,C. Maxwell,J. W. Mellors,D. B. Nash,S. Perryman,Robert T. Schooley,R. Sherer,Stephen A. Spector,G. Torres,Paul A. Volberding,B. A. Brady,E. M. Daniels,D. Feigal,Mark B. Feinberg,H. D. Gayle,T. R. Graydon,Jonathan E. Kaplan,Abe M. Macher,R. F. Martin,Henry Masur,Lynne M. Mofenson,J. Murray,J. O'Neill,L. C. Perez,R. Riseberg,S. Shekar,Sharilyn K. Stanley,J. Whitescarver +46 more
TL;DR: These Guidelines were developed by the Panel* on Clinical Practices for Treatment of HIV Infection convened by the Department of Health and Human Services and the Henry J. Kaiser Family Foundation.
Journal ArticleDOI
Acute Human Immunodeficiency Virus Type 1 Infection
James O. Kahn,Bruce D. Walker +1 more
TL;DR: The diagnosis of acute HIV-1 infection requires a high index of clinical suspicion and correct use of specific diagnostic laboratory tests and the potential clinical benefit of early antiretroviral treatment.
Journal ArticleDOI
New Testing Strategy to Detect Early HIV-1 Infection for Use in Incidence Estimates and for Clinical and Prevention Purposes
Robert S. Janssen,Glen A. Satten,Susan L. Stramer,Bhupat D. Rawal,Thomas R. O'Brien,Barbara J. Weiblen,Frederick Hecht,Noreen Jack,Farley R. Cleghorn,James O. Kahn,Margaret A. Chesney,Michael P. Busch +11 more
TL;DR: The sensitive/less sensitive testing strategy provides accurate diagnosis of early HIV-1 infection, provides accurate estimates of HIV- 1 incidence, can facilitate clinical studies of earlyAIDS, and provides information on HIV-2 infection duration for care planning.
Journal ArticleDOI
Recommendations for use of antiretroviral drugs in pregnant hiv-1-infected women for maternal health and interventions to reduce perinatal hiv-1 transmission in the United States
TL;DR: Tissue specimens showing more than 5 neutrophils/HPF show a sensitivity of 43% to 84% in specificity of 93% to 97% and the preferred culture sources are blood cultures or bone biopsy.
Journal ArticleDOI
Guidelines for using antiretroviral agents among HIV-infected adults and adolescents: The Panel on Clinical Practices for Treatment of HIV
TL;DR: This report provides pathogenesis-based rationale for therapeutic strategies as well as guidelines for implementing these strategies and recommends that, when possible, the treatment of HIV-infected patients should be directed by a clinician who has extensive experience in the care of these patients.
References
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Journal ArticleDOI
HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease
Giuseppe Pantaleo,Cecilia Graziosi,James F. Demarest,Luca Butini,Maria Montroni,Cecil H. Fox,Jan M. Orenstein,Donald P. Kotler,Anthony S. Fauci +8 more
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Journal ArticleDOI
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TL;DR: An extraordinarily large number of latently infected CD4+ lymphocytes and macrophages are discovered throughout the lymphoid system from early to late stages of infection, and the extracellular association of HIV with follicular dendritic cells is confirmed.
Journal ArticleDOI
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TL;DR: Quantitation of HIV-1 in plasma by QC-PCR may be useful in assessing the efficacy of antiretroviral agents, especially in early stage disease when conventional viral markers are often negative.
Journal ArticleDOI
Immunopathogenesis of human immunodeficiency virus infection
TL;DR: In this paper, the role of LFA-1 has been highlighted, and several factors in addition to endogenous viral regulatory proteins have been reported as capable of modulating the state of viral latency and expression in vitro.
Journal ArticleDOI
CD8+ lymphocytes can control HIV infection in vitro by suppressing virus replication
TL;DR: A potential approach to therapy in which autologous CD8 lymphocytes could be administered to individuals to inhibit HIV replication and perhaps progression of disease is suggested.