Abstract:
:Acquired resistance to antiretroviral agents is an established sequela of HIV pharmacotherapy. Viral mutations can confer reduced susceptibility to antiretroviral medications, resulting in virologic and clinical failure in more than half of treated patients. Cross-resistance that can develop within each drug class leads to the progressive loss of future therapeutic options for individual patients. Although protease inhibitors (PIs) are a potent class of antiretrovirals, resistance can still develop rapidly, and multiple-PI resistance has become a serious, growing clinical problem. Development of rational treatment strategies that recognize specific patterns of cross-resistance among PIs are needed to help clinicians choose the most appropriate PI. Rational sequencing of PI use should be based on genotypic and phenotypic resistance testing. Maintaining higher drug plasma levels or using specific PI combinations may also diminish PI cross-resistance. New agents that are less likely to induce or be susceptible to cross-resistance will be of value in HIV treatment. This article reviews the acquisition of resistance to currently available PIs, discussing the drug-specific mutational patterns and evidence of clinical cross-resistance. The resistance profiles of two newer PIs, atazanavir and tipranavir, are also presented.
journal_name
AIDS Patient Care STDSjournal_title
AIDS patient care and STDsauthors
Kozal Mdoi
10.1089/108729104323038874subject
Has Abstractpub_date
2004-04-01 00:00:00pages
199-208issue
4eissn
1087-2914issn
1557-7449journal_volume
18pub_type
杂志文章,评审abstract::Young men who have sex with men (MSM) represent an increasing number of new HIV infections in many communities. Many individuals still hold beliefs that may lead to discrimination against HIV-positive individuals. HIV stigma is associated with negative health and psychosocial outcomes and may lead to greater challenge...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2008.0256
更新日期:2009-05-01 00:00:00
abstract::The increased longevity afforded by combination antiretroviral therapy in developed countries has led to an increased concern regarding senescence-related diseases in patients with human immunodeficiency virus (HIV) infection. Previous epidemiologic analyses have demonstrated an increased risk of chronic obstructive p...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2013.0373
更新日期:2014-05-01 00:00:00
abstract::Injection drug use (IDU) is an important vector of HIV infection in the United States. Many patients with HIV infection have comorbid substance use disorders. Integrated treatment for HIV and substance use disorders has been shown to improve HIV and other health outcomes, but significant barriers to integrated treatme...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2009.0242
更新日期:2010-01-01 00:00:00
abstract::T-20 is a novel antiretroviral agent that inhibits the fusion of human immunodeficiency virus (HIV) with target cell membranes. It is delivered by self-administered, twice-daily, subcutaneous injections. The impact of this mode of administration on patients' ability to conduct normal activities of daily living (ADL) a...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/108729102320231162
更新日期:2002-07-01 00:00:00
abstract::The average reported age of sexual debut for youth in the United States is 14.4 years, with approximately 7% reporting their sexual debut prior to age 13. While the research literature on sexual debut for youth addresses gender and ethnic differences (with males and African-American youth experiencing earlier sexual d...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2011.9879
更新日期:2011-08-01 00:00:00
abstract::We used a standardized screening tool to examine frequency of depression and its relation to antiretroviral medication adherence among HIV-infected persons on highly active antiretroviral therapy (HAART) in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study). This is a p...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章,多中心研究
doi:10.1089/apc.2012.0132
更新日期:2012-12-01 00:00:00
abstract::Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adhere...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2018.0035
更新日期:2018-05-01 00:00:00
abstract::While debate continues at what stage of human immunodeficiency virus (HIV) disease to begin combination antiretroviral therapy, a number of clinical and public health benefits are linked to early entry into primary care soon after first testing HIV positive. However, HIV-infected patients continue to test late and del...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/108729101753205694
更新日期:2001-10-01 00:00:00
abstract::The problem of inadequate adherence to prescribed highly active antiretroviral therapy (HAART) drug regimens to treat HIV infection and AIDS is ubiquitous. Adherence can be inadequate despite both provider and patient understanding of the consequences of nonadherence. Successful long-term treatment of HIV/AIDS require...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章,评审
doi:10.1089/108729103321619773
更新日期:2003-04-01 00:00:00
abstract::The rate of HIV seroprevalence in Nigeria is troublesome because it is one of the highest prevalence rates worldwide. As in most developing countries, vertical transmission from mother to child accounts for most of the HIV infections in Nigerian children. The purpose of this study was to determine the awareness, attit...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2006.0065
更新日期:2007-04-01 00:00:00
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journal_title:AIDS patient care and STDs
pub_type: 杂志文章,评审
doi:10.1089/apc.1998.12.167
更新日期:1998-03-01 00:00:00
abstract::China is experiencing a rapid increase in the incidence of HIV infections, which it is addressing proactively with broad implementation of antiretroviral therapy (ART). Within a cultural context extolling familial responsibility, family caregiving may be an important component to promote medication adherence for perso...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2010.0261
更新日期:2011-12-01 00:00:00
abstract::Mortality rates have decreased in medically compliant patients with HIV. More HIV-positive patients are requesting procedures that improve their quality of life. Reduction mammoplasty has been proven to predictably relieve back, neck, and shoulder pain related to macromastia. A case report is presented demonstrating a...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2005.19.353
更新日期:2005-06-01 00:00:00
abstract::We reviewed the short-term response to and safety of protease inhibitor (PI) therapy in HIV-infected children by performing a retrospective chart review of open-label PI containing combination therapy at two urban pediatric HIV centers. Seventy HIV-infected children received 101 PI containing antiretroviral therapy (A...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/10872910050193761
更新日期:2000-11-01 00:00:00
abstract::Blacks/Hispanics face limited access to HIV testing. We examined in-pharmacy HIV testing among customers in pharmacies participating in a nonprescription syringe program in New York City. Participants were recruited in two pharmacies to complete a survey and receive an optional HIV test. Bivariate and multivariable an...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2015.0017
更新日期:2015-08-01 00:00:00
abstract::The threat of social stigma may prevent people living with HIV from revealing their status to others and serve as a barrier to HIV treatment adherence. We evaluated the effect of such concerns on self-reported treatment adherence using a short, three-item measure among 204 people living with HIV. Overall, the mean age...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2006.20.359
更新日期:2006-05-01 00:00:00
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journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2008.0241
更新日期:2009-08-01 00:00:00
abstract::Guidelines for HIV primary care include visits every 3 months (up to 6 months in those with stable HIV). During pregnancy, women with HIV commonly attend once weekly to once monthly visits; however, after delivery, many are lost to follow-up. Our goal was to assess the frequency of loss to primary care follow-up postp...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2013.0321
更新日期:2014-05-01 00:00:00
abstract::Recent data suggest that the prevalence of HIV/syphilis infections among men who have sex with men (MSM) in China increased rapidly. This cohort study was to assess the correlates of the incident infections for HIV, syphilis, and hepatitis B virus (HBV) among sexually active and HIV-negative MSM in China. A cohort of ...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2010.0083
更新日期:2010-09-01 00:00:00
abstract::Early antiretroviral therapy (ART) initiation reduces the risk of disease progression and HIV transmission, but data on time from HIV care entry to ART initiation are lacking. Using data from the Medical Monitoring Project (MMP), a population-based probability sample of HIV-infected adults receiving medical care in th...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2014.0194
更新日期:2014-12-01 00:00:00
abstract::The introduction of protease inhibitors (PIs) and highly active antiretroviral therapy in the mid-1990s dramatically altered the treatment of HIV infection, enabling suppression of viral replication to undetectable levels and preventing disease progression. Most PIs present a strong barrier against viral resistance; t...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2007.0099
更新日期:2008-04-01 00:00:00
abstract::HIV vaccine availability does not guarantee uptake. Given suboptimal uptake of highly efficacious and already accessible vaccines in the United States, low vaccine coverage in the developing world, and the expectation that initial HIV vaccines will be only partially efficacious, the public health community will face f...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章,评审
doi:10.1089/apc.2004.18.691
更新日期:2004-12-01 00:00:00
abstract::Uptake of HIV pre-exposure prophylaxis (PrEP) is low among women at risk for HIV acquisition. Of 468,000 women, whom the United States Centers for Disease Control and Prevention estimates to be eligible for PrEP, only 10,000 unique women have begun therapy through the third quarter of 2015. These data suggest insuffic...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2018.0030
更新日期:2018-12-01 00:00:00
abstract::Superior mesenteric artery (SMA) syndrome is a unique type of small bowel obstruction resulting from the compression of the duodenum by the SMA. This is a case of SMA syndrome in a cachectic 6-year-old boy with AIDS who presented after a 2.3-kg weight loss in the preceding month. Unfamiliarity with this condition coup...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/108729100318073
更新日期:2000-01-01 00:00:00
abstract::Cytomegalovirus retinitis (CMVR) is the most common intraocular infection encountered in ophthalmic practices. To assess the impact of highly active antiretroviral therapy (HAART) on the incidence of CMVR and subsequent retinal detachments, a retrospective review of the HIV+ patients seen at a single university and co...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/108729100413202
更新日期:2000-07-01 00:00:00
abstract::We describe repeated episodes of hepatitis C (HCV) activation associated with initiation of highly active antiretroviral therapy (HAART) in two HIV/HCV coinfected individuals with undetectable serum HCV RNA. Both patients developed high HCV viremia (>1 million IU/mL) and elevations in aminotransferases >10 times upper...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2007.0017
更新日期:2007-10-01 00:00:00
abstract::In HIV/AIDS, symptoms of depression or post-traumatic stress may interfere with important self-care behaviors such as the ability to adhere to one's medical treatment regimen. However, these problems may frequently go undetected in HIV care settings. The present study used brief self-report screening measures of depre...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/apc.2007.0069
更新日期:2008-04-01 00:00:00
abstract::HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2008.0005
更新日期:2008-11-01 00:00:00
abstract::Kaposi's sarcoma (KS) and bacillary angiomatosis (BA) may be histologically similar. A precise diagnosis is required because of the different management of these diseases. KS or BA involving bone marrow is rare in patients with and without acquired immune deficiency syndrome (AIDS). We report the case of a 40-year-old...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/108729102761882107
更新日期:2002-12-01 00:00:00
abstract::Poor engagement in HIV care has been associated with delayed access to antiretroviral treatment and increased HIV transmission. Using viral load (VL) results from HIV laboratory surveillance data to conduct longitudinal and cross-sectional analyses, we examined linkage to care, retention in care, and their associated ...
journal_title:AIDS patient care and STDs
pub_type: 杂志文章
doi:10.1089/apc.2011.0371
更新日期:2012-08-01 00:00:00