About the Drug Fact Sheets.This issue's drug fact sheets summarize the currently approved drugs indicated for the treatment of HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. infection. The drugs are grouped according to class: nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors Non-Nucleoside Reverse Transcriptase Inhibitors Definition This type of drug interferes with an enzyme that is key to the replication (reproduction) of the human immunodeficiency virus (HIV). (NNRTIs) and protease inhibitors Protease Inhibitors Definition A protease inhibitor is a type of drug that cripples the enzyme protease. An enzyme is a substance that triggers chemical reactions in the body. . Within each class, the drugs are listed in the order of approval by the US Food and Drug Administration. The "Guidelines classification" for each drug refers to that drug's recommended use according to The Panel on Clinical Practices for the Treatment of HIV Infection. This panel was convened in 1996 by the US Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS and the Henry J. Kaiser Henry John Kaiser (May 9, 1882—August 24, 1967) was an American industrialist who became known as the father of modern American shipbuilding. Early life Beginning as a cashier in a dry-goods shop in Utica, New York, Kaiser moved many times as he pursued the Family Foundation. These guidelines can be downloaded from hivatis.org through the HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Treatment Information Service (ATIS ATIS - A Tools Integration Standard ). Table IX (on page 32 of the guidelines) summarizes the panel's recommendations for the use of these drugs in combination for the treatment of established HIV infection. A treatment regimen is usually comprised of a choice from Column A and a choice from Column B. The table is reproduced below for your convenience.
Column A
Strongly Recommended Efavirenz
Indinavir
Nelfinavir
Ritonavir + Saquinavir
(SGC* or HGC*)
Column A
Recommended as an Alternative Abacavir
Amprenavir
Delavirdine
Nelfinavir +
Saquinavir-SGC
Nevirapine
Ritonavir
Saquinavir-SGC
No Recommendation; Insufficient Data** Hydroxyurea in
combination with other
antiretroviral drugs
Ritonavir + Indinavir
Ritonavir + Nelfinavir
Column A
Not Recommended; Should Not Be Offered
(All monotherapies, whether from column
A or B***) Saquinavir-HGC****
Column B
Strongly Recommended Stavudine + Lamivudine
Stavudine + Didanosine
Zidovudine + Lamivudine
Zidovudine + Didanosine
Column B
Recommended as an Alternative Didanosine + Lamivudine
Zidovudine + Zalcitabine
Not Recommended; Should Not Be Offered
(All monotherapies, whether from column
A or B***)
Column B
Not Recommended; Should Not Be Offered
(All monotherapies, whether from column
A or B***) Stavudine + Zidovudine
Zalcitabine + Lamivudine
Zalcitabine + Stavudine
Zalcitabine + Didanosine
(*) Saquinavir-SGC, soft-gel capsule (Fortovase): Saquinavir-HGC, hard-gel capsule (Invirase). (**) This category includes drugs or combinations for which information is too limited to allow a recommendation for or against use. (***) Zidovudine zidovudine /zi·do·vu·dine/ (zi-do´vu-den) a synthetic nucleoside (thymidine) analogue that inhibits replication of some retroviruses, including the human immunodeficiency virus; used in the treatment of HIV infection and AIDS. monotherapy may be considered for prophylactic use in pregnant women with low viral load viral load n. The concentration of a virus, such as HIV, in the blood. viral load, n a measure of the number of virus particles present in the bloodstream, expressed as copies per milliliter. and high CD4 T cell Noun 1. CD4 T cell - T cell with CD4 receptor that recognizes antigens on the surface of a virus-infected cell and secretes lymphokines that stimulate B cells and killer T cells; helper T cells are infected and killed by the AIDS virus counts to prevent perinatal transmission, as discussed under "Considerations in the Pregnant Woman". **** Use of Saquinavir-HGC (Invirase) is not recommended, except in combination with ritonavir ritonavir /ri·to·na·vir/ (ri-to´nah-vir) an HIV protease inhibitor used in treatment of HIV infection and AIDS. ri·ton·a·vir n. . |
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