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Human immunodeficiency virus: 25 years of diagnostic and therapeutic strategies and their impact on hepatitis B and C virus.

Stürmer M, Doerr HW, Gürtler L - Med. Microbiol. Immunol. (2009)

Bottom Line: This progress is not completed; there are beneficial aspects in the response of the scientific community to the HIV burden for the management of other viral diseases.These aspects are described in this contribution.Further aspects as handling a stigmatising disease, education of self-responsiveness within sexual relationships, and ways for confection of a protective vaccine are not covered.

View Article: PubMed Central - PubMed

Affiliation: Institute for Medical Virology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.

ABSTRACT
The human immunodeficiency virus (HIV) had spread unrecognized in the human population as sexually transmitted disease and was finally identified by its disease AIDS in 1981. Even after the isolation of the causative agent in 1983, the burden and death rate of AIDS accelerated worldwide especially in young people despite the confection of new drugs capable to inhibit virus replication since 1997. However, at least in industrialised countries, this trend could be reversed by the introduction of combination therapy strategies. The design of new drugs is on going; besides the inhibition of the three enzymes of HIV for replication and maturation (reverse transcriptase, integrase and protease), further drugs inhibits fusion of viral and cellular membranes and virus maturation. On the other hand, viral diagnostics had been considerably improved since the emergence of HIV. There was a need to identify infected people correctly, to follow up the course of immune reconstitution of patients by measuring viral load and CD4 cells, and to analyse drug escape mutations leading to drug resistance. Both the development of drugs and the refined diagnostics have been transferred to the treatment of patients infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). This progress is not completed; there are beneficial aspects in the response of the scientific community to the HIV burden for the management of other viral diseases. These aspects are described in this contribution. Further aspects as handling a stigmatising disease, education of self-responsiveness within sexual relationships, and ways for confection of a protective vaccine are not covered.

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Related in: MedlinePlus

Scheme of the algorithm of antibody, antigen and viral nucleic acid testing in the diagnostics of HIV, HCV and HBV infection. When the diagnostic window is closed and the initial antibody testing result is negative virus infection is excluded, therefore further data are not documented in the algorithm. When patients have to be treated dependent predominantly on their clinical status, which is not cited in this scheme, a circle of drug application, drug resistance testing and viral load and CD4 cells determination in HIV infected patients, and viral load and liver enzyme testing, as ALT and AST, in hepatitis patients has to be pursued. Permanent treatment is obligatory in AIDS patients and treatment in hepatitis patients occurs until improvement or final failure is obvious
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Fig1: Scheme of the algorithm of antibody, antigen and viral nucleic acid testing in the diagnostics of HIV, HCV and HBV infection. When the diagnostic window is closed and the initial antibody testing result is negative virus infection is excluded, therefore further data are not documented in the algorithm. When patients have to be treated dependent predominantly on their clinical status, which is not cited in this scheme, a circle of drug application, drug resistance testing and viral load and CD4 cells determination in HIV infected patients, and viral load and liver enzyme testing, as ALT and AST, in hepatitis patients has to be pursued. Permanent treatment is obligatory in AIDS patients and treatment in hepatitis patients occurs until improvement or final failure is obvious

Mentions: In 1985, the first HIV antibody ELISAs were available and it was evident from the beginning that numerous test results had been false positive, especially when testing pregnant women. Confirmatory tests were needed, which were based on immunofluorescence, since HIV could be grown nicely on T-cell lines [20, 21], and western blot strips, which used more or less highly purified antigenic material derived from virus concentrated from supernatant of infected cells. A consecutive procedure was the production of line immunoassays with antigenic material purified after cloning individual HIV proteins (Fig. 1).Fig. 1


Human immunodeficiency virus: 25 years of diagnostic and therapeutic strategies and their impact on hepatitis B and C virus.

Stürmer M, Doerr HW, Gürtler L - Med. Microbiol. Immunol. (2009)

Scheme of the algorithm of antibody, antigen and viral nucleic acid testing in the diagnostics of HIV, HCV and HBV infection. When the diagnostic window is closed and the initial antibody testing result is negative virus infection is excluded, therefore further data are not documented in the algorithm. When patients have to be treated dependent predominantly on their clinical status, which is not cited in this scheme, a circle of drug application, drug resistance testing and viral load and CD4 cells determination in HIV infected patients, and viral load and liver enzyme testing, as ALT and AST, in hepatitis patients has to be pursued. Permanent treatment is obligatory in AIDS patients and treatment in hepatitis patients occurs until improvement or final failure is obvious
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2714449&req=5

Fig1: Scheme of the algorithm of antibody, antigen and viral nucleic acid testing in the diagnostics of HIV, HCV and HBV infection. When the diagnostic window is closed and the initial antibody testing result is negative virus infection is excluded, therefore further data are not documented in the algorithm. When patients have to be treated dependent predominantly on their clinical status, which is not cited in this scheme, a circle of drug application, drug resistance testing and viral load and CD4 cells determination in HIV infected patients, and viral load and liver enzyme testing, as ALT and AST, in hepatitis patients has to be pursued. Permanent treatment is obligatory in AIDS patients and treatment in hepatitis patients occurs until improvement or final failure is obvious
Mentions: In 1985, the first HIV antibody ELISAs were available and it was evident from the beginning that numerous test results had been false positive, especially when testing pregnant women. Confirmatory tests were needed, which were based on immunofluorescence, since HIV could be grown nicely on T-cell lines [20, 21], and western blot strips, which used more or less highly purified antigenic material derived from virus concentrated from supernatant of infected cells. A consecutive procedure was the production of line immunoassays with antigenic material purified after cloning individual HIV proteins (Fig. 1).Fig. 1

Bottom Line: This progress is not completed; there are beneficial aspects in the response of the scientific community to the HIV burden for the management of other viral diseases.These aspects are described in this contribution.Further aspects as handling a stigmatising disease, education of self-responsiveness within sexual relationships, and ways for confection of a protective vaccine are not covered.

View Article: PubMed Central - PubMed

Affiliation: Institute for Medical Virology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.

ABSTRACT
The human immunodeficiency virus (HIV) had spread unrecognized in the human population as sexually transmitted disease and was finally identified by its disease AIDS in 1981. Even after the isolation of the causative agent in 1983, the burden and death rate of AIDS accelerated worldwide especially in young people despite the confection of new drugs capable to inhibit virus replication since 1997. However, at least in industrialised countries, this trend could be reversed by the introduction of combination therapy strategies. The design of new drugs is on going; besides the inhibition of the three enzymes of HIV for replication and maturation (reverse transcriptase, integrase and protease), further drugs inhibits fusion of viral and cellular membranes and virus maturation. On the other hand, viral diagnostics had been considerably improved since the emergence of HIV. There was a need to identify infected people correctly, to follow up the course of immune reconstitution of patients by measuring viral load and CD4 cells, and to analyse drug escape mutations leading to drug resistance. Both the development of drugs and the refined diagnostics have been transferred to the treatment of patients infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). This progress is not completed; there are beneficial aspects in the response of the scientific community to the HIV burden for the management of other viral diseases. These aspects are described in this contribution. Further aspects as handling a stigmatising disease, education of self-responsiveness within sexual relationships, and ways for confection of a protective vaccine are not covered.

Show MeSH
Related in: MedlinePlus