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Printable Handouts
Navigable Slide Index
- Introduction
- AIDS in the US: 1985-2004
- Approval of antiretrovirals: 1987-2007
- Survival of HIV infected individuals in Denmark
- Outline of talk
- HIV-1 lifecycle
- US FDA approved antiretroviral drugs
- Mechanisms of action of antiretroviral agents
- US approved nucleoside/tide RT inhibitors
- Nucleoside/nucleotide RT inhibitors
- How do you choose which NRTI/NtRTI to use?
- Potency of NRTI/NtRTIs in monotherapy studies
- Pharmacokinetics of NRTIs/NtRTIs
- Adverse effects of NRTIs
- Antiretroviral agents: RT inhibition by NNRTI
- US approved non-nucleoside RT inhibitors
- Crystal structure of HIV reverse transcriptase
- Non-nucleoside reverse transcriptase inhibitors
- Adverse effects of NNRTIs
- Study 903E: viral suppression results
- Study 903E: mean change in CD4 cell count
- Antiretroviral agents: inhibition of viral protease
- PIs - competitive inhibitors of the protease
- Currently approved protease inhibitors in the US
- Protease inhibitors (PIs)
- Pharmacokinetics of protease inhibitors
- Reasons to use a boosted PI
- Study M98-863: time to virologic response loss
- Medications that interact with protease inhibitors
- Likelihood of significant drug interactions
- Complications of HIV and HAART
- Physical manifestations of lipodystrophy
- Other adverse effects of protease inhibitors
- Study 720: virologic response results
- Study 720: mean change in CD4 cell count
- Study 720: mean values of CD4 cell count
- Antiretroviral agents: inhibition of cell entry
- HIV entry involves three distinct mechanisms
- Maraviroc (Selzentry) safety and efficacy
- The goal: sustained viral suppression
- Collated results of HAART studies
- Lack of durability in clinical cohort studies
- Challenges to successful ART
- Initial therapy choice for treatment-naive patient
- The need to individualize therapy
- IAS-USA guidelines for initial therapy, 2006
- DHHS guidelines for initial therapy
- EACS guidelines for initial therapy, 2005
- Key factors for improved durability
- Regimen choice and durability
- Cell cycle state and antiretroviral drugs potency
- Potency of AZT in activated HIV-infected cells
- Potency of AZT in resting HIV-infected cells
- Cell cycle impact on antiretroviral drugs
- Mutation threshold of the regimen
- Risk of resistance: LPV/RTV vs. NFV
- Study 934: 96-week resistance results
- When to start antiretroviral therapy?
- Strat of antiretroviral therapy: global data
- EACS ART initiation guidelines, 2005
- DHHS initiation guidelines, 2006
- IAS-USA initiation guidelines
- Therapeutic crossroads
- Therapeutic paradigm shift
- Overcoming the risks of early treatment
- Outcomes by timing of therapy
- CD4 cell count and progression to AIDS
- LPV/r-based regimen CD4 cell count model
- Care delivery system and treatment strategy
- Approaches to improve treatment durability
- New directions in antiretroviral therapy
Topics Covered
- Data from recent past about AIDS
- HIV life cycle and mechanisms of action of antiretroviral agents
- Nucleoside-nucleotide reverse transcriptase inhibitors (NRTIs/NtRTIs): potency, pharmacokinetics and adverse effects
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- Protease inhibitors (PIs)
- Cell entry inhibitors
- Initiation of antiretroviral therapy in the naive patient
- Health authorities' guidelines for initial therapy
- Key factors for improved durability
- Cell cycle and effect of antiviral agents
- Risks of early treatment
- New directions in antiretroviral therapy
Links
Series:
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Talk Citation
Redfield, R. (2007, October 1). Antiretroviral therapy 2007, new concepts and lessons learned [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 23, 2024, from https://doi.org/10.69645/POSM3351.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Robert Redfield has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.