PubMed Health⌕ Search

Biomedical subjects

G Tossing

Publications and source records attributed to G Tossing.

5 recordsLinked to original sources
PubMed2002

Treating hepatitis C in HIV-HCV coinfected patients.

As the natural history of HIV infection has changed following the introduction of highly active antiretroviral therapy (HAART), morbidity and mortality in the afflicted patients could be significantly reduced. The decreasing risk of suffering from opportunistic infections and tumors, however, is at the cost of antiretroviral drug-related toxicities. Today, mortality by liver disease is the major cause of death in HIV-infected patients from industrial countries. In the US and Europe about 30% of HIV-positive individuals are also infected with hepatitis C virus (HCV), and approximately 50-90% of persons who acquired HIV from injecting drugs are coinfected with HCV. In these dually infected individuals the presence of each viral infection impacts the natural history of the other one, and worsening of associated liver disease and complications within this population are increasing. The management of chronic hepatitis C (cHC) in HCV-HIV coinfection has become a major challenge, since possible interactions with antiretroviral therapies, increased risk of special side effects and compromises in adherence in patients already taking several drugs have to be taken into account. On the other hand, treatment strategies to fight HCV have been essentially ameliorated during the past 2 years by using pegylated interferon-alpha2b (Peg-IFN-alpha2b) combined with ribavirin, and there is hope that the successful therapeutic outcome in HCV-monoinfected individuals may beat least partly translated into benefits for the difficult-to-treat population of HCV-HIV dually infected persons. During the 15th International AIDS Conference in July 2002 in Barcelona, a satellite symposium, as well as a session in the main program and a number of poster presentations focussed on HCV-HIV coinfection and addressed the urgent problems and therapeutic challenges in managing cHC in the situation of underlying HIV disease.

AIDS-Related Opportunistic Infections↗
PubMed2001

Therapy of chronic hepatitis B and C and treatment options in HCV-HIV co-infection--European Conference on Infectious Diseases and Tropical Medicine, EuCID 2001, 3-6 May 2001, Leipzig.

Viral hepatitis features with an incidence of 500 Mio infected individuals worldwide. Chronification of the infection as seen in hepatitis C, B, and D may lead to liver cirrhosis and its associated complications in later stages of the disease. Especially the chronification of acute hepatitis C is observed in a majority of cases (50-80%). Chronic Hepatitis C (cHC) should be treated in generally when elevated serum concentrations of liver enzymes are found or symptoms of disease occur. Treatment goals are viral elimination, improve in histology, prevention of HCC, and a better quality of life for the patients. As HCV and HIV share the same transmission routes, a relatively high rate of HCV-HIV co-infection is observed. Co-infection is characterized by a more progressive natural course of HCV-infection, leading to an increased mortality due to liver failure in the afflicted patients. The development of treatment options for anti-HCV-specific therapy in dually infected patients is urgently needed. The European Conference on Infectious Diseases and Tropical Medicine, EuCID 2001, which took place in May 3-6, 2001, in Leipzig covered aspects of viral hepatitis and its treatment in several sessions and gave latest results on treatment with interferon-alfa, lamivudine, and adefovir in hepatitis B as well as interferon-alfa, pegylated interferon-alfa, and ribavirin in hepatitis C and HCV-HIV co-infection respectively.

Anti-HIV Agents↗
PubMed2001

New developments in interferon therapy.

As a complex group of naturally occurring proteins and glycoproteins produced by different human cells, interferons (IFN's) have initially been detected as the first line of defense in the natural course of viral infection. Due to their antiproliferative, differentiation-inducing and immunmodulatory properties they also were considered important new drugs in the treatment of cancer. The introduction of recombinant DNA technology in the late 1970's permitted large-scale production of highly purified substrates enabling systematic clinical investigations. After several decades of interferon research there have been peaks and troughs in estimating their therapeutical value. Today the abundant data figure as parts of a giant puzzle which have to be assembled. The identified molecular structure of IFN-alpha2b may serve as a basis for future IFN drug design. The profound knowledge of the endogenous IFN system and its pathological disturbances in the natural course of chronic diseases is a 'conditio sine qua non' to explain seeming inconsistency as e.g. the 'paradox' role of IFN-alpha in HIV-infection. A better understanding of the pathophysiologic function of the acid-lability inducing antigen (ALIA) and the physiologic role of the IFN-type I induced Mx protein will be helpful on this way. IFN signal transduction via the Jak-STAT system reveals mechanisms of action within hematological disorders. In these terms, further developments in interferon therapy as well as future design of IFN substrates have to apply a strict standard. The article critically reviews to which extent actual treatment strategies as the application of IFN-inducers, consensus IFN as well as pegylated IFN's fit into therapeutic schedules which have to take into account all these novel insights.

Animals↗
PubMed1996

Immunodeficiency and its relation to lymphoid and other malignancies.

The reasons why immunodeficiency leads to malignant disorders are multifactorial. The overall incidence of malignancies in persons infected with the human deficiency virus (HIV) is estimated to be 40%. Other infecting agents, especially herpesvirus species, play a pivotal role in HIV-associated non-Hodgkin's lymphoma (NHL) and Kaposi's sarcoma (KS). Mucosaassociated lymphatic tissue (MALT) lymphoma in the stomach may be a result of a chronic gastritis caused by Helicobacter pylori, a gram-negative bacterium. The Epstein-Barr virus (EBV) genome can be found in a high percentage of lymphoma cells of HIV-NHL (nearly 100% in the primary lymphoma of the CNS and about 50% in all other lymphoma entities). In body-cavity based NHL, characterized by the absence of EBV and c-myc oncogen, sequences of a herpesvirus were identified which corresponds to the gamma-herpes viremia found in KS. The Kaposi's sarcoma-associated herpesvirus (KSHV) was usually present in primary-effusion lymphoma (PEL). HIV-infection, which causes multiple dysfunctions within the immune system, triggers the cytokine dysregulation. An abnormal endogenous interferon (IFN)-alpha production is observed in HIV-infected patients with KS, especially in the later natural course of the disease. A monitoring of the IFN-system by MxA, a protein specifically induced by IFN's of type I, may be a necessary stratum of identifying patients who show superior effects and the greatest clinical benefit from treatment with IFN-alpha.

HIV Infections↗