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Vincent Idemyor

Publications and source records attributed to Vincent Idemyor.

12 recordsLinked to original sources
PubMed2003

20 years since human immunodeficiency virus discovery: considerations for the next decade.

The year 2003 marks the 20th anniversary of the discovery of the human immunodeficiency virus type 1 (HIV-1). Among infectious disease-causing agents, HIV-1 is now the number one killer worldwide. Approximately 70% of the cases in the world are in sub-Saharan Africa, where in some regions, the seroprevalence of HIV-1 among adults exceeds 25%. Its high seroprevalence in some countries has raised concern that acquired immunodeficiency syndrome may create a threat to world peace. Despite developments in molecular biology, virology, immunology, and pharmacology, control of HIV-1 still awaits effective vaccines and microbicides. Because significant technologic advances still are needed to overcome the obstacles posed by HIV-1, we must find ways to expand and expedite proven prevention strategies and provide access to HIV-1 treatment for infected individuals throughout the world. Without doing so, the worst of this global pandemic will occur in the next decade before effective vaccines and microbicides are available.

AIDS Vaccines↗
PubMed2003

Emerging opportunistic fungal infections: where are we heading?

Medical mycology involves the study of pathogenic fungi and their identification in the laboratory. Mycology has developed into a field that demands the attention of all clinicians treating patients in hospitals. Interest in medical mycology has grown in recent years due to a dramatic rise in the rates of fungal infections. An overview of well-known medically significant opportunistic fungi, such as Candida, Cryptococcus, Aspergillus and Zygomycetes, as well as emerging fungal pathogens, are discussed. Antifungal failures in these individuals are high; consequently, mortality rates are also high, despite standard therapy with amphotericin-B, lipid-associated formulation of amphotericin-B and the azoles. This underscores the need for new approaches and therapies to improve outcomes in high-risk individuals.

AIDS-Related Opportunistic Infections↗
PubMed2002

Promising microbicide approach for prevention of human immunodeficiency virus transmission needs more support.

The human immunodeficiency virus (HIV) is the number one killer worldwide among infectious disease-causing agents. Because of the speed at which the epidemic has spread, it is crucial for the global community to expand female-controlled preventive options such as the use of microbicides. Much of microbicide research explores how HIV crosses the mucous membranes of the female genital tract and how the virus can be blocked at that point. The field of microbicides has reached a point where increased political will and expanded investment are required to get products to market in the near future.

Administration, Intravaginal↗
PubMed2002

Human immunodeficiency viruses and drug therapy: resistance and implications for antiretroviral therapy.

Through a concerted effort to combat the human immunodeficiency virus (HIV) epidemic, researchers have made significant strides in molecular biology, virology, and immunology, which have resulted in an increased understanding of the complexities of this infection. The biggest obstacle to the success of current HIV therapy, however, is the emergence of viral resistance. Viral resistance is caused by mutations in the HIV-1 genome coding for structural changes in the target enzymes that can affect the binding or activity of the inhibitors. More information on the genetic basis of HIV resistance, mechanisms of viral variation, and therapeutic strategies for overcoming HIV resistance are needed. Sixty million people have been infected with HIV, 24 million have died, and it is projected that 200 million individuals will be infected by 2020.

Anti-HIV Agents↗
PubMed2002

It's time to step up the management of community-acquired pneumonia.

Optimal therapy for serious Streptococcal pneumoniae infections with intermediate or high-grade resistance to penicillin is controversial. It should be noted that data regarding the efficacy of penicillins or cephalosporins for penicillin-resistant strains are limited. Despite the paucity of clinical trials, most clinicians still agree that penicillins remain the mainstay of therapy for community-acquired pneumonia caused by Streptococcal pneumoniae-susceptible strains. Macrolide antibiotics are effective for treatment of community-acquired pneumonia caused by susceptible strains of Streptococcus pneumoniae. But resistance to all macrolides, based on current National Committee for Clinical Laboratory Standards breakpoints, should be assumed among isolates with erythromycin resistance. The late-generation fluoroquinolones have a role for treatment of community-acquired pneumonia, however, there is also the potential for evolution of antimicrobial resistance. Performance indicators for community-acquired pneumonia are being established with implementation of protocols for inpatients with pneumonia. These indicators are being monitored by the Center for Medicare and Medicaid Services (CMS) for medicare patients as part of a national project. The indicators also address documentation of influenza and pneumococcal vaccine status in patients. Several other indicators, such as obtaining blood cultures before antibiotic administration, using antibiotics according to current guidelines, and timely administration of antibiotics, will play critical roles in the management of community-acquired pneumonia. Because of increased incremental costs associated with community-acquired pneumonia, early diagnosis and timely intravenous to oral switch therapy will continue to be emphasized and monitored in those admitted into hospitals, together with the appropriate decision tree-based pneumonia specific severity of illness scoring system.

Anti-Bacterial Agents↗
PubMedDate not supplied

Human immunodeficiency virus: scientific challenges impeding candidate vaccines.

Most initial work with HIV vaccines was directed at developing vaccines that elicited neutralizing antibodies. These neutralizing antibodies have been narrow in the focus of their action and specific almost entirely to the strain of the innoculating virus. Additionally, controversy has been reported about both the design of assay systems to measure the neutralization of such isolates and interpretation of the results. Researchers are now looking for a "broad-spectrum" vaccine; however, the high variability of the HIV envelope glycoprotein and its rapid rate of mutation creates an elusive target. Safety concerns have reduced interest in live attenuated virus or whole killed virus vaccines. Some novel approaches being taken include increasing cytotoxic T-lymphocyte responses, induction of immune responses in mucosal tissue surfaces, peptide-based vaccines, oligomeric envelope protein-based vaccine regimens, recombinant Tat protein vaccines, natural killer T-cell (NKT) ligand serving as adjuvant, and fusion of SIV gag with the extracellular domain of CTLA-4 as adjuvant. Most of the HIV vaccines currently in development are the products of recombinant DNA technology.

AIDS Vaccines↗
PubMedDate not supplied

Human immunodeficiency virus (HIV) entry inhibitors (CCR5 specific blockers) in development: are they the next novel therapies?

Since the introduction of the nucleoside reverse transcriptase inhibitor zidovudine in 1987, the number of the available antiretroviral medications has grown to about 20. Despite the efficacy of these medications, treatment-limiting adverse events are frequent. During the last several years, a new class of antiretroviral drugs often referred to as entry inhibitors, specifically the CCR5 blockers, have moved from the basic science laboratories and are now in the clinical phases of drug development. There are three agents in phase 2/3 development that inhibit viral entry by binding to CCR5, disrupting the interaction between the co-receptor and viral glycoprotein (gp) 120. They are aplaviroc (GW-873140), maraviroc (UK-427,857), and vicriviroc (SCH 417690). The development of these new antiviral agents that target different aspects of the viral life cycle is likely to make it possible to suppress viral strains that are resistant to the currently available antiretroviral drugs. There is a growing need for a new class of antiretrovirals with reduced toxicity and improved tolerability. However, currently available information suggests further pharmacokinetics, resistance, safety, and efficacy data are needed to understand how these agents may be effectively used in the clinical setting.

CCR5 Receptor Antagonists↗
PubMedDate not supplied

Continuing debate over HIV therapy initiation.

Initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infection has changed the landscape of HIV/AIDS care. However, the potential for long-term complications from therapy has emerged, and the risk/benefit associated with usage now merits more extensive evaluation. As data from ongoing and future clinical trials continue to accumulate, individualization of therapy may be the appropriate option for HIV-infected individuals.

Anti-HIV Agents↗
PubMedDate not supplied

The 2004 International AIDS Conference and how to globally counter HIV/AIDS.

This article reports noteworthy HIV/AIDS clinical trials presented at the XVth International AIDS Conference, Bangkok, July 2004, and also outlines goals of comprehensive prevention, care, treatment, and monitoring plans. The Bangkok conference theme was "Access for All." Outlined are goals of comprehensive prevention, care, and treatment programs: increased education and prevention efforts, greater involvement of national health authorities, reduction of new HIV infections, increased use of voluntary counseling and testing, increased acceptance and use of condoms, acceptance of an individual's right to be protected against HIV infection during sexual activity, increased support of NGOs, reduction of sexual partners, increased sexual fidelity, availability of antiretroviral medication, prevention of mother-to-child transmission, reduction of AIDS deaths, improved surveillance of sexually transmitted infections, improved blood supply security, increased coordination with tuberculosis and malaria treatment, equity for urban and rural persons, increased orphan services, reduction of orphan rate, greater involvement of local leaders, increased media involvement, reducing HIV/AIDS discussion taboo, reduced injecting drug user needle sharing, and continuing education for health care professionals. Monitoring parameters include incidence and prevalence of HIV infections, use of voluntary counseling and testing, condom use and attitudes to right of protection, AIDS deaths, orphan rate, public advertisements, leadership participation, antiretroviral use and availability, public awareness of services, blood supply security, and professional education.

Anti-HIV Agents↗
PubMedDate not supplied

The concept of structured treatment interruptions in the management of patients with human immunodeficiency virus (HIV) disease: where are we currently?

The failure to achieve viral eradication with currently available antiretroviral agents has spawned new approaches to limiting drug exposure. Highly active antiretroviral therapy (HAART) lowers morbidity and mortality of HIV disease but cannot eradicate the virus from the body. Structured treatment interruptions (STIs) have been proposed as a strategy to minimize the toxicities of HAART while providing a mechanism to enhance HIV-specific immunity. STIs have been investigated in three distinct clinical scenarios: during acute infection, during chronic infection, and during virologic failure. However, many questions still need to be answered in controlled trials before STIs can be adopted in clinical practice.

Acute Disease↗
PubMedDate not supplied

The evolving role of antiretroviral drug resistance testing in HIV-infected individuals.

Scientific advances have made HIV resistance testing routinely available to clinicians and other HIV caregivers. However, interpretation of HIV resistance results is complicated by the lack of knowledge of the clinical consequences of specific genotypic and phenotypic results for most antiretroviral agents. Limitations of viral genotype and phenotype HIV resistance testing include factors such as lack of uniform quality assurance, turn around time, cost, and insensitivity to those mutant strains present in less than 20% to 30% of the viral population. Since there are currently no multicenter prospective data that compare and support the use of one type of resistance testing over another, clinicians who are caring for HIV-infected individuals should become familiar with the pros and cons of the available assays. Clinicians will need to watch for new developments in HIV resistance testing that are on the horizon and will become available in years to come.

Anti-HIV Agents↗