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2.
Cad. Saúde Pública (Online) ; 35(9): e00115518, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039422

ABSTRACT

Abstract: We evaluated adherence to highly active antiretroviral therapy (HAART) and its associated factors according to the type of regimen in patients initiating treatment in Belo Horizonte, Minas Gerais State, Brazil. We measured adherence using the eight items Morisky Therapeutic Adhesion Scale (MMAS-8) and compared the use of "backbone" tenofovir/lamivudine plus efavirenz one tablet once-daily (STR) or dolutegravir in multi-tablet once-daily (MTR-DTG), or other multi-tablet regimens (MTR-other). We conducted a multivariate logistic regression analysis to address factors associated with adherence. A total of 393 patients were included, 254 used STR, 106 MTR-DTG, and 33 MTR-other. The overall adhesion rate was 44.8% (95%CI: 39.4; 50.1), 50% for MTR-DTG, 43.3% for STR and 39.4% for MTR-other. Multivariate analysis showed a higher chance of adherence among patients using MTR-DTG, those who received and understood counseling about their treatment and with a higher quality of life. Prior use of illicit drugs in the lifetime was associated with poorer adherence. Overall adherence was low, highlighting the need for strategies focusing on counseling about medicines and substance use. Pill burden was not an issue for patients using MTR-DTG once-daily, who achieved better results.


Resumo: Avaliamos a adesão à terapia antirretroviral (TARV) e fatores associados de acordo com o tipo de esquema em pacientes no início do tratamento em Belo Horizonte, Minas Gerais, Brasil. Mensuramos a adesão com a Escala de Adesão Terapêutica de Morisky, de oito itens (MMAS-8), e comparamos o uso de tenofovir/lamivudina com efavirenz, um comprimido uma vez ao dia (STR), ou dolutegravir em múltiplos comprimidos uma vez ao dia (MTR-DTG), com outros esquemas com múltiplos comprimidos ao dia (MTR-outros). Conduzimos uma análise de regressão logística multivariada para avaliar os fatores associados à adesão. Foram incluídos 393 pacientes: 254 em uso de STR, 106 MTR-DTG e 33 MTR-outros. A taxa global de adesão foi 44,8% (IC95%: 39,4; 50,1), sendo 50% para MTR-DTG, 43,3% para STR e 39,4% para MTR-outros. A análise multivariada mostrou chances maiores de adesão em pacientes em uso de MTR-DTG, pacientes que haviam recebido e compreendido o aconselhamento sobre o tratamento e pacientes com melhor qualidade de vida. Uso anterior de drogas ilícitas em qualquer período da vida está associada à pior adesão. A adesão global foi baixa, enfatizando a necessidade de estratégias focadas no aconselhamento sobre medicamentos e uso de drogas. A quantidade de comprimidos não foi um problema para pacientes em uso de MTR-DTG uma vez ao dia, os quais alcançaram melhores taxas de adesão.


Resumen: Evaluamos la adherencia a la terapia antirretroviral altamente activa (TARAA) y sus factores asociados, según el tipo de tratamiento en pacientes que comenzaron su tratamiento en Belo Horizonte, Minas Gerais, Brasil. La adherencia se mensuró por la Escala de Adhesión Terapéutica de Morisky, de ocho ítems (MMAS-8), y se comparó el uso del "eje" tenofovir/lamivudina, además de un comprimido de efavirenz una vez al día (STR) o dolutegravir con varios comprimidos una vez al día (MTR-DTG), u otros tratamientos con múltiples comprimidos (MTR-otros). Se realizó un análisis multivariado de regresión logística para evaluar los factores asociados a la adherencia. Se incluyeron un total de 393 pacientes, 254 usaron STR, 106 MTR-DTG, y 33 MTR-Otros. La tasa de adherencia general fue de un 44,8% (95%CI: 39,4; 50,1), 50% en el MTR-DTG, 43,3% en el STR y 39,4% en el MTR-otros. El análisis multivariado mostró una probabilidad más alta de adherencia entre pacientes usando MTR-DTG, quienes recibieron y comprendieron las orientaciones acerca de sus tratamientos y los que disfrutaban de una calidad mejor de vida. El consumo previo de drogas ilícitas a lo largo de la vida estuvo asociado con una adherencia más escasa. La adherencia general fue baja y resalta la necesidad de estrategias que se enfoquen en brindar orientación sobre el uso de la medicación y de sustancias. El número de comprimidos no fue un problema para los pacientes que tomaban MTR-DTG una vez al día, que obtuvieron mejores resultados.


Subject(s)
Humans , Male , Female , Adult , HIV Infections/drug therapy , HIV Integrase Inhibitors/administration & dosage , Anti-Retroviral Agents/therapeutic use , Medication Adherence/statistics & numerical data , Heterocyclic Compounds, 3-Ring/administration & dosage , Oxazines , Piperazines , Pyridones , Quality of Life , Brazil , Viral Load , Educational Status , Self Report
3.
Acta Pharmaceutica Sinica ; (12): 50-58, 2015.
Article in Chinese | WPRIM | ID: wpr-251818

ABSTRACT

This study is to evaluate the HAART pharmacodynamics with dolutegravir as the "anchor" in vitro. A nucleoside reverse transcriptase inhibitors (NRTIs) resistant recombinant virus model (VSVG/HIV-1(RT-D67N,K70R,T215F)) and an integrase inhibitors (INIs) resistant recombinant virus model (VSVG/HIV-1(IN-G140S,QI48H)) were constructed and established. The anti-viral pharmacodynamics was evaluated with drug combinations including two NRTIs along with one INI or one NNRTI. The results showed that the combination with an INI gave a stronger synergism on wild type HIV-1 replication comparing to that with an NNRTI. Comparing the two INIs as the "anchor" for HAART, DTG exhibited an equivalent CI to that of RAL on wild type HIV-1 replication; but a greater synergy than RAL on INI-resistant HIV-1 replication. Besides of the pharmacodynamics results of DTG-based drug combination, the results may contribute to clinical antiviral therapy.


Subject(s)
Antiretroviral Therapy, Highly Active , Cells, Cultured , Drug Resistance, Viral , HIV Integrase Inhibitors , Pharmacology , HIV-1 , Physiology , Heterocyclic Compounds, 3-Ring , Pharmacology , Humans , Virus Replication
4.
Brasília; CONITEC; 2015. tab, graf.
Monography in Portuguese | LILACS, BRISA | ID: biblio-859332

ABSTRACT

CONTEXTO: HIV é a sigla em inglês do vírus da imunodeficiência humana. Trata-se de um retrovírus que infecta e se replica nos linfócitos e macrófagos humanos, resultando no enfraquecimento do sistema imunológico e por fim no aumento da susceptibilidade do doente a uma série de infecções oportunistas. O Brasil tem programa específico para o tratamento de pacientes infectados pelo HIV/AIDS. Estudos mostram que aproximadamente 80% dos pacientes alcançam o controle da doença (carga viral plasmática inferior a 50 cópias/ml) após um ano de tratamento e terão os níveis de linfócitos-T CD4+ em recuperação, mas os outros 20% terão falha virológica caracterizada e provável falha terapêutica, necessitando de chamada "terapia de resgate" com terceira linha de tratamento. O Programa Nacional de HIV/ AIDS já dispõe de terapia de resgate da mesma classe terapêutica do dolutegravir: inibidores de integrase; neste caso o raltegravir. EVIDÊNCIAS CIENTÍFICAS: Um único estudo foi identificado para o cenário proposto para a incorporação do dolutegravir. Os resultados do estudo SAILING, um estudo de não inferioridade, mostram que o dolutegravir é não inferior ao raltegravir em eficácia e segurança. DISCUSSÃO: O dolutegravir é uma tecnologia que se mostrou não inferior em relação a eficácia quando comparado ao raltegravir. A escolha equivocada do estudo de custo-efetividade prejudicou a análise da tecnologia. No entanto, a segurança do medicamento, de uso contínuo, em longos períodos ainda não é conhecida. O medicamento, embora não tenha indicação em bula para crianças menores de 12 anos, tem potencial para ser alternativa ao raltegravir em adultos. RECOMENDAÇÃO DA CONITEC: : A CONITEC, após apreciação do tema, considerando a falta de evidência disponível do dolutegravir em relação à segurança de longo prazo e ao seu uso em crianças menores de 12 anos, além da escolha equivocada do estudo de custo-efetividade e da maior experiência de uso em vida real com o raltegravir, deliberou por unanimidade recomendar a não incorporação dolutegravir sódico para a Infecção pelo HIV (vírus de imunodeficiência humana). A matéria será disponibilizada em Consulta Pública. CONSULTA PÚBLICA: Foram recebidas 268 contribuições. As novas contribuições da consulta pública, mostraram dados de segurança e corroboram com o já conhecido perfil de segurança dessa classe terapêutica e deste fármaco em particular. DELIBERAÇÃO FINAL: : Após a discussão das contribuições da Consulta Pública, deliberou-se por recomendar a incorporação do dolutegravir sódico para 3ª linha de tratamento da infecção pelo HIV (vírus da imunodeficiência humana), conforme Protocolo Clínico e Diretrizes Terapêuticas do Ministério da Saúde, a atualizar, condicionada à redução de preço. Foi assinado o Registro de Deliberação n˚144/2015. DECISÃO: Incorporar o dolutegravir sódico para 3ª linha de tratamento da infecção pelo HIV (vírus de imunodeficiência humana)no âmbito do Sistema Único de Saúde ­ SUS.


Subject(s)
Humans , HIV Infections/drug therapy , HIV Integrase Inhibitors/administration & dosage , HIV-1 , Raltegravir Potassium/administration & dosage , Brazil , Cost-Benefit Analysis/economics , Technology Assessment, Biomedical , Treatment Outcome , Unified Health System
5.
Article in English | WPRIM | ID: wpr-812288

ABSTRACT

AIM@#To evaluate the anti-HIV activity and mechanism of action of wikstroelide M, a daphnane diterpene from Daphne acutiloba Rehder (Thymelaeaceae).@*METHODS@#The anti-HIV activities of wikstroelide M against different HIV strains were evaluated by cytopathic effect assay and p24 quantification assay with ELISA. The inhibitory effect of wikstroelide M on HIV reverse transcription was analyzed by real-time PCR and ELISA. The effect of wikstroelide M on HIV-1 integrase nuclear translocation was observed with a cell-based imaging assay. The effect of wikstroelide M on LEDGF/p75-IN interaction was assayed by molecular docking.@*RESULTS@#Wikstroelide M potently inhibited different HIV-1 strains, including HIV-1IIIB, HIV-1A17, and HIV-19495, induced a cytopathic effect, with EC50 values ranging from 3.81 to 15.65 ng·mL⁻¹. Wikstroelide M also had high inhibitory activities against HIV-2ROD and HIV-2CBL-20-induced cytopathic effects with EC50 values of 18.88 and 31.90 ng·mL⁻¹. The inhibitory activities of wikstroelide M on the three HIV-1 strains were further confirmed by p24 quantification assay, with EC50 values ranging from 15.16 to 35.57 ng·mL⁻¹. Wikstroelide M also potently inhibited HIV-1IIIB induced cytolysis in MT-4 cells, with an EC50 value of 9.60 ng·mL⁻¹. The mechanistic assay showed that wikstroelide M targeted HIV-1 reverse transcriptase and nuclear translocation of integrase through disrupting the interaction between integrase and LEDGF/p75.@*CONCLUSION@#Wikstroelide M may be a potent HIV-1 and HIV-2 inhibitor, the mechanisms of action may include inhibition of reverse trascriptase activity and inhibition of integrase nuclear translocation through disrupting the interaction between integrase and LEDGF/p75.


Subject(s)
Anti-HIV Agents , Pharmacology , Therapeutic Uses , Cell Line , Daphne , Chemistry , Diterpenes , Pharmacology , HIV Infections , Drug Therapy , Virology , HIV Integrase , Metabolism , HIV Integrase Inhibitors , Pharmacology , Therapeutic Uses , HIV Reverse Transcriptase , HIV-1 , HIV-2 , Humans , Intercellular Signaling Peptides and Proteins , Metabolism , Phytotherapy , Plant Extracts , Pharmacology , Therapeutic Uses , Virus Integration , Virus Replication
6.
Acta Pharmaceutica Sinica ; (12): 466-476, 2013.
Article in Chinese | WPRIM | ID: wpr-235642

ABSTRACT

Both reverse transcriptase (RT) and integrase (IN) play crucial roles in the life cycle of HIV-1, which are also key targets in the area of anti-HIV drug research. Reverse transcriptase inhibitors are involved in the most employed drugs used to treat AIDS patients and HIV-infected people, while one of the integrase inhibitors has already been approved by US FDA to appear on the market. Great achievement has been made in the research on both, separately. Recently, much more attention of medicinal chemistry researchers has been attracted to the strategies of multi-target drugs. Compounds with excellent potency against both HIV RT and IN, evidently defined as dual inhibitors targeting both enzymes, have been obtained through considerable significant exploration, which can be classified into two categories according to different strategies. Combinatorial chemistry approach together with high throughput screening methods and multi-target-based virtual screening strategy have been useful tools for identifying selective anti-HIV compounds for long times; Rational drug design based on pharmacophore combination has also led to remarkable results. In this paper, latest progress of both categories in the discovery and structural modification will be covered, with a view to contribute to the career of anti-HIV research.


Subject(s)
Drug Design , HIV Integrase Inhibitors , Chemistry , Pharmacology , HIV Reverse Transcriptase , HIV-1 , Humans , Molecular Structure , Reverse Transcriptase Inhibitors , Chemistry , Pharmacology , Structure-Activity Relationship
7.
Acta Pharmaceutica Sinica ; (12): 780-789, 2013.
Article in Chinese | WPRIM | ID: wpr-259550

ABSTRACT

A total of 52 endophytic fungi were isolated from roots and stems of Tibetan medicinal plant Phlomis younghusbandii Mukerjee. These fungal isolates were molecularly identified based on ITS sequnces and 28S sequences distributed to 12 genera, including Phoma, Chaetosphaeronema, Fusarium and Leptosphaeria, etc. Among them, the dominant genus was Phoma. Extracts of all strains were evaluated for anti-HIV-1 integrase activity by using soluable integrase expressed in E. coli BL21 (DE3). The results showed that seven samples from five fungal endophytes PHY-24, PHY-38, PHY-40, PHY-51, PHY-53, which belonged to genus Chaetosphaeronema, inhibited strand transfer reaction catalyzed by HIV-1 integrase with IC50 values, of 6.60, 5.20, 2.86, 7.86, 4.47, 4.56 and 3.23 microg x mL(-1) respectively. In conclusion, the endophytic fungi of Phlomis younghusbandii Mukerjee are valuable for further screening anti-HIV-1 integrase agents.


Subject(s)
Ascomycota , Chaetomium , Endophytes , Escherichia coli , HIV Integrase , Genetics , Metabolism , HIV Integrase Inhibitors , Pharmacology , Phlomis , Microbiology , Phylogeny , Plant Roots , Microbiology , Plant Stems , Microbiology , Plants, Medicinal , Microbiology , Plasmids , Recombinant Proteins , Genetics , Metabolism
8.
West Indian med. j ; 61(9): 932-936, Dec. 2012. ilus
Article in English | LILACS | ID: lil-694370

ABSTRACT

The use of new antiretroviral drugs in HIV infection is particularly important in patients with intolerance or resistance to other antiretroviral agents. Raltegravir and maraviroc represent new, important resources in salvage regimens. A reduced grade of liver fibro-steatosis after a combination of raltegravir and maraviroc (second-line) has not been studied and the mechanism by which these new drug classes induced a marked reduction of grade of liver diseases is currently unknown. In the present case report, nested in an ongoing multicentre observational study on the use of new antiretroviral inhibitors in heavy treatment-experienced HIV patients, we evaluated the correlation between a "short therapeutic regimen" raltegravir, maraviroc and fosamprenavir and liver diseases. The aim of this report is to describe the use of a three-drug regimen based on two novel-class antiretroviral agents (raltegravir and maraviroc) plus the protease inhibitor fosamprenavir, in an experienced HIV-infected patient with chronic progressive hepatitis C complicated by liver fibrosis; an overwhelming increased serum creatine kinase level occurred during treatment, and is probably related to integrase inhibitor administration. At present no information is available regarding this correlation.


El uso de nuevos medicamentos antiretrovirales para la infección por VIH es particularmente importante en los pacientes con intolerancia o resistencia a otros agentes antiretrovirales. Raltegravir (RTV) y maraviroc (MRV) representan nuevos e importantes recursos en las terapias de salvamento. Un grado reducido de fibroesteatosis hepática después de una combinación de raltegravir y maraviroc (terapia de segunda línea) no ha sido estudiado, y el mecanismo por el cual estas nuevas clases de droga indujeron una marcada reducción de grado de las enfermedades hepáticas se desconoce hasta el momento. Como parte de la realización en curso de un estudio observacional multicentro acerca del uso de nuevos inhibidores antiretrovirales en pacientes de VIH altamente experimentados en el tratamiento, en el presente reporte de caso se evalúa la correlación entre un "régimen terapéutico corto" (raltegravir, maraviroc y fosamprenavir) y las enfermedades del hígado. El objetivo de este reporte es describir el uso de un régimen de tres medicamentos - basado en dos agentes antiretrovirales de nuevo tipo (raltegravir y maraviroc) además del fosamprenavir inhibidor de la proteasa - en un paciente de VIH experimentado. El paciente también sufre de hepatitis C evolutiva, progresiva, crónica, complicada por fibrosis hepática. Durante el tratamiento, se produjo un aumento extraordinario del nivel de creatina quinasa sérica, el cual probablemente esta relacionado con la administración del inhibidor de la integrasa. Actualmente no hay información disponible con respecto a esta correlación.


Subject(s)
Adult , Humans , Male , Carbamates/adverse effects , Cardiomyopathies/drug therapy , Creatine Kinase/blood , Cyclohexanes/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Fatty Liver/chemically induced , HIV Fusion Inhibitors/adverse effects , HIV Infections/drug therapy , HIV Integrase Inhibitors/adverse effects , HIV Protease Inhibitors/adverse effects , Hepatitis C, Chronic/drug therapy , Liver Cirrhosis/chemically induced , Organophosphates/adverse effects , Pyrrolidinones/adverse effects , Sulfonamides/adverse effects , Triazoles/adverse effects , Carbamates/therapeutic use , Cyclohexanes/therapeutic use , Drug Substitution , Drug Therapy, Combination , Fatty Liver/diagnosis , HIV Fusion Inhibitors/therapeutic use , HIV Integrase Inhibitors/therapeutic use , HIV Protease Inhibitors/therapeutic use , Liver Cirrhosis/diagnosis , Organophosphates/therapeutic use , Pyrrolidinones/therapeutic use , Sulfonamides/therapeutic use , Triazoles/therapeutic use
9.
rio de Janeiro; s.n; 2012. xv,195 p. ilus, graf, tab.
Thesis in English, Portuguese | LILACS | ID: lil-653099

ABSTRACT

A integrase (IN) é uma enzima chave para o ciclo de replicação do HIV, sendo responsável por catalisar a integração do genoma do HIV no cromossomo hospedeiro. Devido ao papel essencial desta enzima para a patogênese da infecção pelo HIV, a recente introdução dos inibidores de IN (INI) na prática clínica e em vista da escassez de informação sobre a diversidade genética da IN do HIV no Brasil, o presente estudo tem como objetivos a) investigar a diversidade genética da IN e os níveis de resistência primária nos subtipos B, C e F do HIV que são prevalentes no Brasil; b) acompanhar pacientes sob terapia antirretroviral em esquemas contendo raltegravir (RAL) a fim de monitorar a emergência de mutações de resistência aos INI; c) desenvolver um método de genotipagem da IN do HIV para ser usado na pratica clínica no Brasil; e d) investigar o envolvimento do processo de integração no controle da replicação do HIV. Não foram detectadas mutações principais associadas aos INI entre os indivíduos virgens de tratamento infectados com diferentes subtipos de HIV-1. O nível de mutações acessórias observadas foi bem baixo, e algumas posições foram polimórficas nas amostras brasileiras dos subtipos B, C e F. Esses resultados encorajam o uso de INI no Brasil. Analisando as coortes de pacientes que trocaram a enfuvirtida por RAL ou sob terapia de resgate com RAL, nós observamos um aumento nas contagens de células T CD4+ e uma rápida diminuição da carga viral no grupo sob terapia de resgate. Três pacientes não atingiram supressão virológica e as mutações Q148H+G140S foram detectadas em dois deles. A fim de monitorar o crescente número de pacientes sob terapia com RAL no Brasil, nós desenvolvemos um método de genotipagem in-house que está atualmente em teste pela rede de Genotipagem do Ministério da Saúde do Brasil para futura incorporação no monitoramento de pacientes falhando INI. Sobre o papel da IN no controle da infecção pelo HIV, não observamos mutações nos resíduos importantes para a atividade catalítica nas sequências de IN obtidas de pacientes controladores da infecção pelo HIV, nem acúmulo de DNA 2-LTR, sugerindo que não há um mecanismo bloqueando a integração nestes pacientes. Juntos, os resultados apresentados trazem informações importantes sobre a diversidade genética da IN, resistência aos INI e sobre o papel da IN na patogênese da infecção pelo HIV.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV , HIV Integrase , HIV Integrase Inhibitors , HIV-1
10.
Indian J Biochem Biophys ; 2011 Dec; 48(6): 427-434
Article in English | IMSEAR | ID: sea-140211

ABSTRACT

A quantitative structure-activity relationship (QSAR) study has been performed on integrase (IN) inhibition activity of a large series of N-methyl pyrimidones [Gardelli et al. (2007) J Med Chem 50, 4953-4975)] having varying heterocyclic ring substitution at 2-position of pyrimidone ring. The activity is found to be significantly correlated with surface tension and molar volume of the molecules. The whole series of compounds is divided into two subsets: a training set and a test set. A significant correlation is obtained for the training set, which is then used to predict the activity of compounds in the test set. The predicted activities of compounds in the test set are found to be very close to their observed activities. The predicting ability of the correlation obtained is judged by leave-one-out jackknife procedure. The correlation shows the effective role of the surface tension and molar volume of the molecules. From the correlation obtained, the integrase inhibition activities are predicted for some new prospective compounds.


Subject(s)
HIV Integrase Inhibitors/chemistry , HIV Integrase Inhibitors/pharmacology , Humans , Pyrimidinones/chemistry , Pyrimidinones/pharmacology , Quantitative Structure-Activity Relationship
11.
Braz. j. infect. dis ; 14(5): 513-518, Sept.-Oct. 2010. ilus
Article in English | LILACS | ID: lil-570569

ABSTRACT

This review will summarize the role of integrase in HIV-1 infection, the mechanism of integrase inhibitors and resistance with an emphasis on raltegravir (RAL), the first integrase inhibitor licensed to treat HIV-1 infection.


Subject(s)
Humans , Drug Resistance, Viral/genetics , HIV Infections/virology , HIV Integrase Inhibitors/pharmacology , HIV Integrase/genetics , HIV-1 , Virus Integration/drug effects , HIV Integrase/drug effects , HIV-1
12.
Infectio ; 14(2): 132-142, jun. 2010.
Article in Spanish | LILACS | ID: lil-560942

ABSTRACT

La infección por el virus de la inmunodeficiencia humana ha generado un impacto mundial que ha sobrepasado los cálculos iniciales previstos para esta enfermedad. En la actualidad, se hace necesaria la búsqueda de nuevos medicamentos antirretrovirales dentro de las familias de medicamentos conocidas, pero, aún más importante, es la búsqueda de nuevos blancos terapéuticos sobre los cuales incidan los fármacos a los que no ha estado expuesto el virus y, asimismo, ante los cuales no presentan resistencia natural. Los inhibidores de la integrasa constituyen la familia de medicamentos antirretrovirales más recientemente aprobada para uso clínico. El raltegravir es un medicamento nuevo, con atributos importantes que lo hacen una herramienta que se debe tener en cuenta en esquemas de rescate, terapia de cambio y acorde con la consideración de paciente naive, es decir, sin tratamiento previo con este fármaco.


Immunodeficiency virus infection in humans (HIV) has generated a worldwide impact exceeding initial estimates for this disease. At present, it is necessary to search for new antiretroviral drugs within the families of known medication, but the search for new therapeutic objectives under the effect of medication which has not been exposed to the virus and, therefore without natural resistance to it, is even more important. Integrase inhibitors are the family of antiretroviral medication most recently approved for clinical use; raltegravir is a new drug with important attributes that make it a tool to be considered in rescue regimens, change therapies, and naïve patient particular cases.


Subject(s)
HIV Integrase Inhibitors , Antiretroviral Therapy, Highly Active , Anti-Retroviral Agents
13.
Acta Pharmaceutica Sinica ; (12): 165-176, 2010.
Article in English | WPRIM | ID: wpr-250659

ABSTRACT

Human immunodeficiency virus type 1 (HIV-1) is the causative agent of acquired immunodeficiency disease syndrome (AIDS). After over 26 years of efforts, there is still not a therapeutic cure or an effective vaccine against HIV/AIDS. The clinical management of HIV-1 infected people largely relies on antiretroviral therapy (ART). Although highly active antiretroviral therapy (HAART) has provided an effective way to treat AIDS patients, the huge burden of ART in developing countries, together with the increasing incidence of drug resistant viruses among treated people, calls for continuous efforts for the development of anti-HIV-1 drugs. Currently, four classes of over 30 licensed antiretrovirals (ARVs) and combination regimens of these ARVs are in use clinically including: reverse transcriptase inhibitors (RTIs) (e.g. nucleoside reverse transcriptase inhibitors, NRTIs; and non-nucleoside reverse transcriptase inhibitors, NNRTIs), protease inhibitors (PIs), integrase inhibitors and entry inhibitors (e.g. fusion inhibitors and CCR5 antagonists). Here, we intend to provide updated information of currently available antiretroviral drugs for ART to promote the development of novel anti-HIV-1 drugs.


Subject(s)
Acquired Immunodeficiency Syndrome , Drug Therapy , Anti-HIV Agents , Chemistry , Pharmacology , Therapeutic Uses , HIV Fusion Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Infections , Drug Therapy , HIV Integrase Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Protease Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV-1 , Humans , Molecular Structure , Reverse Transcriptase Inhibitors , Chemistry , Pharmacology , Therapeutic Uses
14.
Acta Pharmaceutica Sinica ; (12): 154-164, 2010.
Article in Chinese | WPRIM | ID: wpr-250644

ABSTRACT

HIV and AIDS remain as the crucial global health concern, therefore, research and development of novel anti-HIV-1 chemical therapeutics is still of paramount significance, which may be illuminated by cases of successful marketed drugs. Herein, we document the discovery and biological profile of new anti-HIV-1 drugs approved by FDA between 2005 and 2008 and some drug candidates are also discussed.


Subject(s)
Acquired Immunodeficiency Syndrome , Drug Therapy , Anti-HIV Agents , Chemistry , Pharmacology , Therapeutic Uses , HIV Fusion Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Infections , Drug Therapy , HIV Integrase Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Protease Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV-1 , Humans , Molecular Structure , Reverse Transcriptase Inhibitors , Chemistry , Pharmacology , Therapeutic Uses
15.
Acta Pharmaceutica Sinica ; (12): 194-204, 2010.
Article in Chinese | WPRIM | ID: wpr-250641

ABSTRACT

In the two decades since AZT was first approved for clinical use in 1987, 24 additional antiretroviral agents have been approved. They include 7 nucleoside analogs, a nucleotide analog and 4 non-nucleoside reverse transcriptase inhibitors, 10 protease inhibitors, 2 entry inhibitors and an integrase inhibitor. More than 20 investigational agents are currently being studied in clinical trials. Highly active antiretroviral therapy (HAART), which involves a combination of anti-HIV-1 drugs, is extremely effective in suppressing HIV-1 replication and increasing CD4+ number and results in substantial reductions in HIV-1-related morbidity and mortality. In last 20 years, much has been learned about resistance to antiretroviral drugs, drug interactions and metabolic complications of antiviral drug use. Drugs are now selected on the basis of resistance tests and on the risk of specific drug complications in individual patients. As a result, decisions about the therapy of HIV/AIDS have become personalized and are made on a patient-by-patient basis. With appropriate medical management, a person with HIV-1 now has the possibility of a nearly normal life expectancy.


Subject(s)
Anti-HIV Agents , Pharmacology , Therapeutic Uses , Antiretroviral Therapy, Highly Active , Cyclohexanes , Chemistry , Pharmacology , Therapeutic Uses , Drug Resistance, Viral , HIV Envelope Protein gp41 , Chemistry , Therapeutic Uses , HIV Fusion Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Infections , Drug Therapy , HIV Integrase Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Protease Inhibitors , Chemistry , Pharmacology , Therapeutic Uses , HIV Reverse Transcriptase , Chemistry , Pharmacology , Therapeutic Uses , HIV-1 , Physiology , Humans , Molecular Structure , Peptide Fragments , Chemistry , Therapeutic Uses , Pyrrolidinones , Chemistry , Pharmacology , Therapeutic Uses , Raltegravir Potassium , Saquinavir , Chemistry , Pharmacology , Therapeutic Uses , Triazoles , Chemistry , Pharmacology , Therapeutic Uses , Virus Replication , Zidovudine , Chemistry , Pharmacology , Therapeutic Uses
16.
Acta Pharmaceutica Sinica ; (12): 215-223, 2010.
Article in Chinese | WPRIM | ID: wpr-250639

ABSTRACT

HIV-1 integrase (IN) is an essential enzyme for retroviral replication. There is no analogue for this enzyme in human cells so that inhibition of IN will not bring strong effect on human body. Thus, HIV-1 IN has become a rational target for therapy of AIDS. This review provides a comprehensive report of alpha, gamma-diketo IN inhibitors discovered in recent years. Compilation of such data will prove to be beneficial in developing QSAR, pharmacophore hypothesis generation and validation, virtual screening and synthesis of compounds with higher activity.


Subject(s)
Anti-HIV Agents , Chemistry , Pharmacology , HIV Integrase , Chemistry , Physiology , HIV Integrase Inhibitors , Chemistry , Pharmacology , HIV-1 , Humans , Keto Acids , Chemistry , Pharmacology , Molecular Structure , Quantitative Structure-Activity Relationship
17.
Acta Pharmaceutica Sinica ; (12): 263-267, 2010.
Article in Chinese | WPRIM | ID: wpr-250632

ABSTRACT

A series of novel quinolinone acid-containing compounds were designed and synthesized. Their structures were confirmed with 1H NMR and MS. The target compounds were tested for anti-HIV-1 integrase activities in vitro with enzyme linked immunosorbent assay (ELISA). The result showed that D-2, D-4 and D-7 have anti-integrase activity with IC50 < 100 micromol L(-1).


Subject(s)
HIV Integrase , Metabolism , HIV Integrase Inhibitors , Chemistry , Pharmacology , Inhibitory Concentration 50 , Quinolones , Chemistry , Pharmacology , Structure-Activity Relationship
18.
Article in Chinese | WPRIM | ID: wpr-355114

ABSTRACT

<p><b>BACKGROUND</b>To establish an ELISA method for detecting the activity of HIV-1 integrase and screening of inhibitors.</p><p><b>METHODS</b>HIV recombinant plasmid F185K/C280S IN1-288 was transformed into the E.coli strain BL21(DE3) integrase with a histag was induced by adding isopropyl-?-D?thiogalactopyranoside (IPTG)and purified by nickel affinity chromatography. The synthesized donor substrate oligonucleotide representing the HIV-1 U5LTR was immobilized onto covalink polystyrene microtiter plates, and a synthesized biotinlated 20 bp oligonucleotide was used as the target substrate. The products were detected and quantified using a colorimetic avidin?linked alkaline phosphatase reporter system,and identified by 32? autoradiography. Some natural products and chemically synthesized compounds were screened for HIV-1 integrase inhibitors.</p><p><b>RESULTS</b>The purified integrase was identified by SDS?PAGE and showed integration activity by ELISA and?32P radioisotopic assay.?Coefficients of variation (CV)of ELISA in a lot and among the lots were 4.63% and 5.89% respectively, the mean of P/N was 2.836 0.161 under the optimal experimental condition. Some plant extracts were found as potent integrase inhibitors. The IC50s for CEH and CEHL were (20.41 5.68)?g/ml and (7.56 1.86)?g/ml respectively.</p><p><b>CONCLUSIONS</b>The authors have established a simple and rapid ELISA method with stable repeatability for detecting integrase activity, which can be used for screening and studying of specific inhibitors of HIV-1 integrase.</p>


Subject(s)
Antiviral Agents , Pharmacology , Drug Evaluation, Preclinical , Enzyme-Linked Immunosorbent Assay , Methods , HIV Integrase , Metabolism , HIV Integrase Inhibitors , Pharmacology , HIV-1 , Recombinant Fusion Proteins , Metabolism
19.
Acta Pharmaceutica Sinica ; (12): 253-256, 2002.
Article in Chinese | WPRIM | ID: wpr-274832

ABSTRACT

<p><b>AIM</b>Three major enzymes of HIV-1, reverse transcriptase (RT), protease (PR), and integrase (IN), are important targets for anti-HIV drugs. Nine RT and five PR inhibitors have been effectively used in treatment of AIDS patients. In order to find active integrase inhibitors, twenty polyhydroxylated aromatic compounds were tested.</p><p><b>METHODS</b>ELISA method was used to test the integrase activity. The synthesized donor substrate oligonucleotide representing the HIV-1 U5LTR was immobilized onto Covalink polystyrene microtiter plates, and a synthesized biotinlated 20 bp oligonucleotide was used as the target substrate. The products were detected and quantified by a colorimetric avidin-linked alkaline phosphatase reporter system.</p><p><b>RESULTS</b>Compound NQ-2 was found to inhibit HIV-1 integrase with the IC50 of 78.5 mumol.L-1 by ELISA method. Its novel analogue NQ-3 was found to be 2 fold more potent on HIV intrgrase than NQ-2, IC50 was 37.2 mumol.L-1. The IC50s of NQ-2 and NQ-3 to inhibit the 3'-pro + assembly activity of integrase were 96.94 mumol.L-1 and 8.48 mumol.L-1; to inhibit assembly activity were 168 and 6.9 mumol.L-1 and to inhibit strand-transfer activity were 49.8 and 1.1 mumol.L-1, respectively. Compound NQ-2 mostly inhibited the strand transfer activity of HIV-1 integrase. Compound NQ-3 inhibited both the assembly and strand-transfer with high activities.</p><p><b>CONCLUSION</b>Naphthoquinone compound NQ-3 was found to be a novel HIV integrase inhibitor which warrants further study. Uncoupled ELISA HIV integrase assay is shown to be useful to screen HIV-1 integrase inhibitors.</p>


Subject(s)
Coumarins , Pharmacology , HIV Integrase , Metabolism , HIV Integrase Inhibitors , Pharmacology , HIV-1 , Inhibitory Concentration 50 , Naphthoquinones , Pharmacology , Polycyclic Aromatic Hydrocarbons , Pharmacology , Stilbenes , Pharmacology
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