4th International AIDS Conference Stockholm, Sweden. — June 12-16, 1988

Int Conf AIDS. 1988 Jun 12-16;4:1.109 (abstract no. PL12)

Anthony J Pinching
Department of Immunology, St Mary's Hospital Medical School, London W2 1PG

Improved management flows from greater understanding of the biology of HIV, better use of existing therapy and new agents for opportunist disease and notably zidovudine. Nutrition and health maintenance together with a positive ethos are crucial. Developments in therapy, maintenance and prophylaxis include: second-line treatment for Pneumocystis and the role of steroids in acute management; inhaled pentamidine and other prophylaxis; improved antifungal therapy; ganciclovir for CMV disease; and new drug regimes for atypical mycobacterial infection and Kaposi's sarcoma. In some patients IL-2 has led to resolution of cryptosporidiosis. In AIDS and ARC, zidovudine reduces the frequency/severity of opportunist infections, delaying the onset of more severe immunodeficiency and improving survival; HIV encephalopathy may show improvement. Early onset of profound anaemia is common, serious neutropenia and thrombocytopenia generally developing later. Drug interactions include increased marrow suppression with ganciclovir and daily dapsone. A polymyositis has been seen after prolonged use. An acute meningoencephalitis may be seen after dose reduction. While zidovudine offers substantial benefits, serious problems of toxicity are compounded by those of dose reduction, indicating a need for careful monitoring and drugs with a better therapeutic ratio.

880612
PL12

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