Protease inhibitors for HIV infection

Article Abstract:

Protease inhibitors are a promising new class of anti-HIV drugs, but they, too, have drawbacks. Protease inhibitors compete for the same site used by HIV protease. This enzyme cleaves a giant HIV protein into smaller, functional units. Unfortunately, saquinavir, the first approved drug, is poorly absorbed, rapidly metabolized, and expensive to produce. This means that at current recommended dosages of 1,800 milligrams daily, patients must take 9 tablets daily at an annual wholesale cost of $5,800 per year. A recent study found that 7,200 milligrams daily was more effective. This would mean 36 tablets per day at a cost of $23,000 per year. Moreover, HIV develops resistance, which means that protease inhibitors must be combined with other drugs. Long-term durability of effects is still a question as is toxicity. Nonetheless, new, less toxic, more effective, and more bioavailable protease inhibitors are in the pipeline. Long-term maintenance with low virus and high CD4 counts may become a reality.

Evaluation, HIV infection, Drug therapy, HIV infections, Protease inhibitors

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Clostridium difficile colitis: an efficient clinical approach to diagnosis

Article Abstract:

The diagnosis of Clostridium difficile colitis may follow antibiotic therapy and be verified by a laboratory finding of toxin in the stool. Researchers analyzed stool specimens of 268 hospital inpatients, and identified the C. difficile toxin in 43, an incidence of 16.4%. Factors that may predict a diagnosis of C. difficile are the presence of white blood cells in the stool, semi-formed rather than watery stools, cephalosporin treatment, and diarrhea beginning more than six days after antibiotic therapy. One stool sample may be sufficient for making a positive diagnosis of C. difficile. Enzyme-linked immunoassays and tissue-culture assays both identified the C. difficile toxin. Both tests should be used as either alone may not detect the toxin in all samples.

Diagnosis, Antibiotics, Complications and side effects, Clostridium, Colitis

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