Brian Gazzard

New concepts in anti-HIV therapies

Fewer than one million HIV infected individuals are currently receiving anti- retroviral therapy. The limitations of such treatment have underscored the need to develop more effective strategies to control the spread and pathogenesis of infection. In 1996, the era of highly active anti-retroviral therapy (HAART) commenced in established market economies, causing a dramatic reduction in morbidity and mortality in those infected individuals who received these medicines. These agents target aspects of the viral life cycle and there are now 20 approved therapeutic agents for licensed for treatment of infection with the human immunodeficiency virus (HIV), a pathogen that in the 1980s was uniformly fatal. These advances have been associated with significant toxicities and drug resistance. Antiviral potency and durability causing suppression of viremia has been the cornerstone of the initial success of HAART regimens. Following this, the restoration of immune function, the prevention of the emergence of resistance, and ultimately the prevention of disease progression has been the focus of treatment. Future progress will allow greater choices for physicians and patients.

Gut Infection in HIV: Past, Present and Future

Thirty years ago parasitic infection of the gut was an esoteric rarity in the developed world and was chiefly of interest to individuals involved in tropical medi- cine. This was revolutionized by the advent of the AIDS epidemic, when gut infection became a com- mon terminal event and studying parasitic disease became important to reduce symptoms and prolong life. The study of these infections provides an ideal opportunity to tease out the complex host-parasite interaction, which normally leads to the elimination of infection.