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Paul A Volberding

Publications and source records attributed to Paul A Volberding.

6 recordsLinked to original sources
PubMed2003

Opportunities and options for treatment research in resource-constrained settings.

HIV clinical research faces limitations even in research-rich settings. Even though important questions remain unanswered, clinical trials will probably never be conducted that address, prospectively, when treatment is optimally indicated, for example. In resource-constrained settings, large, prospective clinical trials are also unlikely. On the other hand, ones with a more observational design or that compare cohort experiences may well be feasible and able to provide information important in those settings, as well as in regions with abundant financial resources.

Anti-HIV Agents↗
PubMed2003

HIV therapy in 2003: consensus and controversy.

HIV therapy has well-established and substantial clinical benefits. Awareness of these benefits has brought many infected persons into care. Many more infected persons would be treated were it not for the frequent side effects associated with antiretroviral drugs. All antiretroviral agents can cause both short-term and long-term toxicities. This is a particularly vexing problem as current data does not allow accurate predictions of treatment toxicities and, in many cases, side effects are only partially reversible. Moreover, therapy is frequently associated with the selection of drug-resistant viral isolates and incomplete viral suppression. This is commonly caused by inadequate medication adherence and leads to increasingly severe virologic failure. The present review will address both the striking advantages of HIV therapy as well as the ongoing challenges in its application.

Antiretroviral Therapy, Highly Active↗
PubMed2002

Antiretroviral treatment for adult HIV infection in 2002: updated recommendations of the International AIDS Society-USA Panel.

OBJECTIVE: New information warrants updated recommendations for the 4 central issues in antiretroviral therapy: when to start, what drugs to start with, when to change, and what to change to. These updated recommendations are intended to guide practicing physicians actively involved in human immunodeficiency virus (HIV)- and acquired immunodeficiency syndrome (AIDS)-related care. PARTICIPANTS: In 1995, physicians with specific expertise in HIV-related basic science and clinical research, antiretroviral therapy, and HIV patient care were invited by the International AIDS Society-USA to serve on a volunteer panel. In 1999, others were invited to broaden international representation. The 17-member panel met regularly in closed meetings between its last report in 2000 and April 2002 to review current data. The effort was sponsored and funded by the International AIDS Society-USA, a not-for-profit physician education organization. EVIDENCE AND CONSENSUS PROCESS: The full panel was convened in late 2000 and assigned 7 section committees. A section writer and 3 to 5 section committee members (each panel member served on numerous sections) identified relevant evidence and prepared draft recommendations. Basic science, clinical research, and epidemiologic data from the published literature and abstracts from recent (within 2 years) scientific conferences were considered by strength of evidence. Extrapolations from basic science data and expert opinion of the panel members were included as evidence. Draft sections were combined and circulated to the entire panel and discussed in a series of full-panel conference calls until consensus was reached. Final recommendations represent full consensus agreement of the panel. CONCLUSIONS: Because of increased awareness of the activity and toxicity of current drugs, the threshold for initiation of therapy has shifted to a later time in the course of HIV disease. However, the optimal time to initiate therapy remains imprecisely defined. Availability of new drugs has broadened options for therapy initiation and management of treatment failure, which remains a difficult challenge.

Adjuvants, Immunologic↗
PubMed2002

Who cares for AIDS?

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Clinical Competence↗