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Adjunctive Medicines 

Adjunctive Medicines
Chapter:
Adjunctive Medicines
Author(s):

Harris A. Gelbard

and Stuart A. Lipton

DOI:
10.1093/med/9780195399349.003.0072
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date: 27 June 2019

Antiretroviral drugs are the only therapy currently in general use for the treatment of HIV-associated neurocognitive disorders (HAND), but the treatment response to these agents may be unsatisfactory or short lived. One reason for this unsatisfactory response may be that the pathophysiology of HAND is initiated by the virus but involves a cascade of ongoing inflammation mediated by peripheral and central immune effector cells, viral neurotoxins, pro-inflammatory cellular metabolites, and by a reduction in normal levels of trophic factors in the central nervous system. Steps in this inflammatory cascade may provide useful targets for adjunctive therapies for HAND. There is a similar need for adjunctive therapies for HIV-associated peripheral neuropathy. This chapter discusses the design of clinical trials for these therapies as well as particular targets and drugs.

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