ARTICLE BY DISEASE ON “ANAL CANCER”
Anal cancer represents an increasing health problem, especially in immune-compromised patients, as HIVpositive patients. Notably, a significant higher incidence rate is reported among HIV infected patients with the advent of highly active antiretroviral therapy (HAART). To date, no randomised trial supports the correlation between existing screening strategies and reduced progression of anal intraepithelial neoplasia (AIN) to anal cancer or improved survival. Nevertheless, screening and treatment of AIN by topical agents should be implemented in high risk population. Data on invasive anal cancer treatment show that combined modality treatment (CMT) is the treatment of choice. Early reports on HIV-positive patients describe higher treatment toxicity and a relation with lower CD4 count and higher HIV viral load. More recently, reported outcomes seem to be similar in HIV-positive population and general population. Reports on a rise in local recurrence rates and in acute side effects along with a correlation with pre-treatment CD4 counts in HIV-positive patients, are not confirmed by all authors. The development of the first approved vaccine is a milestone in the field of anogenital cancers. However, many questions are still unresolved especially as concerns immunization in the setting of HIV infection.
Highly active antiretroviral therapy and direct acting antiviral agents are key elements in the effective pharmacotherapy of human immunodeficiency virus and Hepatitis C virus respectively.
Highly active antiretroviral therapy (HAART) and direct acting antiviral agents (DAAs) are key elements in the effective pharmacotherapy of human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) respectively. These two chronic illnesses affect millions of persons worldwide at any given time, though only a select proportion has been eligible for successful treatment. With the development of newer, safer and more effective antiviral therapies it is expected that a greater proportion of those infected by HIV and/or HCV will have access to these life-saving therapies. However, it is also important to appreciate that this very population will also be subject to increased toxicities from these agents.
In this review by Drs. Mitema and Atta, a thorough outline of the published nephrotoxic effects of select new agents used in the management of HIV and HCV is provided, specifically commenting, where possible, on the role of specific epithelial organic transporters in explaining potential renal toxicities. Drs. Mitema and Atta also tabulate the substrates, inhibitors, and additional distribution of organic transporters located in the basolateral and apical membranes of the proximal renal tubular epithelium (as well as other organs), providing a useful reference for clinicians to make inferences regarding potential drug-drug interactions.
Read more here: http://www.eurekalert.org/pub_releases/2016-03/bsp-tro031416.php