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      Medicinal Plants Used in the Treatment of Human Immunodeficiency Virus

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          Since the beginning of the epidemic, human immunodeficiency virus (HIV) has infected around 70 million people worldwide, most of whom reside is sub-Saharan Africa. There have been very promising developments in the treatment of HIV with anti-retroviral drug cocktails. However, drug resistance to anti-HIV drugs is emerging, and many people infected with HIV have adverse reactions or do not have ready access to currently available HIV chemotherapies. Thus, there is a need to discover new anti-HIV agents to supplement our current arsenal of anti-HIV drugs and to provide therapeutic options for populations with limited resources or access to currently efficacious chemotherapies. Plant-derived natural products continue to serve as a reservoir for the discovery of new medicines, including anti-HIV agents. This review presents a survey of plants that have shown anti-HIV activity, both in vitro and in vivo.

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          HIV infection: epidemiology, pathogenesis, treatment, and prevention.

          HIV prevalence is increasing worldwide because people on antiretroviral therapy are living longer, although new infections decreased from 3.3 million in 2002, to 2.3 million in 2012. Global AIDS-related deaths peaked at 2.3 million in 2005, and decreased to 1.6 million by 2012. An estimated 9.7 million people in low-income and middle-income countries had started antiretroviral therapy by 2012. New insights into the mechanisms of latent infection and the importance of reservoirs of infection might eventually lead to a cure. The role of immune activation in the pathogenesis of non-AIDS clinical events (major causes of morbidity and mortality in people on antiretroviral therapy) is receiving increased recognition. Breakthroughs in the prevention of HIV important to public health include male medical circumcision, antiretrovirals to prevent mother-to-child transmission, antiretroviral therapy in people with HIV to prevent transmission, and antiretrovirals for pre-exposure prophylaxis. Research into other prevention interventions, notably vaccines and vaginal microbicides, is in progress. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities

            Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.
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              Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial.

              The AIDS Clinical Trials Group protocol 076 zidovudine prophylaxis regimen for HIV-1-infected pregnant women and their babies has been associated with a significant decrease in vertical HIV-1 transmission in non-breastfeeding women in developed countries. We compared the safety and efficacy of short-course nevirapine or zidovudine during labour and the first week of life. From November, 1997, to April, 1999, we enrolled 626 HIV-1-infected pregnant women at Mulago Hospital in Kampala, Uganda. We randomly assigned mothers nevirapine 200 mg orally at onset of labour and 2 mg/kg to babies within 72 h of birth, or zidovudine 600 mg orally to the mother at onset of labour and 300 mg every 3 h until delivery, and 4 mg/kg orally twice daily to babies for 7 days after birth. We tested babies for HIV-1 infection at birth, 6-8 weeks, and 14-16 weeks by HIV-1 RNA PCR. We assessed HIV-1 transmission and HIV-1-free survival with Kaplan-Meier analysis. Nearly all babies (98.8%) were breastfed, and 95.6% were still breastfeeding at age 14-16 weeks. The estimated risks of HIV-1 transmission in the zidovudine and nevirapine groups were: 10.4% and 8.2% at birth (p=0.354); 21.3% and 11.9% by age 6-8 weeks (p=0.0027); and 25.1% and 13.1% by age 14-16 weeks (p=0.0006). The efficacy of nevirapine compared with zidovudine was 47% (95% CI 20-64) up to age 14-16 weeks. The two regimens were well tolerated and adverse events were similar in the two groups. Nevirapine lowered the risk of HIV-1 transmission during the first 14-16 weeks of life by nearly 50% in a breastfeeding population. This simple and inexpensive regimen could decrease mother-to-child HIV-1 transmission in less-developed countries.

                Author and article information

                Int J Mol Sci
                Int J Mol Sci
                International Journal of Molecular Sciences
                14 May 2018
                May 2018
                : 19
                : 5
                [1 ]Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, 88777539 Tehran, Iran; bahar.salehi007@ 123456gmail.com
                [2 ]Student Research Committee, Shahid Beheshti University of Medical Sciences, 22439789 Tehran, Iran
                [3 ]Department of Chemistry, Manipal Institute of Technology, Manipal University, Manipal 576104, India; nv.anil@ 123456manipal.edu
                [4 ]Department of Pharmacognosy, Gazi University, Faculty of Pharmacy, 06330 Ankara, Turkey; bilgesener11@ 123456gmail.com (B.Ş.); klcmehtap89@ 123456gmail.com (M.K.)
                [5 ]Department of Medical Parasitology, Zabol University of Medical Sciences, 61663-335 Zabol, Iran
                [6 ]PAHO/WHO Collaborating Centre for Traditional Medicine, College of Pharmacy, University of Illinois, 833 S. Wood St., Chicago, IL 60612, USA; g.b.mahady@ 123456gmail.com
                [7 ]Department of Chemistry, Biochemistry and Environmental Protection, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 3, 21000 Novi Sad, Serbia; sanja.vlaisavljevic@ 123456dh.uns.ac.rs
                [8 ]Department of Agricultural and Environmental Sciences, Milan State University, 20133 Milan, Italy
                [9 ]Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, 11369 Tehran, Iran; farzadkf@ 123456yahoo.com (F.K.); majid_ayatollahi@ 123456yahoo.com (S.A.A.)
                [10 ]Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, 11369 Tehran, Iran
                [11 ]Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL 35899, USA
                [12 ]Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, 11369 Tehran, Iran
                [13 ]Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, Winnipeg, MB R3B 2G3, Canada; a.ata@ 123456uwinnipeg.ca
                Author notes
                [* ]Correspondences: mehdi_sharifirad@ 123456yahoo.com (M.S.-R.); marcello.iriti@ 123456unimi.it (M.I.); wsetzer@ 123456chemistry.uah.edu (W.N.S.); javad.sharifirad@ 123456gmail.com or javad.sharifirad@ 123456sbmu.ac.ir (J.S.-R.); Tel.: +98-54-322-51-790 (M.S.-R.); +39-2-5031-6766 (M.I.); +1-256-824-6519 (W.N.S.); +98-21-88200104 (J.S.-R.)
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).



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