Paul A. Volberding - Böcker

The three years since our last conference in San Francisco have again seen a dramatic expansion of the number of antivirals either licensed or in the late stages of clinical trials. d4T is now licensed for HIV infection, famciclovir and the oral pro-drug of acyclovir, valacyclovir, are now licensed for VZV infections in some countries. Moreover. oral ganciclovir, cidofovir, and sorivudine are not far behind. Clinical trials with the second-site reverse transcriptase inhibitors and the protease inhibitors for HlV infection are proceeding rapidly and on a broad scale, and the preliminary results would suggest that several of these classes of drugs will be licensed as well. Despite this optimism, however, there is increasing evidence that antiviral-resistant strains of pathogenic viruses will be a significant problem, perhaps especially with therapy of HIV infection, and there remains a desperate need for improved drugs (with either improved efficacy or decreased toxicity, or both) for CMV and HIV infections. This book is the edited proceedings of the Fourth Triennial Conference on Antiviral Chemotherapy, held in San Francisco, in November 1994. The conference was sponsored by the University of California, San Francisco, and co-sponsored by the International Society for Antiviral Research (ISAR), the Macfarlane Burnet Centre for Medical Research in Melbourne, Australia, and the Australian National Centre for HIV Virology Research. The conference had been organized to present an overview of the field of antiviral chemotherapy.

This is an edited expansion of a conference held in San Francisco in November 1997, at which a faculty of over 40 experts provided a comprehensive overview of the field of antiviral chemotherapy. The text discusses treatment issues and updates regarding HIV, herpesvirus infections, influenza virus, respiratory syncytial virus, hepatitis B virus, and enterovirus infections.

Heritable disorders of connective tissue (HDCTs) are a diverse group of inherited genetic disorders and subtypes. Because connective tissue is found throughout the body, the impairments associated with HDCTs manifest in multiple body systems and may change or vary in severity throughout an affected individual's lifetime. In some cases, these impairments may be severe enough to qualify an eligible child or adult for monetary benefits through the U.S. Social Security Administration's (SSA's) Social Security Disability Insurance or Supplemental Security Income program. SSA asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee that would provide current information regarding the diagnosis, treatment, and prognosis of selected HDCTs, including Marfan syndrome and the Ehlers-Danlos syndromes, and the effect of the disorders and their treatment on functioning. The resulting report, Selected Heritable Disorders of Connective Tissue and Disability, presents the committee's findings and conclusions.

The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs. To receive SSDI or SSI disability benefits, an individual must meet the statutory definition of disability, which is "the inability to engage in any substantial gainful activity [SGA] by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." SSA uses a five-step sequential process to determine whether an adult applicant meets this definition. Functional Assessment for Adults with Disabilities examines ways to collect information about an individual's physical and mental (cognitive and noncognitive) functional abilities relevant to work requirements. This report discusses the types of information that support findings of limitations in functional abilities relevant to work requirements, and provides findings and conclusions regarding the collection of information and assessment of functional abilities relevant to work requirements.

Sickle cell disease (SCD), a group of inherited blood disorders affecting approximately 100,000 people in the U.S., is a life-long condition that impacts every organ system in the body. Symptoms and complications vary from mild to severe and can include acute and chronic pain, acute chest syndrome, stroke, and organ damage. The cumulative burden of SCD-related health effects can affect an individual's quality of life as well as their ability to participate in school and work. These factors impact how the Social Security Administration (SSA) determines whether applicants with SCD qualify for benefits.The SSA tasked the National Academies with convening an expert committee to review the latest published scientific research and address best practices and patient experiences in the management and treatment of SCD. The resulting report, Sickle Cell Disease in Social Security Disability Evaluations, presents the committee's findings and conclusions including the importance of coordinated care and support for patients navigating the transition from pediatric to adult health care.

Since the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits.At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on children's health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, many individuals infected with the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have continued to experience lingering symptoms for months or even years following infection. Some symptoms can affect a person's ability to work or attend school for an extended period of time. Consequently, in 2022, the Social Security Administration requested that the National Academies convene a committee of relevant experts to investigate and provide an overview of the current status of diagnosis, treatment, and prognosis of long-term health effects related to Long COVID. This report presents the committee conclusions.

This is the first of two reports requested by the Social Security Administration (SSA) to address best practices and community experiences in the management and treatment of sickle cell disease (SCD). SCD, a group of inherited blood disorders affecting approximately 100,000 people in the United States, is a chronic, life-long condition that affects every organ system in the body. The life of an individual with SCD is often complicated by frequent bouts of extreme pain and hospitalizations, fatigue, organ damage, and mental health conditions. The cumulative burden of SCD-related health effects can significantly affect quality of life, including the ability to regularly attend and participate fully in school and work.In response to SSA's request, the National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to review the latest published scientific research and generate findings and conclusions on a variety of topics related to SCD. This report is the first report in a two-report series, and presents the committee's findings and conclusions pertaining to SCD pain crises, pain management, and treatment settings relevant to SSA disability determinations.

The latest in the crucial series documenting scientific discoveries at the forefront of HIV and AIDS research!This volume updates the most important and controversial issues facing physicians, nurses, microbiologists, pharmacists, and epidemiologists who deal directly with patients suffering from HIV and AIDS, focusing on specific areas in which important new advances have occurred in diagnosis, therapy, and prevention of infection and related complications.Outlines new disease management strategies being tested in prospective clinical trials and observational studies!Combining elements of virology, epidemiology, immunology, oncology, endocrinology, neurology, psychiatry, and the behavioral sciences, AIDS Clinical Review 2000/2001clarifies substantive advancements in vaccine development, realistically assessing potential efficacy and limitations explores short-term antiretroviral therapy for dramatically reducing the rate of vertical transmission from mother to child evaluates the efficacy of antiretroviral prophylaxis for workers who experience high-risk exposure to HIV-infected blood discusses preservation of HIV specific immunity when antiretroviral therapy is initiated early in the course of acute infection considers complex drug interactions that occur when drugs are used in combination highlights cytokine and other immune-based therapies suggests chronic hepatitis may ultimately be more fatal than HIV for coinfected patients and more!Including results recently presented at scientific meetings but not yet published in peer-reviewed journals, AIDS Clinical Review 2000/2001 is essential reading for infectious disease specialists, epidemiologists, virologists, immunologists, pharmacologists, microbiologists, hematologists, hepatologists, oncologists, neurologists, medical students in these disciplines, and all medical professionals involved in both AIDS research and clinical practice.

Scientists and clinicians attending the last "New Directions in Antiviral Therapy" conference in late 1994 could hardly have predicted the revolution in the management of patients with HIV infection that has occurred since. Two new classes of antiretrovirals have been licensed, the second-site RT inhibitors and the protease inhibitors; the long in­ cubation period of active HIV infection, when the infection is clinically latent, is now un­ derstood to be a period of intense viral replication and turnover of CD4 lymphocytes; measurements of HI V RNA concentration in plasma have been shown to be essential tools for monitoring the course of HIV infection, deciding when to treat, and assessing the re­ sults of treatment; and finally, combinations of antiretrovirals, particularly combinations including protease inhibitors, have been shown to have dramatically beneficial effects on patients with HIV infection. These advances, coupled with new drugs for the management of herpesvirus infections, have made dramatic differences in the quality and length of life of HIV-infected patients. Additional advances have been made since 1994 in the prevention or management of influenza virus (zanamavir), respiratory syncytial virus (palvizumab), hepatitis B virus (lamivudine and famciclovir), and enterovirus infections (pleconaril). It is difficult to re­ member that only slightly more than a decade ago there were only a handful of antiviral agents available (none of which were antiretrovirals), and a number of those were either highly toxic, of dubious efficacy, or both.