Hiv Aids Treatment

AIDS treatment has progressed remarkably since the discovery of the disease in 1981. Early HIV treatment was extremely limited in effectiveness and most AIDS patients had life expectancies of less than two years.

By 2005, the U.S. Food and Drug Administration had approved approximately twenty drugs for the treatment of HIV and AIDS. HIV treatment is also referred to as antiretroviral therapy because the medication attacks the HIV retrovirus.

AIDS Treatment Goals

AIDS treatment does not cure HIV: the goal of HIV treatment and antiretroviral therapy is to suppress the HIV virus, ideally until it cannot be detected by clinical tests. Remember, no matter how well a person responds to HIV treatment, (s)he is never free of the virus. The disease will resurface if treatment for HIV is stopped, and can still be transmitted even when it is suppressed.

AZT and the First Wave of AIDS Treatment

The first medications approved for HIV treatment were a family of drugs known as reverse transcriptase (RT) inhibitors. RT inhibitors interfere with the virus’ reverse transcriptase enzyme that is essential for viral replication. AZT, or Retrovir, is one of the most commonly used RT inhibitors.

RT inhibitors are divided into two different groups. The first group, including AZT, consists of the nucleoside drugs that provide the virus with incorrectly coded DNA to hinder its ability to multiply. Nucleoside drugs used in the treatment of HIV include:

  • 3TC (Lamivudine)
  • ABC (Abacavir)
  • AZT (Retrovir)
  • d4T (Stravudine)
  • ddC (Zalcitabine)
  • ddl (Didanosine).

The second family of RT inhibitors used in antiretroviral therapy consists of the non-nucleoside RT inhibitors that bind to the virus to prevent replication. This branch of AIDS treatment medications includes Delavirdine, Nevirapine and Efavirenz.

Protease Inhibitors

Protease inhibitors, or PI, also interfere with an enzyme needed for virus replication, specifically the protease enzyme. HIV requires the protease enzyme to produce viral particles. These HIV treatment drugs include Saquinavir, Indinavir, Nelfinavir, Ritonavir and Amprenavir.

Fusion Inhibitors

Fusion inhibitors are some of the newest weapons in the treatment of HIV. These drugs actually change the shape of the virus’ covering, preventing it from binding to and infecting cells.

HAART and AZT

HIV treatment requires a combination of different antiretroviral therapy medications. Because HIV can develop a resistance to medication very quickly, at least three drugs are generally used during AIDS treatment.

These combinations of HIV treatments are known collectively as HAART, or Highly Active Antiretroviral Therapy.

AZT, or Retrovir, is one of the most common medications used in HAART combinations and is present in most initial HAART regimens. AZT is also one of the few HIV treatments that can be safely administered during pregnancy, reducing the risk of HIV infecting the baby.

Side Effects of HIV Treatment

Because AZT and other HAART medications are powerful drugs, they can produce a number of adverse side effects. Potential side effects of HAART include:

  • anemia
  • diabetes
  • fevers
  • high cholesterol
  • liver disorders
  • low bone density
  • nausea and vomiting
  • nerve problems
  • numbness of hands or feet
  • pancreatitis
  • skin rashes
  • unusual fat distribution.

HAART Compliance

Treatment for HIV may be complicated by HAART side effects. The timing and frequency of doses also makes it difficult for people to adhere to AIDS treatment regimens.

HAART medications must be taken on different timetables. Some of the drugs require certain food restrictions, while others even require periods of fasting.

The difficulty of managing HIV treatment drugs, and the unpleasant side effects associated with AZT and other drugs, often require doctors and patients to experiment with different HAART combinations to customize AIDS treatment.

AIDS Treatment Monitoring

AIDS treatment requires regular check ups to ensure that antiretroviral therapy is working. Side effects from HAART drugs must be monitored and doses altered as needed.

Symptoms of AIDS are closely monitored as part of AIDS treatment. Signs of opportunistic infections indicate that the body may not be responding properly to the current mix of HAART medications. Symptoms to watch for during AIDS treatment include:

  • a drop in CD4 cell counts
  • a rise in the HIV viral load
  • chills and night sweats
  • coughs
  • diarrhea
  • enlarged lymph nodes
  • fatigue
  • fever
  • headaches
  • mouth sores
  • newly developed nausea and vomiting
  • shortness of breath
  • weight loss.

If any of these symptoms are present, changes to antiretroviral therapy may be required.

The goal of HIV treatment is to lower the viral load in the body as much as possible and to prevent the level of CD4 white blood cells from decreasing. If treatment for HIV is progressing well, the level of CD4 cells may even increase, improving the body’s ability to fight off opportunistic infections.

Antiretroviral Therapy and the Developing World

Antiretroviral therapy and HAART have become standards of AIDS treatment in the developed world. However, treatment of HIV lags in developing countries, where resources are scarce. Antiretroviral therapy costs more than many developing countries can afford and the administration of HIV treatment requires specialized medical training that is also less common in poorer nations.

Resources

American Academy of Family Physicians. (reviewed June 2005). HIV: Medicines for people who are HIV positive.

American Medical Association. (updated 9 December 2004). First drug in new class of HIV/AIDS treatments approved by FDA.

American Medical Association. (updated 9 November 2004). WHO report on effective HIV treatment in developing countries.

National Institute of Allergy and Infectious Diseases. (updated 2 December 2004). Treatment of HIV infection.

U.S. Department of Health and Human Services. (reviewed October 2004). HIV and its treatment: What you should know.