Advancement in HIV/AIDS Treatment

Advancement in HIV/AIDS Treatment

History

AIDS (Acquired Immunodeficiency Syndrome) are also known as HIV (Human Immunodeficiency virus). AIDS was first clinically observed in 1981 in the United States. The initial cases were a cluster of injection drug users and gay men with no known cause of impaired immunity who showed symptoms of Pneumocystis pneumonia (PCP or PJP, the latter term recognizing that the causative agent is now called Pneumocystis jirovecii), a rare opportunistic infection that was known to occur in people with very compromised immune systems. Soon thereafter, additional gay men developed a previously rare skin cancer called Kaposi's sarcoma (KS). Many more cases of PJP and KS emerged, alerting U.S. Centers for Disease Control and Prevention (CDC) and a CDC task force was formed to monitor the outbreak. In the beginning, the CDC did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy, and the disease after which the discoverers of HIV originally named the virus. In the general press, the term GRID, which stood for gay-related immune deficiency, had been coined. However, after determining that AIDS was not isolated to the gay community, it was realized that the term GRID was misleading and AIDS was introduced at a meeting in July 1982. By September 1982 the CDC started using the name AIDS.

Management of HIV/AIDS

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same sex and opposite sex partners as long as the HIV-positive partner maintains an undetectable viral load.

5 Things to Know About HIV Medications

There are lots of myths and stale, outdated information about HIV treatment. Here are five things you should know about ART.

• It's easier to take than it used to be. A lot of people with HIV just take one pill once a day. That's it. That one combination pill -- Atripla, Complera, or Stribild -- packs in all the different active ingredients you need. Most people don't need the "cocktails" with complicated dosing schedules anymore.
• You have lots of options. Some people need drug combinations. There are six classes of antiretroviral drugs for HIV and more than 30 drugs. If one doesn't work or causes side effects, the doctor has many other choices.
• Medications work for a long time. People used to worry that their drugs would stop working after a while and that they'd have to keep switching to new ones. That's not really a risk now. "As long as you keep taking your medications, the same treatment can work for decades," Hare says.
• Drugs have fewer side effects. While specific side effects depend on the drug, HIV treatment is much safer and easier to tolerate than it used to be. For most people, side effects -- like upset stomach and diarrhea -- are minor and often go away. Long-term risks include cholesterol problems and weakened bones. But even so, the risks of treatment are much lower than the risks of not getting it, Hare says.
• You may start taking medication as soon as you're diagnosed. Many experts believe that the sooner you start treatment, the better. However, some doctors prefer to wait until your CD4 count, a measure of some immune cells, drops to a certain point before starting treatment. See what your doctor recommends.

 Choosing a Medication

Doctors have quite a few good medications to choose from. So they'll tailor your treatment to you specifically. The right treatment can depend on:

1.     How organized you are. Do you have trouble remembering to take medication? Some treatments are better for people who are more likely to miss a dose now and then.

2.     You’re eating habits. You have to take some drugs with food. If you have a very irregular eating pattern, some drugs might not be a good fit.

3.     If you want to get pregnant. Atripla contains the drug efavirenz and isn't safe for women who are breastfeeding, pregnant, or planning to get pregnant.

4.     Other health considerations. Some HIV medications can interact with other drugs, like medications for acid reflux. If you have high cholesterol, heart disease, or other issues, your doctor will opt for the medication least likely to cause problems.

5.     Viral resistance. You'll get a test to show if the strain of HIV you have is resistant to any drugs. If it is, you'll use other medications instead.

But even if you're feeling well, it's crucial that you stay on your medication. Stopping treatment gives the virus a chance to spread and cause serious problems.

HIV is now a manageable disease. But you have to do your part to manage it -- and that means sticking with treatment.