AIDS Treatment

AIDS Treatment

Human immunodeficiency virus or HIV infection causes AIDS treatment (Acquired Immunodeficiency Syndrome) which is mostly fatal and there is no cure. AIDS occurs in the later stages of the disease.

Currently, HIV-positive patients are treated with antiretroviral drugs that block the transmission of the virus inside the body and delay the onset of AIDS treatment. In addition, opportunistic infections in AIDS can be prevented with the use of biological and anti-cancer drugs.

Aids Treatment
Aids Treatment

History of HIV treatment

Initially in the late 1980’s, monotherapy with zidovudine was the only antiretroviral therapy (ARV). By 1996, more anti-HIV drugs were being developed and compound therapies were becoming more widely used. This highly active combination therapy is now known as highly active antiretroviral therapy (HAART).

Drug classes

ARVs work primarily on an enzyme called reverse transcriptase. This enzyme helps in the multiplication of viral particles. Medications inhibit this enzyme and prevent viral replication. There are four main classes of drugs used as antiretroviral agents:

  1. Nucleoside reverse transcriptase inhibitors (NRTIs)
  2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  3. Protease inhibitors
  4. Ribonucleotide reductase inhibitor

The drugs, along with their possible side effects, are shown in the table below.

Drug Category Drug Hame Toxicity
Nucleoside reverse transcriptase inhibitors (NRTI) Zidovudine (AZT) Hepatic steatosis, lactic acidosis, myopathy, cardiomyopathy, dyshaemopoiesis (anemia, macrocytosis, neutropenia)
Didanosien (ddI), Stavudine (d4T) Hepatic steatosis, lactic acidosis, pancreatitis, myopathy, peripheral neuropathy, dyshaemopoiesis, gynaecomastia
Lamivudine (3TC) Dyshaemopoiesis
Non-Nucleoside reverse transcriptase inhibitors (NNRTI) Nevirapine, Efavirenz Skin rashes, Stevens-Johnson syndrome, hepatitis
Protease inhibitors (PI) Saquinavir, Ritonavir, Indinavir, Nefinavir Lipodystrophy, hyperglycaemia, hyperlipidaemia, hepatitis
Ribonucleotide reductase inhibitor (RNR) Hydroxyurea Bone marrow suppression, mouth ulcers, hepatitis

Management of HIV-positive patients

Management of HIV-positive patients according to the guidelines of the British HIV Association (BHIVA):

  • All patients with HIV infection need antiretroviral therapy if they have a CD4 cell count of below 350 cells/mm3 or signs of nervous system involvement. If an AIDS treatment defining condition is present therapy may be indicated despite normal CD4 levels.
  • If CD4 cell counts are 351-500 cells/mm3 patients require treatment if they have Hepatitis B or C infection, low percentage of CD4 cells (less than 14%) and have a high risk of heart disease.
  • Those with late-stage HIV need ARV except in presence of tuberculosis when CD4  cell counts are more than 350 cells/mm3

AIDS Pathophysiology

Acquired Immune Deficiency Syndrome (AIDS) is caused by HIV or the human immunodeficiency virus. Infection primarily causes progressive destruction of the cell-mediated immune system (CMI) by eliminating CD4 + T-helper lymphocytes.

Lack of immunity leads to opportunistic infections and some cancers. Opportunistic infections are caused by organisms that do not cause infections in healthy people. HIV also directly damages certain organs, such as the brain.

How is therapy begun and maintained?

Initial treatment is done with three drugs: efavirenz plus tenofovir or abacavir, plus lamivudine or emtricitabine

Patients need to be vaccinated against hepatitis B, pneumococcal disease and Haemophilus influenzae type b (and possibly influenza and hepatitis A). These patients should not be vaccinated against live viral or organism vaccines such as BCG, yellow fever, oral typhoid, or live oral polio. People who are at risk for opportunistic infections need antifungal or antibiotic agents to prevent them.

How to manage accidental exposure to HIV infection?

This situation is normal among medical services laborers and the individuals who deal with HIV positive patients. There might be a coincidental needle stick injury or openness to HIV polluted blood or body liquids of the patients.The individuals who have been presented to the infection inside the most recent 72 hours (three days) need to take hostile to HIV medicine to forestall the contamination conceivably.

This is called post-operative prophylaxis or PEP. PEP infection should begin within about 72 hours of exposure. The faster PEP is initiated, the better – preferably after exposure to HIV.Energy is an extended treatment with a mix of antiretroviral drugs, which makes serious side impacts and doesn’t ensure outright security.

HIV infection in pregnancy

Antiretroviral drugs given to pregnant women with HIV help prevent the baby from transmitting the infection. Without treatment, one in four children will have an infection. With treatment, the risk is less than one hundred. Breastfeeding is not recommended in HIV-infected women as the virus can infect the baby through breast milk.

HIV vaccine

Efforts are underway to develop a vaccine against the infection. To date, however, there is no approved vaccine against the infection because the HIV-1 virus poses a difficult target against which a vaccine can be developed.