What is Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)?
The infection caused by the Human Immunodeficiency Virus (HIV) is a global health concern. Due to advances in medicine, it has become a manageable condition. The progress in treatment has significantly reduced the number of additional infections and slowed the progression to AIDS, which is a severe stage of the disease. Current advice on HIV treatment recommends starting therapy earlier as recent studies show that it leads to better health outcomes. In this summary, we will discuss the HIV treatment using antiretroviral therapy.
What Causes Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)?
HIV is a type of virus, specifically called a ribonucleic retrovirus, and it belongs to a group known as lentiviruses. There are two types of this virus that can cause disease in humans. The first one, HIV-1, is quite infectious and harmful, and can be found all around the world. The second one, HIV-2, is less infectious and harmful and is primarily found in West Africa.
Risk Factors and Frequency for Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)
HIV has become more common globally due to the longer lifespan of people living with the disease, made possible by effective treatments like antiretroviral therapy. However, new cases of HIV are decreasing, and this trend is expected to continue thanks to growing knowledge about the disease and preventative strategies such as pre-exposure prophylaxis therapy.
Signs and Symptoms of Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)
Acute HIV infection can sometimes show symptoms similar to mononucleosis, or it could have no symptoms at all, remaining completely undetected. If this infection remains untreated for an extended period, it evolves into a chronic form. This stage leads to a decrease in CD-4 cells, crucial for our immune system, and results in acquired immunodeficiency syndrome, better known as AIDS. This stage is marked by many different health issues including:
- Opportunistic infections (infections that occur more frequently and are more severe in individuals with weakened immune systems)
- Metabolic disorders
- Cardiovascular diseases
- Cancer
- Neurocognitive disorders (problems with memory, attention and thinking ability)
Testing for Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)
Recent advancements in medical research and technology have led to more sensitive tests for diagnosing HIV. Now, the initial diagnosis and screening process includes a type of blood test known as an antigen/antibody immunoassay. This technique is beneficial as it can detect both HIV-1 and 2, as well as a p24 antigen. It improves early detection of infection, unlike earlier versions of this test, which only tested for antibodies.
In cases where the test comes back negative, no further testing is needed. However, if the test is positive, a different antibody test (immunoassay) is done to tell apart between HIV-1 and HIV-2. This is why western blot, the traditional technique, has been replaced with this newer method. A positive result on this test confirms an HIV diagnosis, specifying whether it’s HIV-1 or HIV-2.
If the test result is negative or unclear, another type of test called HIV-1 NAT (nucleic acid testing) is done. If the nucleic acid test result is positive, it indicates an acute infection of HIV-1. But, if it’s negative, it implies that the initial positive test was a false alarm, and the person can be considered not infected.
Once the diagnosis is confirmed, it’s important to understand the severity and possible effects of HIV on a patient. This is assessed by testing the CD4 cell count, the HIV RNA viral load (the amount of HIV virus in the blood), general blood count, and metabolic profile. An additional genotype resistance test is also done for the virus. This information is crucial in outlining the most effective treatment plan for the patient.
Treatment Options for Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS)
There are several types of medication that can help manage HIV:
* Some forms of medication prevent the virus from entering cells by blocking key points, known as fusion or entry inhibitors.
* Medications known as nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) stop the virus from rewriting its RNA code into the cell’s DNA.
* Integrase inhibitors prevent the virus’s DNA from merging with the DNA of the healthy cell.
* Protease inhibitors block the production of new viruses.
The latest guidelines suggest beginning antiviral therapy for HIV early on regardless of CD4 cell count, a measure of immune system health, for all adults and adolescents. Starting treatment early can reduce the health impacts of HIV and lessen the risk of spreading the virus.
Treatment for HIV involves multiple medications used together. The usual start to treatment pairs two NRTIs with another antiviral drug from one of three options: an integrase inhibitor, an NNRTI, or a protease inhibitor coupled with a booster drug. This choice is based on its successful track record and generally manageable side effects. However, other treatment options might be better for some patients.
There are also several recommended pathways using integrase inhibitors, known for their effectiveness, safety, and ease of use, along with fewer drug interactions. One protocol using a protease inhibitor is also recommended, despite being less easy to tolerate. It’s often reserved for patients who might not follow their treatment plan closely, or if their virus has already resisted other drugs.
Since the goal is to make treatment manageable for the patient, several once-a-day treatment options are available. Some additional considerations might be necessary based on a patient’s health. For example, certain HIV medications might be unsuitable for patients with kidney disease, osteoporosis, mental health issues, heart conditions, or problematic cholesterol levels. Appropriate treatment decisions ensure that all patients get the best care possible.
What else can Acquired Immune Deficiency Syndrome Antiretroviral Therapy (HIV and AIDS) be?
These are some conditions or treatments that can weaken the immune system:
- Cancer
- Chemotherapy
- Common Variable Immunodeficiency (CVID) – a disorder that impairs the immune system
- DiGeorge Syndrome – a genetic disorder that can cause a range of health problems, including immune deficiency
- Hepatitis B – a virus that attacks the liver and can cause chronic disease
- Malnutrition – lack of sufficient nutrients in the body
- Severe Combined Immunodeficiency (SCID) – a serious immune disorder
- Steroid Therapy – long-term use of steroid medications
- Syphilis – a sexually transmitted bacterial infection
- Wiskott-Aldrich Syndrome – a rare genetic disorder affecting the immune system
- Lyme Disease – a bacterial infection you get from the bite of an infected tick
These can make you more susceptible to diseases and infections because they reduce the body’s ability to defend itself.
