Antiretroviral Therapy Advancements, Benefits, and Management of HIV/AIDS
Antiretroviral therapy (ART) is a combination of medications used to treat human immunodeficiency virus (HIV) infection. ART works by inhibiting the replication of the virus, thereby slowing the progression of the disease and reducing the risk of HIV-related complications.
The main goal of ART is to suppress the virus to undetectable levels, which is defined as less than 50 copies of HIV per milliliter of blood. This is known as viral suppression and is considered to be a sign of successful treatment.
With viral suppression, the risk of transmitting HIV to others is greatly reduced, and the individual’s overall health and quality of life improves.
ART is typically recommended for all individuals living with HIV, regardless of their CD4 cell count. CD4 cells are a type of white blood cell that play a critical role in the immune system and are targeted by HIV. A low CD4 cell count is a marker of advanced HIV disease and a higher risk of developing AIDS-related complications.
Antiretroviral Therapy Advancements
ART is usually prescribed as a combination of at least three medications from different drug classes. This is known as a highly active antiretroviral therapy (HAART) regimen. The most commonly used drug classes include:
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) – These drugs work by inhibiting the reverse transcriptase enzyme, which the virus needs to replicate. Examples include zidovudine (AZT), lamivudine (3TC), and emtricitabine (FTC).
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) – These drugs also inhibit the reverse transcriptase enzyme, but in a different way than NRTIs. Examples include efavirenz (Sustiva), nevirapine (Viramune), and rilpivirine (Edurant).
Protease inhibitors (PIs) – These drugs inhibit the protease enzyme, which the virus needs to mature and infect new cells. Examples include ritonavir (Norvir), atazanavir (Reyataz), and darunavir (Prezista).
Integrase inhibitors (INSTIs) – These drugs inhibit the integrase enzyme, which the virus uses to insert its genetic material into the host cell’s DNA. Examples include raltegravir (Isentress) and dolutegravir (Tivicay)
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Entry inhibitors (EIs) – These drugs target the mechanism HIV uses to enter the host cells, preventing the virus from infecting new cells. Examples include maraviroc (Selzentry) and enfuvirtide (Fuzeon).
The specific combination of drugs used in a person’s ART regimen will depend on several factors, including their HIV viral load, CD4 cell count, and any other medical conditions they may have. It’s important to work closely with a healthcare provider to determine the most appropriate regimen for an individual.
Adherence to ART is crucial for the success of treatment.
Missing doses or not taking the medication as prescribed can lead to the development of drug-resistant strains of the virus, making it more difficult to achieve viral suppression.
While ART can effectively suppress the virus and improve overall health, it is not a cure for HIV. The medications must be taken for life, and regular monitoring is required to ensure that the virus is remaining at undetectable levels.
Some common side effects of ART include nausea, diarrhea, and fatigue. These side effects are usually mild and can be managed with medication or lifestyle changes.