HIV and latest treatment
HIV (human immunodeficiency virus) is a virus that attacks the body's immune system and makes it harder to fight off infections and diseases. HIV can lead to AIDS (acquired immunodeficiency syndrome), which is the most advanced stage of the infection. There is no cure for HIV, but there are effective treatments that can help people with HIV live longer and healthier lives, and prevent transmitting the virus to others.
The main treatment for HIV is called antiretroviral therapy (ART). ART involves taking a combination of medicines every day that stop the virus from replicating in the body. ART does not eliminate HIV from the body, but it reduces the amount of virus in the blood (called viral load) to very low levels. This helps the immune system recover and fight off other infections. It also lowers the risk of developing AIDS and other complications.
ART is recommended for everyone who has HIV, regardless of how long they have been infected or how healthy they are. People with HIV should start ART as soon
as possible after diagnosis, even on the same day. Starting ART early can improve the health outcomes and quality of life of people with HIV, and reduce the chances of passing the virus to others.
People on ART take a combination of HIV medicines called an HIV treatment regimen. There are many different types of HIV medicines, and they are grouped into classes based on how they work against the virus. The most common classes are:
- Nucleoside reverse transcriptase inhibitors (NRTIs), which block an enzyme that HIV needs to make copies of itself.
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs), which bind to and disable the same enzyme as NRTIs.
- Protease inhibitors (PIs), which block an enzyme that HIV uses to cut up proteins for making new viruses.
- Integrase strand transfer inhibitors (INSTIs), which block an enzyme that HIV uses to insert its genetic material into human cells.
- Entry inhibitors, which prevent HIV from entering human cells.
- Pharmacokinetic enhancers (also called boosters), which increase the effectiveness of some other HIV medicines.
Usually, an HIV treatment regimen consists of three or more HIV medicines from at least two different classes. This helps prevent the virus from becoming resistant to the medicines. Resistance means that a medicine no longer works against the virus. Resistance can develop when people do not take their medicines as prescribed, or when they switch or stop their medicines without consulting their health care provider.
To find the best HIV treatment regimen for each person, health care providers consider several factors, such as:
- The person's medical history and current health status
- The results of laboratory tests, such as viral load and CD4 count
- The possible side effects of the medicines
- The potential interactions of the medicines with other drugs or supplements
- The person's preferences and lifestyle
People with HIV need to take their medicines every day, exactly as prescribed. They also need to see their health care provider regularly for monitoring and follow-up. Taking ART correctly can help people with HIV achieve and maintain viral suppression, which means having a very low or undetectable viral load. Viral suppression improves the health and well-being of people with HIV, and prevents them from transmitting the virus to others.
New research on HIV prevention and treatment
Research into possible treatments and potential cures for HIV is ongoing. Every year, scientists and doctors reveal exciting new updates. Some of these may soon be the standard of care for people with HIV.
Some examples of recent advancements in HIV prevention and treatment include:
Anal cancer screening: People with HIV are more likely to get infected with human papillomavirus (HPV), which can cause anal and cervical cancers. A study found that early detection and treatment of precancerous anal lesions can reduce the risk of developing anal cancer by more than half compared with only monitoring the lesions . Anal cancer screening should become the standard of care for people with HIV, especially men who have sex with men.
mRNA vaccines: mRNA vaccines are a new type of vaccine that use messenger RNA (mRNA) to teach the immune system how to fight off a disease. mRNA vaccines have been successfully developed for COVID-19, and are now being tested for HIV . If proven safe and effective, mRNA vaccines could offer a new way to prevent HIV infection or improve immune responses in people with HIV.
Stem cell transplants: Stem cell transplants are procedures that replace damaged or diseased bone marrow with healthy stem cells from a donor. Stem cell transplants have been used to treat some cancers and blood disorders, but they also have potential for curing HIV. Two people with both cancer and HIV have been cured of HIV after receiving stem cell transplants from donors who had a rare genetic mutation that made them resistant to HIV . However, stem cell transplants are very risky and expensive, and not widely available. More research is needed to find safer and simpler ways to replicate this outcome.
Long-acting injectables: Long-acting injectables are medicines that are given by injection every few weeks or months, instead of daily pills. Long-acting injectables can offer more convenience and privacy for people with HIV, and may improve adherence and outcomes. Two long-acting injectables, cabotegravir and rilpivirine, have been approved by the FDA for the treatment of HIV in adults who have achieved viral suppression with a stable regimen . Another long-acting injectable, cabotegravir, has been shown to be highly effective for preventing HIV infection in women and men who have sex with men . More long-acting injectables are being developed and tested for both treatment and prevention of HIV.
Conclusion:
HIV is a serious but manageable chronic condition that can be treated with antiretroviral therapy. People with HIV can live long and healthy lives if they take their medicines as prescribed and see their health care provider regularly. They can also prevent transmitting the virus to others by achieving and maintaining viral suppression. New research on HIV prevention and treatment is bringing hope and optimism for the future of people with HIV and the global response to the epidemic.
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References:
https://www.who.int/news-room/fact-sheets/detail/hiv-aids
https://medlineplus.gov/hivmedicines.html
https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/hiv-treatment-overview
https://www.healthline.com/health/hiv-prevention/advancements-in-prevention-and-treatment
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