The Human Immunodeficiency Virus (HIV) is a retrovirus which is passed through blood or sexual fluid, usually by injections, sexual activity (especially in homosexual males), blood transfusion, or passed from mother to baby through the placenta. The virus works by inserting itself into the DNA of the immune system cells in the body, and can stay dormant for years, reproducing itself until it becomes active and effects the whole body. An individual may have HIV for years before knowing it. HIV can be detected through the Western Blot and the Line Immunoassay tests (more about detecting HIV…). Oftentimes a patient will not detect HIV until years later when they get an infection from being immunocompromised and get tested at a hospital. The final stage of HIV is known as Acquired Immunodeficiency Syndrome (AIDS), in which the patient will be severely immunocompromised, and ends in certain death.
Though HIV/AIDS is increasing, still not enough victims receiving treatment.
UN Humanitarian Affairs report
HIV/AIDS is a hot topic in the health care world today, as it affects millions of people worldwide. Since its first case in 1959, millions of people have died, and the treatment for victims has transformed and become very effective. While there is still no cure for the deadly virus, there are now drugs that can prolong the life of a victim, give them strength, and give them hope that one day there may be a cure.
There are three main classes of antiretrovirals (ARVs) used for HIV/AIDS treatment. Protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) are the most effective, but nucleoside reverse transcriptase inhibitors (NRTIs) are another common type of ARV used.
As already stated, these drugs cannot cure HIV/AIDS. But recently experts have reported that patients who take 3 different drugs (on average) for HIV daily (and taken correctly) for at least 6 months will decrease the HIV in the blood and cause the patient to be less infectious. This is great news for the HIV community, because now, with the added use of a condom, a heterosexual couple which has one HIV infected individual and one non-infected individual will have no HIV transmission when the virus is below a certain level in the blood.
Check out this article by Michael Carter, Editor for NAM, the HIV/AIDS information charity!
Different factors can influence drug metabolism in the body. Drug interactions and genetics are the biggest reasons why many treatments don’t work for people. ARVs are metabolized by the enzyme CYP450, which is used for many other chemicals as well. If ARVs are taken with another drug or food which needs this enzyme, it can increase the toxicity of the drug in the blood and/or decrease the drugs effectiveness on the virus.
Recently, many studies suggest that in order to properly treat a patient, a routine therapeutic drug monitoring (TDM) should be used measuring the drug concentration in the blood to measure its effectiveness. Through looking at the TDM, the health care professional can alter the dosage of the ARV to match the patient’s needs. For example, some patients’ genetics can cause a drug to be metabolized quickly in the body, therefore increasing its toxicity in the blood and harming the body more. Also, if the patient is not getting enough drug, the virus can become immune to the class of drug because of its exposure, but not effectiveness to destroy the drug. (Drug resistance is a scary thing in the health care field, especially in treating HIV considering the treatments are so young anyway.) However, the TDM is not supported by all experts, because the values for the TDM may not relate to active drug, may need adjustment for drug resistance, or may not be known.
In poor or underdeveloped parts of the world, laboratories available to perform TDMs do not exist. Actually, many times laboratories to perform other tests, CAT scans, etc. do not exist. HIV is a virus which affects people from all across the world, with many different income levels. In many parts of the world, financial access to healthcare is a huge problem to those
infected with HIV. Even in countries that may offer free ARVs, the tests and treatments involved in the diagnosis of HIV as well as the overall nutrition care for the patient is more than the ARVs themselves. Sadly, these people usually have no hope except in donations given from strangers.
As HIV affects more people throughout the world, scientists are more determined to find treatments for this deadly virus, and health care providers are desperate for effective care. Hundreds of people die daily and hundreds more are infected. Condoms are central to eliminating the spread of the virus, as well as minimizing the number of sexual partners. Another idea suggested to stop the spread of HIV is for more people to be tested and treatments given earlier on in the virus’ life. Perhaps if treatments are given at the very beginning the virus would be weak enough to be totally eliminated from the system. However, this doesn’t help those infected individuals who don’t have the financial means…
References:
http://news.bbc.co.uk/2/hi/health/8068074.stm
http://www.encyclopedia.com/topic/HIV.aspx
http://www.informaworld.com/smpp/content~db=all~content=a902175225
http://www.aidsmap.com/cms1189782.aspx
What a great post! I loved the picture above, that is a CUTE baby. I didn’t realize there were so many new treatment options to slow the progression of HIV/AIDS down. This is definitely a neglected disease process in the pharmaceutical world.
I may be wrong, but I seem to remember hearing something about the AIDS epidemic worsening due to tainted blood being used in the late 80s or early 90s in some sort of treatment for diabetics or something? I know in the UK AIDS has gotten into countless haemophiliacs and killed some 800 of them due to tainted blood. It is a terrible affliction and warrants more research for sure in any area of the globe.
That is so interesting Steven! I had never done any research on that topic until I read your post.
Have you ever heard of the Ryan White Act?
The article below explains everything; Ryan White was a hemophiliac from Indiana who received AIDS tainted blood during a routine transfusion in 1971 when he was just six days old.
He only lived until age 18, but he dedicated his whole life advocating for HIV treatment and created the Ryan White Foundation.
The article is sooo interesting! I hope you enjoy it!
Check this article out:
http://www.examiner.com/eyewonder/interim.html?url=http://cdn1.eyewonder.com/200125/756293/1086494/exp_Inc.js?interim=http%3A//www.examiner.com/eyewonder/interim.html&clickTagFramePrepend=ewclickthru&iframeURL=http%3A//www.examiner.com/x-11108-DC-HIV-and-AIDS-Examiner~y2009m10d23-Ryan-White-Act-Extended&extra=&stime=1256663676163&cb=1256663676163&guid=0c7c3df8-9a85-4b94-b790-61ef80a21e90
First of all Steven, I totally agree that HIV warrants more research attention, and more attention from the general public. It’s not a “fad” illness–it affects and kills millions of people, and is only getting worse.
This summer, I (Elena) spent 7 weeks at an HIV clinic in India. I met many people there who had contracted HIV from blood transfusions. It is very rare in the US but it still happens. Obviously when a person donates blood in the US tests are done on the blood to be sure the donator isn’t giving the recipient any illnesses. One of the tests they do is for the HIV antibodies; the only problem with it is that if the donor isn’t aware of their HIV status, and the virus is still young in their blood, than the antibodies won’t show up in the test, and because the blood is not in a body, nothing will change until the blood is transfused into the recipient, in which case it infects them. THis is more common in countries where their testing isn’t as advanced, is more expensive, and/or in countries where there is a very large sex- or drug-trade (basically the countries where HIV is growing the most). Like I stated in the blog itself, a person can have HIV for years, infecting lots of other individuals, and never know it.
I found an article which talks specifically about HIV transmission through blood transfusions before and after 1985. Hope it helps!
http://hivinsite.ucsf.edu/InSite?page=kb-07-02-09
this is a great post! It is encouraging to hear of the number of positive medications and treatments for affected people to extend their life and hopefully lengthen the time of progression from HIV to AIDS. This would give us more time to find a cure. I have worked with people with terminal AIDS, and it is a terrible disease. I hope more research will get us a cure soon.
I think this is not only a great post, buy my gosh it stimulated some INTERESTING discussion in the comments. I love the information provided! I’ll definitely pass it on, thanks!