HIV Care: The Top 10 Treatments You Need to Know About
HIV is a chronic, potentially fatal virus that targets the body's immune system, particularly CD4 cells, also called T cells. HIV can damage these cells over time, reducing the body's ability to fight infections and diseases. If left untreated, HIV can progress to Acquired Immunodeficiency Syndrome (AIDS), the most severe form of the disease.
Numerous advances have been achieved in the treatment and management of HIV with the advent of modern medicine. While there are currently no cures for HIV, there are effective treatments that keep the virus under control so that people with HIV, as well as those at considerable risk, may continue to live a productive life.
Below, we examine each type of HIV treatment, providing an understanding of their mechanisms and roles in managing this complex disease.
1. Antiretroviral Therapy (ART)
Antiretroviral therapy is a collection of medications that are combined to treat HIV synergistically. Multiple aspects of HIV are targeted by these medications, such as impairing virus entry into healthy tissues or retaining its ability to reproduce and mutate. ART is one of the most successful treatments for HIV, reducing viral loads in patients to undetectable levels.
The patient's immune system is also boosted by ART, in addition to reducing viral load. This ultimately enables their body to handle potential illnesses more efficiently and maintain a healthier quality of life. The approach has come a long way since it was introduced in 1996, when it was primarily just one medication called AZT. As technology advanced, ART became more easily accessible, allowing individuals with the virus to lead regular lives.
2. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
These drugs, also known as "nukes," target the reverse transcriptase enzyme, a protein HIV needs to replicate. NRTIs mimic the building blocks of DNA. When incorporated into the viral DNA, they act as chain terminators, halting the DNA chain's growth and thus stopping the virus from replicating.
3. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
NNRTIs bind to a specific pocket in the reverse transcriptase enzyme, causing a conformational change in the enzyme's active site, which prevents nucleotides from interacting properly, which results in the inhibition of DNA synthesis. In general, NNRTIs are well tolerated, but they can sometimes cause a rash and liver toxicity.
4. Protease Inhibitors (PIs)
These drugs inhibit the HIV protease enzyme, which is crucial for the virus's maturation. After HIV replicates inside a cell, it needs to be cut into specific pieces by protease for new, infectious virus particles to form. By blocking this enzyme, PIs prevent the virus from replicating and spreading.
5. Fusion Inhibitors
This class of drugs aims to prevent the virus from entering human immune cells by blocking the merging of the HIV envelope with the host cell membrane (fusion). These drugs are usually prescribed to patients who have previously tried other treatment options but still carry the virus in their bodies.
6. Integrase Strand Transfer Inhibitors (INSTIs)
These drugs inhibit the integrase enzyme, which HIV uses to insert its genetic material into the DNA of the host cell. By preventing this step, INSTIs halt the replication process of the virus.
7. Entry Inhibitors
This class of drugs blocks HIV from entering human immune cells. They do this by attaching to proteins found on immune cells that HIV uses to enter the cell. This prevents HIV from binding to the cell and slipping inside.
8. Pharmacokinetic Enhancers/Boosters
These drugs don't fight HIV directly but work to increase the effectiveness of other HIV drugs. They do this by inhibiting the breakdown of certain HIV medications by liver enzymes. This allows those medications to stay in the body longer and at higher concentrations.
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9. Post-Exposure Prophylaxis (PEP)
When HIV-infected blood or body fluids are exposed through high-risk sources, such as sexual exposure, suffering a needlestick injury, or other contact to HIV-infected blood or body fluids, this short-term treatment should be initiated as soon as possible. An HIV prevention program should be implemented within 72 hours following a recent exposure to HIV. It should be administered for 28 days.
10. Pre-Exposure Prophylaxis (PrEP)
Those who are HIV-negative and at high risk of acquiring HIV are eligible for this preventive option. It involves taking a specific HIV medicine every day to reduce the risk of acquiring HIV. PrEP has been proven to reduce HIV infection risk in people at high risk when taken consistently.
Please consult a healthcare provider for the most up-to-date treatments available, as advancements in HIV treatment are continuously being made. The best treatment for any individual depends on their overall health, CD4 count, and other factors.