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| Home » About HIVAIDS » Treatment |
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| Is there treatment against HIV and AIDS?
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| Till today, there is no conclusive treatment to eliminate
HIV from the body; however, timely treatment of opportunistic
infections can keep one healthy for many years. The commonly
available treatment for AIDS is the treatment against opportunistic
infections. Normally standard treatment regimens, used against
such infections in non-HIV patients, also work well with the
HIV-positive persons. If properly treated, almost all the opportunistic
infections can be contained. |
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| However, during the last decade, researchers have developed
powerful drugs that check the replication of the virus at various
levels. Called Antiretroviral drugs, they are available in three
classes and under various brands. Taken in combinations (called
cocktail or combination therapy) under specialised medical advice,
these drugs drastically reduce the viral load in blood. However,
they do not permanently cure one of HIV. This line of treatment,
called HAART (Highly Active Antiretroviral Therapy) has resulted
in a huge reduction or AIDS-related deaths. Though many positive
persons and caregivers have welcomed these drugs, others have
experienced serious side effects. They are also very expensive
and are out of reach for a majority of the infected people.
But of late, the prices have been steeply falling. |
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| The three classes of drugs are: |
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- Nucleoside analogue Reverse Transcriptase Inhibitors (NRTIs).
NRTIs were the first antiretroviral drugs to be developed.
They inhibit the replication of HIV in the early stage by
inhibiting an enzyme (which is necessary for viral replication)
called Reverse Transcriptase. The drugs include Zidovudine
(Retrovir, AZT), Lamivudine (Epivir, 3TC), Didanosine (Videx,
ddI), Zalcitabine (Hivid, ddC), Stavudine (Zerit, d4T) and
Abacavir (Ziagen).
The major reported side effect of Zidovudine is bone marrow
suppression, which causes a decrease in the number of red
and white blood cells. The drugs ddI, ddC and d4T can damage
peripheral nerves (peripheral neuropathy), leading to tingling
and burning in the hands and feet. Treatment with ddI can
also cause pancreatitis, and ddC may cause mouth ulcers.
Approximately 5 percent of people treated with Abacavir
experience hypersensitivity reactions such as a rash along
with fever, fatigue, nausea, vomiting, diarrhea and abdominal
pain. Hypersensitivity reactions can also occur without
a rash. In either case, symptoms usually appear within the
first 6 weeks of treatment and generally disappear when
the drug is discontinued. If a person had a hypersensitivity
reaction to Abacavir, he/she should avoid taking the drug
again.
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs).
These drugs bind directly to the enzyme, Reverse Transcriptase.
There are three NNRTIs currently approved for clinical use:
Nevirapine (Viramune), Delavirdine (Rescriptor) and Efavirenz
(Sustiva). A major side effect of all NNRTIS is a rash.
In addition, people taking Efavirenz may have side effects
such as abnormal dreams, sleeplessness, dizziness and difficulty
concentrating.
- Protease inhibitors (PIs). PIs interrupt HIV replication
at a later stage in its life cycle by interfering with an
enzyme known as HIV protease. This causes HIV particles
in the body to become structurally disorganized and noninfectious.
Among these drugs are Saquinavir (Fortovase), Ritonavir
(Norvir), Indinavir (Crixivan), Nelfinavir (Viracept), Amprenavir
(Agenerase) and Lopinavir (Kaletra).
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| The most common side effects of PIs include nausea, diarrhoea
and other digestive tract problems. They can also cause a significant
number of side effects when they interact with certain other
medications. That is because all PIs, to one degree or another,
affect an enzyme system in the liver that is responsible for
metabolising a large number of drugs. Newer side effects have
also appeared with the continuing and widespread use of Protease
Inhibitors. These include elevated triglyceride levels and problems
with sugar metabolism that may sometimes progress to diabetes.
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| There may also be abnormalities in the way fat is metabolised
and deposited in the body. Some people lose much of their total
body fat while others gain excess fat on the back between their
shoulders (buffalo hump) or in the stomach (protease paunch).
Right now, no one knows exactly why these abnormalities occur.
In fact, it is not even certain whether these problems are a
direct result of treatment with protease inhibitors or due to
some other cause that has yet to be identified. Similar metabolic
abnormalities have occurred in people on antiretroviral therapy
that does not include PIs. Although these body changes can be
distressing, the possibility they may occur should not stop
one from obtaining treatment for HIV/AIDS. |
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| In simple combination therapy, some physicians prescribe a
combination of RTIs. But in HAART, which in fact has made a
dramatic change in AIDS treatment, a combination of RTIs and
PIs is prescribed. |
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| People respond differently to treatment and maintaining the
drug schedule is extremely important. Indiscriminate treatment
results in drug resistance and resurgence of the viral load.
Therefore it should be taken only under expert medical advice.
Click here to consult
an expert. |
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| What about vaccines? |
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| More than a dozen HIV vaccines are currently being tested.
As of now, there is no vaccine to prevent HIV infection. |
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| What is Parent to Child Transmission? |
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| Babies born to mothers infected with HIV may or may not be
infected with the virus, but all carry their mothers' antibodies
to HIV for several months after birth. If these babies lack
symptoms, a definitive diagnosis of HIV infection using standard
antibody tests cannot be made until after 15 months of age.
By then, the babies are unlikely to still carry their mothers'
antibodies and will have produced their own, if they are infected.
New technologies to detect HIV itself are being used to more
accurately determine HIV infection in infants between ages 3
months and 15 months. A number of blood tests are being evaluated
to determine if they can diagnose HIV infection in babies younger
than 3 months. |
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| For information regarding WHO's guiding principles
for expanding testing and counselling, click
here. |
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| For information regarding UNAIDS' technical
update on counselling and HIV/AIDS, click
here. |
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| UNAIDS/WHO
Policy Statement on HIV Testing |
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