Currently there is no cure for AIDS. Over the past 10 years, however, therapies have been developed to fight both HIV infection and its associated health problems (infections and cancers) to help them stay healthier and live longer.
Some medications used today target HIV itself, to reduce the virus’s assault on the immune system, or to even prevent the virus from entering human immune cells. Other treatments are used to treat or prevent specific opportunistic infections that threaten the health of people with HIV-damaged immune systems.
HIV treatment has 4 major goals they are:
1. Extend patients’ life expectancy and quality of life.
2. Prevent HIV from progressing by reducing the viral load to undetectable levels.
3. Restore and preserve the immune system to normal.
4. Reduce the risk of transmitting HIV to others.
Treatments that Suppress HIV
Drugs that interfere with the activity of a retrovirus such as HIV are generally known as antiretrovirals.
Nearly all antiretroviral medications currently approved to treat HIV infection target reverse transcriptase and protease that are involved in different stages of viral replication.
A new treatment approved in the past year works in a completely new way by preventing the virus from entering the human immune cells.
Four classes of antiretroviral drugs have been developed to interfere with the activity of these viral enzymes and slow down the multiplication of the virus. These are:
I. Nucleoside analog reverse transcriptase inhibitors (NRTIs): NRTIs interrupt at an early stage of HIV replication by interfering with the activity of reverse transcriptase. AZT (zidovudine) is the first drug approved for treating HIV infection,
II. Non-nucleoside reverse transcriptase inhibitors (NNRTIs): NNRTIs also work by hindering the action of reverse transcriptase. This class of drugs includes delavirdine, nevirapine, and efavirenz.
III. Protease inhibitors: Protease inhibitors interrupt a later stage of viral replication. This class of drugs includes saquinavir, indinavir, ritonavir, nelfinavir, and amprenavir.
IV. Fusion inhibitors: Fusion inhibitors prevent HIV from entering human immune cells. The only fusion inhibitor approved to date is enfuvirtide.
Studies have found that various combinations of antiretroviral drugs are more effective in suppressing HIV than antiretroviral drugs used alone.
Experts refer to one common treatment approach, usually involving a protease inhibitor combined with two other antiretroviral drugs, as “highly active antiretroviral therapy” or “HAART”.
Drug combinations, or drug “cocktails,” also can help reduce the risk that drug-resistant HIV will develop. When drug resistance occurs, medications that initially succeeded in suppressing the replication of HIV in the patient’s body, loose their effectiveness.
Antiretroviral drugs have side effects that can limit their use in some people. AZT, for example, may result in a loss of blood cells and protease inhibitors can cause nausea, diarrhea, and other symptoms.