How treatments give new life to patients with HIV/AIDS

PharmaAdv-HIVTreatment1If you watched HBO’s adaptation of “The Normal Heart,” based on Larry Kramer’s 1985 play about the AIDS crisis — or you’ve read or watched any of the numerous other books, movies, plays and articles on the subject — you might wonder at how much the management of HIV and AIDS has improved beyond what 1980s patients could have hoped for. Back then a person with full-blown AIDS could count life expectancy in months; now, it’s increasingly measured in decades.

That does not mean that AIDS is not a problem. In the United States alone, more than 1 million people are living with HIV.

HIV and AIDS are no longer death sentences. They are life sentences.

When it comes to the distance between the time a person is infected with HIV and the time that person develops AIDS, there are factors that cannot be changed: age, genetics, the subtype of HIV, and other viruses and infections the person is carrying. The list that a person can change is longer, and includes diet, stress management, retroviral therapy, medication, attitude, choice of physician, and heeding that physician’s advice.

PharmaAdv-HIVTreatment2Treatments include medications called NRTIs — Nucleoside/Nucleotide Reverse Transcriptase Inhibitors, commonly referred to as “nukes” — that include Didanosine, Stavudine and Tenofovir. They help to block HIV reproduction. But NRTIs can come with side effects that cause burning sensations in the extremities, kidney or pancreatic problems, lung or blood infections, nausea, tiredness, fever, muscle aches, and flu-like symptoms. Patients should ask their doctor about side effects and ameliorative treatments.

Protease inhibitors (including Liponavir, Ritonavir and Atazanavir) affect the virus at a later stage in its lifecycle. Possible side effects include liver problems, diabetes, skin reactions, malaise, insomnia, and diminished sex drive. Here, too, it is important for a patient to communicate clearly with a doctor, so that side effects can be treated immediately.

Other treatments include:

  • Highly Active Antiviral Therapy (HAART) a combination therapy in which a “cocktail” of drugs reduces the virus
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) which help to prevent new cells from being infected by HIV
  • Integrase inhibitors which interfere with one of the enzymes HIV needs in order to put its genetic material in human cells
  • Fusion inhibitors which work to stop HIV from fusing with healthy cells – a critical stage in HIV’s self-replication

The drugs that fight HIV and AIDS are themselves wearing on the body. It can be tempting for a patient to bypass a treatment, or to self-medicate for side effects.

The exciting thing – apart from extending life — is that the treatments developed since the 1980s give to HIV/AIDS patients more years in which new treatments continue to be developed. Every day around the world, researchers and physicians are working to make drugs more effective against the virus that causes AIDS, to reduce side effects, and to end the disease.

A patient with HIV/AIDS who works with their pharmacist and physician, and diminishes their risk factors (including unprotected sex, sharing needles, and eating a poor diet), might live to see the disease cured.