HIV TREATMENT

HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, specifically CD4 cells
(T cells), which help the immune system fight off infections. If left untreated, HIV can lead to the disease
AIDS (Acquired Immunodeficiency Syndrome). However, with proper medical care, HIV can be
controlled.

The primary mode of treatment for HIV is antiretroviral therapy (ART). ART is a combination of
medications that work to suppress the virus, slow down its progression, and allow the immune system to
recover. These medications are typically taken daily and are prescribed based on individual factors such
as the specific strain of the virus, overall health, and potential drug interactions.

Key points regarding HIV treatment:

Antiretroviral Therapy (ART): This is the cornerstone of HIV treatment. ART involves taking a
combination of HIV medicines to control the virus and prevent its progression. There are different classes
of antiretroviral drugs that target different stages of the HIV life cycle.

Treatment as Prevention (TasP): Taking HIV medicine as prescribed can make the viral load
undetectable, which not only benefits P the individual's health but also significantly reduces the risk of
transmitting the virus to others. This concept is known as "undetectable = untransmittable" (U=U).

Lifestyle and Supportive Care: Adopting a healthy lifestyle, including proper nutrition, exercise, and
avoiding substances like tobacco and excessive alcohol, can contribute to overall well-being.
Additionally, mental health support and adherence to medication are crucial aspects of managing HIV.

Regular Monitoring: People living with HIV should have regular check-ups and monitoring of their
CD4 cell count and viral load to assess the effectiveness of treatment. Adjustments to the medication
regimen may be made based on these results.

Preventive Measures: In addition to treating HIV, it's important to take preventive measures to avoid
opportunistic infections. This may involve vaccinations, prophylactic medications, and lifestyle
modifications.

It's important for individuals living with HIV to work closely with healthcare providers to develop a
personalized treatment plan. Adherence to the prescribed medication regimen is crucial for the success of
HIV treatment. Early diagnosis and prompt initiation of treatment can significantly improve outcomes for
people living with HIV.

GOALS OF ARTs

Antiretroviral drugs (ARVs) are medications used to treat infections caused by retroviruses, particularly
human immunodeficiency virus (HIV). The primary goals of antiretroviral therapy (ART) with these
drugs are to:
Suppress Viral Replication: Antiretroviral drugs work by inhibiting different stages of the HIV life
cycle. By doing so, they help reduce the amount of virus in the body, known as the viral load, to
undetectable levels. Suppression of viral replication is crucial in controlling the progression of HIV
infection.

Preserve or Restore Immune Function: HIV attacks and weakens the immune system, specifically the
CD4 T cells. Antiretroviral drugs help to slow down this process, preserving existing CD4 cells and
allowing the immune system to recover. The goal is to maintain or improve the overall function of the
immune system.

Prevent Opportunistic Infections: A weakened immune system in individuals with HIV makes them
susceptible to opportunistic infections, which are infections that take advantage of a compromised
immune system. Antiretroviral therapy helps prevent these opportunistic infections, improving the overall
health and well-being of individuals with HIV.

Reduce Transmission of HIV: Effective antiretroviral treatment can significantly lower the viral load in
an individual, making them less likely to transmit the virus to others. This is a crucial aspect of HIV
prevention, as it helps reduce the spread of the virus within communities.

Prolong and Improve Quality of Life: By achieving viral suppression and preserving immune function,
antiretroviral therapy helps individuals with HIV live longer, healthier lives. It contributes to an improved
quality of life by reducing the risk of HIV-related complications and enhancing overall well-being.

Prevent HIV Transmission from Mother to Child: Antiretroviral drugs are used to prevent the vertical
transmission of HIV from an infected mother to her child during pregnancy, childbirth, or breastfeeding.
This is a critical component of preventing the spread of HIV to the next generation.

CLASSES OF ARTs

Antiretroviral drugs are medications used to treat infections caused by retroviruses, primarily human
immunodeficiency virus (HIV). These drugs work by targeting various stages of the HIV life cycle,
inhibiting viral replication and reducing the viral load in the body. There are several classes of
antiretroviral drugs, each with its own mode of action. Here are the main types:

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs):

Examples: Zidovudine (AZT), Lamivudine (3TC), Tenofovir disoproxil fumarate (TDF), Emtricitabine
(FTC).

Mode of Action: NRTIs interfere with the reverse transcriptase enzyme, which is essential for the
conversion of viral RNA into DNA. NRTIs resemble natural building blocks of DNA, and when
incorporated into the growing viral DNA chain, they terminate the process, preventing further viral
replication.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs):

Examples: Nevirapine, Efavirenz, Rilpivirine.

Mode of Action: NNRTIs bind directly to the reverse transcriptase enzyme, causing a conformational
change that inhibits its activity. Unlike NRTIs, NNRTIs do not require conversion within the cell and act
directly on the enzyme.

Protease Inhibitors (PIs):

Examples: Ritonavir, Atazanavir, Darunavir.

Mode of Action: PIs target the viral protease enzyme, which is responsible for cleaving long viral
polyproteins into functional components required for viral maturation. Inhibition of protease prevents the
production of infectious viral particles.

Integrase Strand Transfer Inhibitors (INSTIs):

Examples: Raltegravir, Elvitegravir, Dolutegravir.

Mode of Action: INSTIs block the activity of the integrase enzyme, which is responsible for inserting
viral DNA into the host cell's genome. By inhibiting this process, INSTIs prevent the establishment of a
stable viral reservoir within the host cell.

Fusion Inhibitors:

Examples: Enfuvirtide, Maraviroc.

Mode of Action: Fusion inhibitors block the entry of the virus into the host cell. Enfuvirtide, for example,
interferes with the fusion of viral and cellular membranes, while Maraviroc inhibits the interaction
between the virus and the CCR5 receptor on the host cell surface.

CCR5 Antagonist:

Examples: Maraviroc.

Mode of Action: Maraviroc specifically inhibits the interaction between the viral envelope protein and
the CCR5 receptor on the surface of CD4 cells, preventing the entry of HIV into the host cell.

Post-Attachment Inhibitors:

Examples: Ibalizumab.

Mode of Action: Ibalizumab blocks the entry of HIV into CD4 cells by binding to the CD4 receptor,
preventing the attachment of the virus.

Combination antiretroviral therapy (CART), often referred to as highly active antiretroviral therapy
(HAART), typically involves a combination of drugs from different classes to target multiple stages of
the HIV life cycle and reduce the risk of drug resistance.

ARTs adherence
Adherence to antiretroviral drugs is crucial for the effective treatment of HIV (Human Immunodeficiency
Virus) and AIDS (Acquired Immunodeficiency Syndrome). Antiretroviral therapy (ART) involves taking
a combination of medications to suppress the virus and slow the progression of the disease. Here are some
key points related to antiretroviral drug adherence:

Consistent Medication Schedule: Adherence to a consistent medication schedule is vital. Antiretroviral

drugs are typically prescribed to be taken at specific times each day. It's important to follow the
prescribed dosage and timing to maintain a consistent level of the medication in the bloodstream.

Follow Healthcare Provider's Instructions: Patients should follow the instructions provided by their
healthcare providers regarding the specific antiretroviral drugs they are prescribed, including dosage,
frequency, and any special instructions regarding food intake.

Understanding the Importance of Adherence: Adherence to antiretroviral therapy is critical for

maintaining viral suppression and preventing the development of drug-resistant strains of the virus.
Consistent adherence helps to keep the viral load low, allowing the immune system to function more
effectively.

Managing Side Effects: Some antiretroviral drugs may have side effects. It's important for patients to
communicate any side effects they experience to their healthcare providers. In some cases, adjustments to
the treatment plan may be necessary to manage side effects while maintaining adherence.

Incorporating Medication into Daily Routine: Establishing a routine for taking medication can help
with adherence. This could involve taking medication at the same time each day and associating it with
another daily activity, such as brushing teeth or having a meal.

Use of Pillboxes and Reminders: Pill organizers or pillboxes can be useful tools to help individuals keep
track of their daily medication. Setting reminders, such as alarms or mobile app notifications, can also be
effective in prompting individuals to take their medication on time.

Regular Follow-up with Healthcare Providers: Regular follow-up appointments with healthcare
providers are important for monitoring the effectiveness of the treatment and addressing any issues
related to adherence or side effects. Open communication with healthcare providers can help troubleshoot
any challenges with adherence.

Psychosocial Support: Living with HIV can have emotional and psychological challenges. Having a
strong support system, including friends, family, or support groups, can contribute to overall well-being
and, consequently, adherence to medication.

Education and Counseling: Patients should receive comprehensive education about their condition and
the importance of adherence. Counseling services can provide additional support, addressing any
concerns or barriers to adherence.

Access to Medication: Ensuring a consistent and reliable supply of medication is crucial. Healthcare
systems should work to provide easy access to antiretroviral drugs to avoid interruptions in treatment.
Adherence to antiretroviral therapy plays a pivotal role in managing HIV/AIDS effectively and improving
the quality of life for individuals living with the virus. Regular communication with healthcare providers
and the use of support systems can contribute to successful adherence to medication regimens.