AIDS

AIDS is an acronym for Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome and is defined as a collection of symptoms and infections resulting from the depletion of the immune system caused by infection with HIV. Although treatments for both AIDS and HIV exist, there is no known cure. The rate of clinical disease progression varies widely between individuals and has been shown to be affected by many factors such as host susceptibility, immune function, health care, the presence of co-infections and peculiarities of the viral strain.

Treatment

There is currently no cure or vaccine for HIV or AIDS. Current optimal treatment options consist of combinations ("cocktails") consisting of at least three drugs belonging to at least two types, or "classes," of anti-retroviral agents. Typical regimens consist of two nucleoside analogue reverse transcriptase inhibitors (NRTIs) plus either a protease inhibitor or a non nucleoside reverse transcriptase inhibitor (NNRTI). This treatment is frequently referred to as HAART (highly-active anti-retroviral therapy). http://www.hab.hrsa.gov/tools/HIVpocketguide05/PktGARTtables.htm#ARTtable3 Anti-retroviral treatments, along with medications intended to prevent AIDS-related opportunistic infections, have played a part in delaying complications associated with AIDS, reducing the symptoms of HIV infection, and extending patients' life spans. Over the past decade the success of these treatments in prolonging and improving the quality of life for people with AIDS has improved dramatically. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12646794&query_hl=5, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12957089&query_hl=9.

Related Topics:
HIV - Anti-retroviral - Nucleoside analogue reverse transcriptase inhibitors - Protease inhibitor - HAART

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However, treatment guidelines are changing constantly. The current guidelines for antiretroviral therapy from the World Health Organization reflect the 2003 changes to the guidelines and recommend that in resource-limited settings (i.e., developing nations), HIV-infected adults and adolescents should start ARV therapy when HIV-infection has been confirmed and one of the following conditions is present:

Related Topics:
World Health Organization - 2003

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• Clinically advanced HIV disease:
• WHO Stage IV HIV disease, irrespective of the CD4 cell count;
• WHO Stage III disease with consideration of using CD4 cell counts <350/µl to assist decision-making.
• WHO Stage I or II HIV disease with CD4 cell counts <200/µl

The US Department of Health and Human Services, the federal agency responsible for overseeing HIV/AIDS healthcare policies in the United States, have recently stated on April 7, 2005 that:

Related Topics:
April 7 - 2005

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• All patients with history of an AIDS-defining illness or severe symptoms of HIV infection regardless of CD4+ T cell count receive ART.
• Antiretroviral therapy is also recommended for asymptomatic patients with <200 CD4+ T cells/µl
• Asymptomatic patients with CD4+ T cell counts of 201?350 cells/µl should be offered treatment.
• For asymptomatic patients with CD4+ T cell of >350 cells/µl and plasma HIV RNA >100,000 copies/ml most experienced clinicians defer therapy but some clinicians may consider initiating treatment.
• Therapy should be deferred for patients with CD4+ T cell counts of >350 cells/µl and plasma HIV RNA <100,000 copies/mL.

The preferred initial regimens are either:

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• efavirenz + lamivudine or emtricitabine + zidovudine or tenofovir; or
• lopinavir boosted with ritonavir + zidovudine + lamivudine or emtricitabine.

The DHHS also recommends that doctors should assess the viral load, rapidity in CD4 decline, and patient readiness while deciding when to begin treatment. http://aidsinfo.nih.gov/other/cbrochure/english/cbrochure_en.html#03

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There are several concerns about antiretroviral regimens. The drugs can have serious side effects (Saitoh et al., 2005). Regimens can be complicated, requiring patients to take several pills at various times during the day. If patients miss doses, drug resistance can develop. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12617573&query_hl=1 Also, anti-retroviral drugs are costly, and the majority of the world's infected individuals do not have access to medications and treatments for HIV and AIDS.

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Research to improve current treatments includes decreasing side effects of current drugs, simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage drug resistance.

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Alternative medicine

Ever since AIDS entered the public consciousness, various forms of alternative medicine have been used to treat its symptoms. In the first decade of the epidemic when no useful conventional treatment was available, a large number of people with AIDS experimented with alternative therapies (massage, herbal and flower remedies and acupuncture). Interest in these therapies has declined over the past decade as conventional treatments have improved. People with AIDS, like people with other illnesses such as cancer, also sometimes use marijuana to treat pain, combat nausea and stimulate appetite.

Related Topics:
Alternative medicine - Acupuncture - Cancer - Marijuana

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