Antiretroviral (ART) Treatment for People with HIV and How It Works
The Human Immunodeficiency Virus (HIV) is a global health threat that has claimed the lives of millions since its discovery. However, over the decades, immense progress has been made in the development of antiretroviral therapy (ART) to treat HIV. This article delves into ART treatment for people with HIV and how it functions to suppress the virus.
Understanding HIV and its Replication Process HIV primarily targets the immune system, specifically the CD4 T-cells, which are pivotal for the body’s defense mechanisms. The virus replicates by inserting its genetic material into these cells, converting them into viral factories and ultimately leading to their destruction. As CD4 T-cell numbers plummet, the individual becomes increasingly vulnerable to infections, eventually leading to Acquired Immunodeficiency Syndrome (AIDS) without treatment.
What is Antiretroviral Therapy (ART)? Antiretroviral therapy (ART) consists of the use of a combination of antiretroviral (ARV) drugs to slow the progression of HIV and prevent its complications. Initiated as early as possible after diagnosis, ART has been transformational, turning what was once a fatal diagnosis into a chronic, manageable condition (World Health Organization, 2020).
Mechanism of ART ART drugs work by inhibiting the replication of the virus at different stages:
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Reverse Transcriptase Inhibitors (RTIs): HIV uses an enzyme called reverse transcriptase to convert its RNA into DNA, a necessary step for its replication. RTIs block this process. They can be further divided into nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) (U.S. Department of Health & Human Services, 2021).
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Protease Inhibitors (PIs): After the virus creates long chains of polypeptides, another enzyme, protease, chops them up into smaller, functional protein units. PIs block this enzyme, resulting in non-functional and immature HIV particles.
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Integrase Strand Transfer Inhibitors (INSTIs): For HIV to replicate, its DNA must be integrated into the host cell’s genome. The enzyme integrase facilitates this. INSTIs prevent this integration, effectively stopping the virus from multiplying.
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Entry and Fusion Inhibitors: These prevent the virus from binding to or entering the CD4 T-cells.
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Pharmacokinetic Enhancers: They don’t act against HIV directly but are used to boost the effectiveness of other antiretroviral drugs.
The combination therapy ensures that the virus is attacked at various stages of its life cycle, decreasing the chances of drug resistance.
Benefits of ART Commencing ART during the early stages of infection and adhering to the prescribed regimen provides numerous benefits:
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Viral Suppression: ART reduces the viral load (amount of virus in the blood) to an undetectable level. This doesn’t mean the virus is eradicated, but it is suppressed to a point where routine tests cannot detect it.
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Improved Immune Function: By halting the destruction of CD4 cells, the immune system remains relatively intact and can combat infections and certain HIV-related cancers.
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Reduced Transmission: An undetectable viral load dramatically reduces the risk of transmitting the virus to others, encapsulated in the “U=U” (Undetectable equals Untransmittable) message (Centers for Disease Control and Prevention, 2019).
Conclusion Antiretroviral therapy has revolutionized HIV care. While it doesn’t cure the infection, it substantially extends, and improves the quality of, the lives of those affected. Continued adherence to ART is paramount for sustained viral suppression and preventing drug resistance.
References:
- World Health Organization. (2020). Antiretroviral therapy (ART).
- U.S. Department of Health & Human Services. (2021). Types of HIV/AIDS Antiretroviral Drugs.
- Centers for Disease Control and Prevention. (2019). Evidence of HIV Treatment and Viral Suppression in Preventing the Sexual Transmission of HIV.