Management of HIV/AIDS

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection.[1] There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death.[2] HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.[3]

Treatment has been so successful that in many parts of the world, HIV has become a chronic condition in which progression to AIDS is increasingly rare. Anthony Fauci, former head of the United States National Institute of Allergy and Infectious Diseases, has written, "With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach." In the same paper, he noted that an estimated 700,000 lives were saved in 2010 alone by antiretroviral therapy.[4] As another commentary noted, "Rather than dealing with acute and potentially life-threatening complications, clinicians are now confronted with managing a chronic disease that in the absence of a cure will persist for many decades."[5]

The United States Department of Health and Human Services and the World Health Organization[6] (WHO) recommend offering antiretroviral treatment to all patients with HIV.[7] Because of the complexity of selecting and following a regimen, the potential for side effects, and the importance of taking medications regularly to prevent viral resistance, such organizations emphasize the importance of involving patients in therapy choices and recommend analyzing the risks and the potential benefits.[7]

The WHO has defined health as more than the absence of disease. For this reason, many researchers have dedicated their work to better understanding the effects of HIV-related stigma, the barriers it creates for treatment interventions, and the ways in which those barriers can be circumvented.[8][9]

  1. ^ Arachchige AS (2021). "A universal CAR-NK cell approach for HIV eradication". AIMS Allergy and Immunology. 5 (3): 192–194. doi:10.3934/Allergy.2021015.
  2. ^ Cite error: The named reference :9 was invoked but never defined (see the help page).
  3. ^ Cite error: The named reference Fauci-JAMA was invoked but never defined (see the help page).
  4. ^ Fauci AS, Folkers GK (July 2012). "Toward an AIDS-free generation". JAMA. 308 (4): 343–4. doi:10.1001/jama.2012.8142. PMID 22820783.
  5. ^ Deeks SG, Lewin SR, Havlir DV (November 2013). "The end of AIDS: HIV infection as a chronic disease". Lancet. 382 (9903): 1525–33. doi:10.1016/S0140-6736(13)61809-7. PMC 4058441. PMID 24152939.
  6. ^ "Guidelines: HIV". World Health Organization. Archived from the original on 26 March 2005. Retrieved 27 October 2015.
  7. ^ a b Cite error: The named reference :0 was invoked but never defined (see the help page).
  8. ^ Lazarus JV, Safreed-Harmon K, Barton SE, Costagliola D, Dedes N, Del Amo Valero J, et al. (June 2016). "Beyond viral suppression of HIV - the new quality of life frontier". BMC Medicine. 14 (1): 94. doi:10.1186/s12916-016-0640-4. PMC 4916540. PMID 27334606.
  9. ^ Logie C, Gadalla TM (June 2009). "Meta-analysis of health and demographic correlates of stigma towards people living with HIV". AIDS Care. 21 (6): 742–53. doi:10.1080/09540120802511877. PMID 19806490. S2CID 29881807.