It’s no longer a death sentence.
The human immunodeficiency virus (HIV) attacks white blood cells, leaving you vulnerable to even minor infections. The term HIV is sometimes and incorrectly used interchangeably with acquired immune deficiency syndrome (AIDS).
AIDS is the result of long-term untreated HIV, and despite being called late-stage HIV or advanced HIV disease, Avert chronicles explained how AIDS was discovered first.
This was in 1981 when supposedly healthy individuals were diagnosed with a serious infection that typically happens to the severely immunosuppressed. In 1983, scientists were able to pinpoint HIV as the virus that caused AIDS.
In those days, being diagnosed with HIV was a death sentence — it was novel and incurable. However, following scientific advancements, people with HIV can now have long and normal lives with proper treatment. The first HIV drug, zidovudine, became available only in 1987. While it was a failed cancer drug from the 1960s, it proved able to block the proteins that HIV needed to spread inside the body. However, having only one drug meant the virus could mutate so the medication would eventually be rendered ineffective.
The 1990s saw a wave of new kinds of drugs — such as saquinavir, which stops the virus from copying itself, and combination pills, which contained two anti-HIV drugs. As of present writing, there are at least 30 HIV medications that people can take to effectively manage the virus. Below is a quick rundown of the classifications:
First on this list is the combination pills, which are actually the most commonly prescribed drugs for people with HIV. These were invented because people often quit their HIV treatment because they had to take multiple pills a day — combination pills made it easier for people to stick to the treatment. Most combination pills out there contain three or more anti-HIV drugs, such as Triumeq and Genvoya.
A study on Wiley Online Library says that these remain the standard as they reduce mortality by lowering the number of resistant mutations. However, those who can’t tolerate or afford three-drug pills can still opt for two-drug pills like Combivir.
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
NRTIs keeps HIV from multiplying by preventing it from correctly copying its RNA into DNA. The previously-mentioned zidovudine falls under this kind of anti-HIV drug. It’s worth noting that some NRTIs, on their own or in combination with other medications, are referred to as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medicines.
SymptomFind features these two in their health guide on HIV, explaining that PrEP pills like Truvada can protect you from getting HIV as long as you take it before you potentially get exposed to the virus. Taking this drug daily will lower your chances of getting it. Meanwhile, PEP medicines like Retrovir are taken as soon as possible after potential exposure to HIV. These can usually prevent you from being infected, though they must be used within 72 hours of the exposure and continued for 28 days.
Protease Inhibitors (PIs)
HIV uses the enzyme protease to replicate itself. As the name of these drugs suggests, PIs block the actions of protease so HIV can’t multiply. Saquinavir, the first anti-HIV drug after zidovudine is one such drug. While these might seem effective, using single-agent PIs may result in drug-resistant HIV. To prevent this, and to make the drugs fully effective, they’re used in combination drugs, such as Evotaz. There are combination pills that contain only PIs, such as Kaletra (having lopinavir and ritonavir), but they’ll still need to be taken with other anti-HIV pills.
Interestingly, a previous article we wrote on WHO drug trials talks about how Kaletra was also initially used in COVID-19 trials due to the similarities of the viruses. But it was discontinued when the drugs failed to reduce mortality.
HIV treatment has improved greatly since the first anti-HIV drug. Proper treatment will enable those with HIV to live a full and typical life. It’s no longer a death sentence.
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