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About 30 years ago , getting test as HIV positive spelt doom ; however , thing have changed now and undecomposed news is now HIV is a condition which can be care efficiently with the correct treatment and medicines.(1 , 5 )
get us be clear and first remark that as of now there is no cure for AIDS or HIV . However , there have been some remarkable measure fore in the clinical sympathy and discourse of the progression of HIV , which allows affected role hurt from it to be best and long lives.(1 )
Let us now delve deep into the HIV intervention present today and the essence of it on the patients and the hereafter of the HIV treatment .
What is the Primary Treatment for HIV and How Do The HIV Medicines Work?(1, 5, 7, 8)
In today ’s time , antiretroviral medications are the primary treatment for HIV.(1)Antiretroviral medications work by suppressing the virus and lessen its progress in the body . These medicine can not remove the virus or the disease from the body , but can suppress the computer virus such that it can not be detected in many cases . If an antiretroviral medicine is good and works for a patient , then it can contribute greatly in productive and healthy years to the affected role ’s life along with decreasing the hazard of transmission to other masses .
Different Types of Antiretroviral Drugs(9)
There are five categories of antiretroviral treatment prescribed for HIV positive affected role and these are :
What are the FDA Approved Medications for HIV Treatment?(3)
The keep up medications have been approved by FDA for handling of HIV .
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
NRTIs are the medications that prevent cellular phone which have HIV in them from duplicate themselves by hindering the reconstruction of the DNA concatenation of the virus when it utilizes the enzyme reverse transcriptase . Some of the medications in this class are : lamivudine ; abacavir ; zidovudine ; emtricitabine ; tenofovir alafenamide fumarate and tenofovir disoproxil fumarate .
Tenofovir alafenamide fumarate is utilized in various combining pills for process HIV . This drug when used by itself has have tentative approval for the discussion of HIV and has been approved by the FDA for treatment of chronic hepatitis B infection . Some of the other drugs in this category that can be used for address hepatitis B are : tenofovir disoproxil fumarate , lamivudine and emtricitabine .
Zidovudine is also known as AZT or azidothymidine was the first FDA approved drug for the treatment of HIV . Nowadays , this medicine is more commonly used as post - exposure prophylaxis in neonate with mother who are HIV - positivist .
Some Of The Combination NRTIs Are:(11 )
Integrase Strand Transfer Inhibitors (INSTIs)
This course of drugs work by disenable integrase , which is an enzyme used by HIV to place DNA of the HIV into the desoxyribonucleic acid of the humanity within the CD4 T cells . INSTIs are a part of the stratum of drugs term as integrase inhibitor , which are well - established drug . Other categories of integrase inhibitors like integrase binding inhibitors ( INBIs ) are known as experimental drugs , which are yet to receive blessing from the FDA .
Medications belong to the INSTIs are : dolutegravir ; raltegravir ; elvitegravir ; and bictegravir .
Protease Inhibitors ( PIs):Protease inhibitor work out by disabling the enzyme proteinase , which is call for by HIV as a part of its life cycle . Some of the medications belonging to this family are : darunavir ; atazanavir ; indinavir ; fosamprenavir ; lopinavir ; Ritonavir ; nelfinavir ; ritonavir ; tipranavir ; Norvir and saquinavir . The medications saquinavir , nelfinavir and indinavir are rarely used due to their side effect .
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
This social class of medicinal drug work in treatment of HIV by preventing the HIV from duplicating itself and inhibiting the enzyme rescind transcriptase . Some of the drugs belong to the class of non-nucleoside reverse transcriptase inhibitor are : nevirapine ; efavirenz ; doravirine ; etravirine and rilpivirine .
Entry inhibitor : Entry inhibitors work in treating HIV by blocking HIV from go in the CD4 T cells . medicament belonging to this category are : ibalizumab - uiyk ; maraviroc and enfuvirtide . This class of drug is rarely used as first - line HIV treatment .
Antiretroviral Therapy : The HIV can alter and grow resistance to a single medication . This is the reason why many health care professional take to order multiple HIV medicine together . Antiretroviral therapy is where combining of two or more antiretroviral drugs are used for treating HIV . This is the usual line of discourse prescribe for patient diagnosed with HIV .
Antiretroviral therapy was first bring in in 1995 and thanks to this effective therapy , deaths related to AIDS in America were decreased by 47 % between the old age 1996 and 1997.(12)The commonly prescribed medication regime contains two NRTIs and either an NNRTI or INSTI or a PI boosted with cobicistat . New data has emerge that supports the use of only two drugs like INSTI and an NNRTI or NSTI and an nucleoside reverse transcriptase inhibitor .
The procession in the HIV medicine are also do it easier for a patient role to adhere to their intervention regime . Thanks to these advances , a person diagnosed with HIV necessitate to not take increased amount of medications needed as antecedently . These raw HIV handling also have less phone number of side outcome for many patient using antiretroviral medicine . Last but not the least , these advancement in HIV treatments also consist good drug to drug interaction profiles .
Adherence to the Treatment is the Key to Successful Treatment of HIV(13, 14)
The meaning of adherence is sticking and continuing with the prescribed treatment plan for HIV . Adherence is vital for treatment of HIV . If a patient with HIV is not taking their medicinal drug as prescribed , then the drugs will not work as in effect or stop figure out altogether resulting in progression of the computer virus . Adherence mean being diligent and take every single dose , day by day as advise by the MD .
Combination Pills a Great Boon for HIV Patients(15)
One major and important advancement that is make life promiscuous and discussion regime easier for HIV patients be antiretroviral therapy is the forward motion of combination pills . These combination medications are the commonly dictate treatment for patient role suffering from HIV and who have n’t sought discourse before .
compounding pills are those which have more than one drug in a undivided pill . As of now , there are eleven combination pill for HIV intervention that have two antiretroviral drug . presently about 12 compounding pill are there which have three or more antiretroviral drugs in them .
The most recommended drug regime for discourse of HIV is the INSTI - base combination tablets , as they are not only effective , but cause few side effect when compared to other discourse regime . Some of the examples consist of Genvoya , Triumeq and Biktarvy .
Atripla is an HIV drug that was sanction by FDA in 2006 and was among the first effective combination oral contraceptive containing three antiretroviral drug . However , this medicine is used very less now because of its side effects that let in modality changes and sleep disturbances .
Single-Tablet Regimen (STR)
A unmarried - tab regimen ( STR ) is also a treatment plan which consist of a single tablet with a combination of about three antiretroviral drugs in it . However , there are a few new combinations which comprise two - drug from different classes and are approved by FDA as double-dyed treatment regime for HIV and they also are term as STRs .
Even though compounding pills are the up-to-the-minute development in the HIV treatment and they show beneficial results too , not every affected role may be suited for this variety of drug therapy . It is important for the patient and the Doctor of the Church to have discussion regarding this and decide on the suitable treatment plan according to each patient .
What is the Outlook of Treatment for HIV?(2)
young therapies are acquire and find more ground each year with regards to treating and finding a possible cure for HIV . Research is going on regarding antiretroviral nanosuspensions for bar and treatment of HIV . These medications need to be taken every four to eight week and this could improve the adherence rate by trim down down on the amount of medications a patient role call for to take .
A combining of rilpivirine with cabotegravir chip in in a monthly injectant manakin is mean to be uncommitted soon for HIV-1 contagion intervention .
A hebdomadary injectant known as Leronlimab show promise effect in affected role who are resistive to or not respond to HIV discussion in clinical trials.(16)This injection has gotten the status of “ Fast Track , ” which will fasten the development cognitive process of this particular drug.(4 , 16 )
Research is going on for development of HIV vaccine and is showing skilful results.(17 )
To know more about the latest HIV discourse and the medicines useable now or in the future tense , keep in mite with your pharmacist or health care professional .
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