Highly Active Antiretroviral Therapy
In 1996, highly active antiretroviral therapy was introduced for people with HIV and AIDS. HAART â often referred to as the anti-HIV “cocktail” â is a combination of three or more drugs, such as protease inhibitors and other anti-retroviral medications. The treatment is highly effective in slowing the rate at which the HIV virus replicates itself, which may slow the spread of HIV in the body. The goal of HAART is to reduce the amount of virus in your body, or the viral load, to a level that can no longer be detected with blood tests.
How To Prevent Hiv From Advancing To Aids
AIDS is the most advanced stage of HIV. The best way to avoid AIDS is to start antiretroviral therapy as soon as possible. Taken every day as prescribed, these drugs will keep you healthy and make your viral level so low, it canât be detected. Sticking to the right treatment can keep AIDS at bay for years and decades. It also practically eliminates the chances that youâll pass HIV to your sexual partners and others. Many HIV-positive people live normal life spans.
Treating Stds And Hiv
Its important to get tested if you think youve been exposed to any STD or to HIV. Getting proper treatment can reduce your risk of serious complications and the chance of spreading it to others. Although the treatments for STDs and HIV are different, theres some overlap.
Treating an STD can help to slow the spread of HIV in your body. But STD treatments wont prevent or stop HIV. Similarly, the antiretroviral drugs used to treat HIV wont prevent or cure STDs.
The treatments youll need for an STD depend on which one you have.
STDs caused by bacteria like chlamydia, gonorrhea, and syphilis are treated with antibiotics. STDs caused by viruses like human papilloma virus , hepatitis B, and herpes cant be cured, but treatments can reduce your symptoms and your risk of passing them on to others.
HIV is also caused by a virus and cant be cured. But treatments can stop HIV from progressing to AIDS and can greatly reduce the risk of passing the virus on to sexual partners.
In fact, people who take antiretroviral drugs as directed and have an undetectable amount of HIV in their blood effectively have no risk of transmitting the virus to sexual partners.
Viral STDs or HIV cant be cured, but many people living with them still lead full and active lives. When treated, these conditions dont cause symptoms and dont continue to damage your body. The virus will continue to live in your body, but the treatments will keep it from harming you.
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Is A Cure Possible
You may have heard of the âLondon patientâ and the âBerlin patientâ as having been cured of HIV. But their cases arenât the same as HIV remission, as they both had blood cancer and got stem cell transplants from people who had a genetic resistance to HIV.
Both were dealing with another condition — a blood cancer that wasnât helped by chemotherapy — as well as having HIV. They both got stem cell transplants from people who had a genetic resistance to HIV. The goal was to treat their cancer and also target their HIV.
Stem cell transplants arenât likely to become a common treatment for HIV, because they can have dangerous side effects.
The London patient, who is anonymous, had no signs of HIV after the stem cell transplant. The patient stayed on antiretroviral medications for 16 more months. After stopping those medications, the patient still had no sign of HIV 18 months later.
Timothy Ray Brown is the âBerlin patient.â Heâs an American who was living in Berlin when he tested positive for HIV in 1995. He started ART and lived with the virus. Eleven years later, Brown faced another health crisis. This time it was the blood cancer leukemia. To survive, he needed a stem cell transplant — a treatment that replaces unhealthy blood cells with normal ones.
Are People With Hiv At Higher Risk Of Severe Covid
The largest studies looking at the risk of severe illness have reached differing conclusions about the risk for people with HIV of being admitted to hospital or suffering severe illness due to COVID-19.
In the United States, the National COVID Cohort Collaborative analysed COVID-19 cases up to February 2021 and found that people with HIV were at 32% higher risk of being admitted to hospital with COVID-19 and 86% higher risk of requiring mechanical ventilation.
Similarly, a US study which matched people with HIV admitted to hospital with COVID-19 to people without HIV by sex, race, body mass and underlying conditions found that people with HIV were 70% more likely to require in-patient care.
However, a study of COVID-19 admissions in major UK hospitals up to 31 May 2020 found that HIV status did not affect a personâs chances of improvement after admission, when the analysis controlled for severity of illness at admission, frailty, pre-existing conditions, age and ethnicity. Nor were people with HIV at greater risk of requiring mechanical ventilation.
Each of these studies of severe outcomes found that underlying health conditions contributed substantially to the increased risk observed in people with HIV. A high prevalence of underlying health conditions such as diabetes, kidney disease and hypertension in people with HIV leads to higher COVID-19 risk but may not entirely explain it.
There are no data on âlong COVIDâ in people with HIV.
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A Second Hiv Patient May Have Been ‘cured’ Of Infection Without Stem Cell Treatment In Extremely Rare Case
By Jacqueline Howard, CNN
Researchers say they have found a second patient whose body seemingly had rid itself of the human immunodeficiency virus that causes AIDS — supporting hope that it may be possible someday to find a way to cure more people of the virus.
How Does Someone Get Hiv
The most common way people get HIV is through unprotected anal or vaginal sex with someone with HIV who is not aware of their status or not on antiretrovirals , the medications used to treat HIV. According to the U.S. Centers for Disease Control & Prevention , HIV transmission through oral sex is extremely rare.
Sharing used needles, syringes, or other drug preparation equipment increases risk of getting HIV.
HIV can be passed from mother to child during pregnancy, birth and through breastfeeding, although this risk can be almost eliminated with treatment.
HIV is not spread through sharing glasses or plates, food, holding hands, toilet seats, or other casual contact.
You cannot get HIV through closed-mouth or social kissing or saliva.
As important as knowing how HIV is spread, is knowing how it is NOT. HIV is not spread by sharing glasses or plates, food, holding hands, toilet seats, or other casual contact.
You cannot get HIV through closed-mouth or social kissing or saliva.
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Strategies To Cure Hiv
Whilst a person living with HIV can suppress the virus with antiretrovirals, there is no cure. A cure for HIV would be the total eradication of the virus from the body. However, this is not the only option that scientists are looking into. Here are some of the strategies scientists are looking into for an HIV cure.
Light Painting | JonathanCohen via Photopin
Induce And Reduce: Our Approach To Hiv Cure
HIV is a sneaky virus that can persist in a small population of cells even while its spread to new cells is being suppressed by ARVs. Unless we can find a way to expose hidden HIV and selectively target these cells, well continue to require chronic treatments to keep the virus at bay. Thats why cure research currently underway by Qura Therapeutics and ViiV Healthcare targets these pockets of virus through the concept of induce and reduce.
This strategy is first focused on driving HIV hidden in human immune cells to make viral proteins that allow the cells with HIV to be recognised . Once cells harbouring HIV are exposed, drugs can then tag these reservoir cells for elimination by the host immune system . The Induce and Reduce agents will all be given while people are on suppressive ARV therapy to protect healthy cells from the virus. While it may sound straight forward, it has been a major challenge to reactivate the virus in animals or people in an effective and safe way.
The research required to develop an HIV cure is complex and requires a commitment to the long-term. As we look ahead to the future, were optimistic that the initial steps weve taken towards establishing our approach to HIV cure will move from the laboratory into clinical studies in people, big steps in the long journey to finding a cure for HIV. It is our lifes work to end the HIV epidemic, and we will be here until HIV isnt.
Reference
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People With Hiv And Sexually Transmitted Infections
Sexually transmitted infections are very common among people who are sexually active. Anyone who has sex is at risk, including people with HIV. STIs are also commonly referred to as sexually transmitted diseases .
STIs are infections that are spread from person to person through sexual activity, including anal, vaginal, or oral sex. HIV is an STI. Other types of STIs include:
- Chlamydia
- Human papillomavirus
- Syphilis
STIs in the United States have increased in the past 5 years and are a public health crisis. Many STIs do not have symptoms, but when left undetected and untreated they can lead to serious health consequences. If you have HIV, it can be harder to treat STIs, especially if you have a low CD4 count. Thats why STI testing and treatment should be part of your regular HIV care if youre sexually active.
Hepatitis B and hepatitis C can also be transmitted through sexual contact and pose health risks to people with HIV. Read more about these viruses.
Mapping The Path Forward To A Cure For Hiv
How do you find a cure for HIV? Our approach is simple: collaboration. We realised a long time ago that we could go much further in our efforts if we worked to bring together the best brains in the business to focus on exploring every avenue, mechanism and compound towards our end goal of an HIV cure.
For that reason, ViiV Healthcare became half of a unique public-private research partnership that began in 2015 with the University of North Carolina at Chapel Hill , creating a dedicated HIV Cure center and a jointly owned new biotechnology company, Qura Therapeutics, that focus exclusively on discovering a cure for HIV.
This collaboration, the first-of-its-kind in the field of HIV cure, has unified the strengths of a world-renowned public research institution and a pioneering private industry leader. Together, ViiV Healthcare and UNC scientists became part of a joint team based in labs on the UNC Chapel Hill campus, creating and working together on several exciting areas of research to cure HIV.
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Barriers To Cd4 Recovery
A chief goal of antiretroviral therapy is to restore the immune strength of a person with HIV by preventing the virus from actively replicating. As long as ART is adhered to consistently, there generally will be an increase in the number CD4 cells detected in blood tests.
However, if this doesn’t occur, a couple of factors largely having to do with the timing of the start of medication may be to blame.
Symptoms And Stages Of Hiv Infection
FAST FACTS
- There are three stages of HIV infection. The symptoms vary in type and severity from person-to-person.
- Stage 1 after initial infection can feel like flu but not everyone will experience this.
- Stage 2 is when many people start to feel better and may last for 10 years or more. During this time a person may have no symptoms.
- Stage 3 is when a persons immune system is very badly damaged and can no longer fight off serious infections and illnesses.
- The earlier a person is diagnosed with HIV and starts treatment, the better their health will be over time.
- Some people dont get any symptoms during stages 1 and 2, and may not know they have the virus, but they can still pass on HIV.
The signs of HIV infection can vary in type and severity from person-to-person, and some people may not have any symptoms for many years.
The stages below describe how HIV infection progresses in the body if it is left untreated. Without antiretroviral treatment for HIV, the virus replicates in the body and causes more and more damage to the immune system.
However with effective treatment, you can keep the virus under control and stop it from progressing. This is why its important to start treatment as soon as possible after testing positive.
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Facts About Hiv: Life Expectancy And Long
Overview
The outlook for people living with HIV has significantly improved over the past two decades. Many people who are HIV-positive can now live much longer, healthier lives when regularly taking antiretroviral treatment.
Kaiser Permanente researchers found that the life expectancy for people living with HIV and receiving treatment increased significantly from 1996 on. Since that year, new antiretroviral drugs have been developed and added to the existing antiretroviral therapy. This has resulted in a highly effective HIV treatment regimen.
In 1996, the total life expectancy for a 20-year-old person with HIV was 39 years. In 2011, the total life expectancy bumped up to about 70 years.
The survival rate for HIV-positive people has also dramatically improved since the first days of the HIV epidemic. For example,
, a person with undetectable levels of HIV in their blood isnt able to transmit the virus to a partner during sex.
Between 2010 and 2014, the annual number of new HIV infections in the United States fell by
How To Prevent Hiv
There are more options than ever to prevent the spread of HIV, including:
- Condoms: When used consistently and correctly, condoms are highly effective in protecting against HIV, as well as many other sexually transmitted diseases . Condoms are also the only method of protection that prevents both pregnancy and disease. Like male condoms, female condoms are another barrier method of protection. Female condoms are inserted into the vagina.
- PrEP: This once a day pill is available by prescription for people who do not have HIV and want added protection. When taken as prescribed, PrEP is highly effective at preventing HIV. Studies show it is more than 99 percent effective at preventing sexual transmission, and more than 74 percent effective from drug injection transmission.
- Treatment as Prevention: In addition to improving health, antiretrovirals , the prescription medications used to treat HIV, also prevent the spread of the virus to others by lowering the amount of virus in the body, often to levels undetectable by standard lab tests. According to the U.S. Centers for Disease Control and Prevention there is effectively no risk of sexual transmission to others when the viral load is undetectable.
- Clean injection equipment: Needle-exchange programs in many cities offer free, clean syringes and provide a safe means of disposal of used ones. Only use syringes that come from a reliable source.
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What Is Hiv Associated Dementia
When someone has the human immunodeficiency virus and acquired immune deficiency syndrome they may develop a complication to the disease which is known as HIV associated dementia, or as AIDS Dementia Complex .
ADC is a complicated syndrome made up of different nervous system and mental symptoms that can develop in some people with HIV disease. The incidence of ADC is uncommon in people with the early stages of the disease, but may increase as the disease advances to around 7% in people not taking anti-HIV drugs.
Not everyone who has HIV/AIDS will develop ADC, but some will.
Is There Treatment Available
ADC can be treated to some degree and may even be preventable. The best treatments seem to be the anti-HIV drugs. Initially it was feared that highly active antiretroviral therapy would not be effective against HIV in the brain, because many of these drugs do not cross the blood-brain barrier. However recent research has shown evidence of improvements in dementia and other neurological problems due to HAART. Despite these encouraging results, there is evidence that HAART is not as effective against dementia as it is against other opportunistic infections, as dementia is related more to tissue damage rather than removal of an infective organism.
Much of the evidence for the effectiveness of anti-HIV drugs against dementia relates to the drug AZT, mainly because for many years it was the only available anti-HIV drug which crossed the blood-brain barrier to any appreciable extent.
Some of the newer drugs such as d4T, abacavir, nevirapine, indinavir and efavirenz also cross the blood-brain barrier and reduce the amount of HIV in the CSF. However, by treating the HIV outside of the brain, the immune system can recover and fight the HIV inside the brain to help reduce or prevent ADC.
Medications that can also relieve some of the symptoms of ADC include antipsychotics, antidepressants and anticonvulsants.
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How Has Treatment Improved
Antiretroviral medications can help to slow damage caused by HIV infection and prevent it from developing into stage 3 HIV, or AIDS.
A healthcare provider will recommend undergoing antiretroviral therapy. This treatment requires taking three or more antiretroviral medications daily. The combination helps suppress the amount of HIV in the body . Pills that combine multiple medications are available.
The different classes of antiretroviral drugs include:
- non-nucleoside reverse transcriptase inhibitors
- integrase inhibitors
Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing stage 3 HIV. The other benefit of an undetectable viral load is that it helps reduce transmission of HIV.
The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means that the viral load is below 50 copies per milliliter .
This discovery has led to an HIV prevention strategy known as treatment as prevention. It promotes constant and consistent treatment as a way to reduce the spread of the virus.
HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Initial reports from a clinical trial in the United Kingdom and a from the United States showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.