Treatment of HIV

The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: “Why not self-medicate?”. Treatment of HIV is a series of treatment and preventive measures aimed at maintaining a normal standard of living for the patient. Medicine continues to carefully study both the immunodeficiency virus itself and ways to deal with it. Despite the lack of a single cure, science has advanced far in infection control. New generations of drugs make it possible to equalize the life expectancy of HIV-positive and HIV-negative people. But the treatment process still requires a lot of effort from the patient, his relatives and doctors.

Is it possible to fully recover

It is impossible to get rid of the virus completely. In 2010, at a conference at Johns Hopkins University, scientists reported that they had completely cured an infant of HIV infection. A Mississippi girl was born with the virus in her blood. Usually, HIV-positive children are given active therapy from the age of 4 weeks, she was also prescribed a course of potent drugs on the first day after birth.

Aggressive treatment was followed by a standard course of treatment for a year and a half. After that, the mother of the girl from Mississippi refused therapy for the child. All tests during treatment and 10 months later were negative. The child was named one of the first cured patients. However, a year later, the Associated Press announced that a pathogen was again found in the baby’s blood. ^[1].

Before the girl from Mississippi became aware of Timothy Brown. While studying in Berlin, he learned that he was HIV positive. Brown also developed leukoencephalopathy, a disorder of the white matter of the brain. The disease is fatal, and the patient underwent a complex operation for transplantation of hematopoietic stem cells. Among the donors for Brown was a man with two copies of the cell receptor. This rare phenomenon occurs in 10% of Europeans, and makes a person resistant to HIV.

After the operation, the doctors found no traces of the virus and antibodies to it in Timothy. Even after stopping antiretroviral therapy, the tests showed a negative result. Scientists believe that the donation of a person with a mutation in cell receptors led to a cure. However, this treatment comes with many risks and may not be suitable for everyone. These two cases suggest that scientists have yet to study the infection. So far, the disease is considered incurable. ^[2][3][4].

Ways to fight HIV

Medical products (drugs, medicines, vitamins, medicines) are mentioned for informational purposes only. We do not recommend using them without a doctor’s prescription. Recommended reading: “Why can’t you take medications without a doctor’s prescription?”. HIV infection quickly swept the world. From the middle of the last century to the present day, it has affected tens of millions of people around the planet. Today, the fight against HIV includes prevention for the healthy and treatment for the sick. As a preventive measure, informing the population is the main weapon. According to WHO data for 2016, the number of new infections is decreasing every year. The only regions where the epidemic is gaining momentum are Africa and Eastern Europe.

Treating the infected is hard work. For people with reduced immunity, it is especially important to carefully protect yourself from secondary infections, poor nutrition, and bad habits. The main essence of the treatment is antiretroviral therapy, which is aimed at suppressing the virus. Also, reduced immunity should be maintained with the help of immunomodulators.

An individual course of therapy is selected for each patient. It consists of drugs directed against the virus and to maintain immunity. Symptomatic therapy, treatment of secondary manifestations is carried out. Unfortunately, an infected person has to be treated for life. But well-chosen therapy is relatively easy to tolerate, and the most important medicines are provided free of charge. ^[5][6][7].

Antiretroviral therapy

The main hope for treatment relies on antiretroviral drugs (ARVs). Therapy with ARVs is called ART. Medicines of this group, unfortunately, do not destroy the pathogen, but suppress its development. Suppressing the virus also means controlling the progress of the infection. Today, 4 types of drugs are registered that affect the virus in different ways:

1. The first group is nucleopreparations. They attack the virus at the fourth stage of the development of the disease, i.e. when the pathogen is transformed into DNA. Today, 11 names of nucleopreparations are registered, which are included in complex treatment.
2. The second group is NNRTIs or non-nucleoside reverse transcriptase inhibitors. They also block the fourth stage of pathogen development, but in a different way. Only 3 such funds are registered. To prevent the virus from developing resistance to treatment, the patient may be given the first and second groups of drugs in turn.
3. The third group is protease inhibitors. Unlike the previous two, this type of drug blocks the 10th stage of pathogen development. At this stage, new HIV cells are formed from the protease enzyme.
4. The fourth group is fusion inhibitors. These are new generation drugs, they attack the virus at the second stage of its development. At this stage, the pathogen attaches itself to the cell of the infected person.

The latest generation of drugs is considered more successful and less toxic to the patient. But so far, only one type of fusion inhibitor has been registered – enfuvirtide (T-20, Fuzeon®). Antiretroviral therapy consists of prescribing several drugs to the patient at once. This tactic is aimed at preventing pathogen resistance.

The virus, getting into the blood, gradually multiplies. At the same time, its mutation frequency is very high, so each new genome is slightly different from its predecessor. Because of this feature, the infectious agent quickly develops resistance to drugs. If a patient is given single-drug ART, it will be more difficult for the pathogen to develop. With two types of drugs – to cope even more difficult. If you use simultaneously three types of agents that attack the microorganism at different stages of development, the probability of resistance is very small.

Treatment with the use of 3-4 groups of drugs of different effects is considered the most effective. Until recently, patients were forced to take a handful of tablets 5 times a day at the exact time. Today, pharmaceuticals combine drugs into one medicine. Therefore, the process of therapy becomes more and more simplified. But, unfortunately, the most advanced and effective means remain inaccessible to a large number of infected people due to the high price. ^[5][6][7].

Strengthening immunity

When infected, the pathogen develops rapidly and the patient has a sharp decrease in immune cells with CD4 (T-helpers). In a healthy person, the number of T-cells reaches 1500-1600 units per microliter of blood. In a person with another infectious disease, during the latent course of HIV infection, this figure can be halved. In fact, the entire complexity and danger of infection lies in the reduced barrier function of the body, a person cannot resist even primitive diseases. The impact on the virus should be accompanied by an increase in immunity, an “increase” in the number of T-helpers.

To support the body, the patient may periodically be prescribed immunomodulators. But the main role here is still played by the mode and quality of nutrition, living conditions. For HIV infection, you need:

• eat regularly, preferably in small portions;
• consume more carbohydrates: flour, cereals, potatoes, etc.;
• diversify the menu to get more benefit from all products;
• drink clean water and juices;
• introduce proteins into the diet: butter, nuts, beans, meat and dairy products.

In general, with an infection, it is recommended to eat hearty and consume more calories, this helps the body fight the disease on its own. It is also important for HIV-positive people not to give up sweets, sugar or honey (if there is no allergy) can be added to cereals, drinks, desserts. At the time of the progress of the disease, the patient is shown high-calorie food with a high content of carbohydrates and lipids.

Immunity support tactics also include physical activity. They should be feasible for the patient and regular. Fresh air and walks are very important. A positive mood also increases the strength of the body. You can take immunomodulators, vitamin complexes and nutritional supplements only with the permission of a doctor and in a clearly established dose. ^[5][6][7].

Symptomatic treatment

Attachment of infections is a very common occurrence for HIV. The pathogen itself does not cause illness or death, but opportunistic diseases do. These are common infections that do not pose a danger to a person with strong immunity. However, against the background of a reduced barrier function, fungi and bacteria cause complications. Therefore, in addition to direct exposure to the virus, symptomatic treatment is often indicated for HIV-positive patients.

Symptomatic therapy is a complex of therapeutic and preventive methods to eliminate the manifestations of secondary diseases. Most often, “positive” patients encounter infections of a bacterial, viral and fungal nature. These include:

• candidiasis;
• papilloma;
• pneumonia;
• tuberculosis;
• herpes;
• toxoplasmosis and others.

To maintain a normal state of health and a full standard of living, the treatment of such manifestations should begin immediately. Therapy is selected taking into account the patient’s condition, viral load, the degree of damage to the secondary disease. Particular attention is paid to the prevention of opportunistic infections: personal hygiene, immunity support, timely and professional treatment.

Self-treatment is contraindicated for HIV carriers. The attending physician should prescribe therapy against the symptoms and causative agents of associated diseases. It is better if even the headache is eliminated with the help of pills prescribed by the doctor. Any new symptoms that disturb the patient should be discussed with a specialist. All diseases associated with HIV are treatable up to the last stage. ^[5][6][7].

Chemotherapy

Aggressive treatment is used to suppress the development of the virus. Chemotherapy is usually used in the early stages of the infection and at times of special progress of the virus. There is also an opinion that in the first hours of infection, effective chemoprophylaxis can neutralize the pathogen. Today, the main hope is placed on four drugs:

• Zalcitabine;
• Didanosine;
• Zidovudine;
• Stavudin

Treatment begins with a “shock dose”, gradually reducing the number of drugs. In parallel with specific antiviral therapy, the patient is prescribed symptomatic treatment. The use of chemotherapy makes it possible to drastically reduce the activity of the virus, and then diligently control it. However, these drugs are associated with side effects, so they are used only in extreme cases. The use of chemotherapy drugs gives a chance to delay the onset of the terminal stage as much as possible ^[5][6][7].

Gene therapy

The joint work of scientists on the study of the virus and its features is bearing fruit. Not so long ago, genetic engineers proposed a completely new approach to the treatment of HIV infection. With artificially engineered DNA cells, it is possible to prevent a pathogen from attaching itself to a cell. Also, the introduction of new artificial information into the cell makes it possible to stop the appearance of viral proteins, due to which the disease stops progressing.

The fight against the pandemic will presumably be carried out with the help of cell immunization. That is, with the introduction of a special design of cells, they will become resistant to the virus. This innovation is very promising. Compared to chemotherapy and antiretrovirals, the genetically engineered solution appears to be safer. However, research on cell immunization is still ongoing. While doubts remain about whether the new transformation will change the normal life cycle of the cell ^[5][6][7].

Used drugs

Comprehensive treatment enables the patient to maintain good health and fullness of life. Along with the right lifestyle, self-improvement and sports, of course, medications are used. Medications periodically replace each other in order to better influence the virus. Also, HIV-positive people often have to use other medications for symptomatic treatment.

These drugs are intended for chemotherapy and antiretroviral therapy. They are used at different stages of the disease and in various combinations. With a special resistance of the virus, 3-4 drugs can be prescribed at the same time. In addition, to prevent the resistance of the pathogen to treatment, the patient periodically changes the tactics of therapy.

Medicines and external agents are added to the main treatment to prevent secondary infections. Methods of protection against bacteria, viruses and fungi are especially important. For disinfection of the mucous membrane and skin, it is recommended to use Miramistin, Tsiteal and other similar agents. If a secondary infection has already joined – only a doctor prescribes treatment ^[5][6][7].

Treatment at different stages

At the first stage of the disease, antiviral and “heavy” therapy is usually not prescribed. Emergency prophylaxis is indicated for people whose work is associated with a risk of infection – medical staff, employees of beauty salons and tattoo parlors, etc. In the first three days after the alleged infection, HIV chemoprophylaxis is prescribed.

The second stage is the period when the infection can be laboratory confirmed and the viral load can be established. Antiviral therapy is prescribed from the moment when the level of T-helpers drops to 0,2×10 / l. From the moment the pathogen is detected in the blood, the patient is selected for effective ART with the use of several drugs. This makes it possible to prolong the latent period and the asymptomatic course of the disease. General rules of conduct for HIV-positive people must be added to ART.

In the third stage, highly active antiretroviral therapy (HAART) is most often used. It includes the use of chemotherapy and ART, sometimes they are forced to add symptomatic treatment. Such a set of measures is aimed at suppressing a sharp increase in virus replication and maintaining acceptable immunity.

In the fourth stage, antiviral therapy is used when the proportion of pathogen RNA is more than 100 copies per microliter of blood. In the progression stage, HAART is indicated regardless of CD4 and HIV RNA levels. “Heavy” therapy is not stopped until resistance is detected or the patient’s condition improves. Children receive ART regardless of the phase of infection ^[5][6][7][8].

Is traditional medicine strong

Traditional medicine has its own answer to all cases of any disease. Considering that traditional medicine does not yet have a 100% effective cure, it is not surprising that non-traditional medicine is looking for its own ways to fight HIV infection. Today you can find recipes and recommendations for the treatment of HIV infection and even AIDS with the help of “improvised” products. For example, propolis is a blood purifier, it is recommended to chew it 3 times a day 15 minutes before meals and at bedtime.

To increase immunity, it is advised to boil oats in a ratio of 1: 5, dilute the strained jelly with milk and boil. This remedy is drunk warm three times a day. There are a lot of recipes for fighting infection. Almost all of them are aimed at increasing the body’s defenses and replenishing the reserves of nutrients. This can be very useful in immunodeficiency, so traditional medicine can adequately complement drug treatment.

However, it is worth remembering that using any methods or prescriptions without the approval of the attending physician is life threatening. ^{[9][10][11][12]}.

What should an infected person do?

At the moment when a person only learns about his HIV status, he will inevitably face a psychological trauma. Since stress is very dangerous for “positive” patients, it is important to stabilize the person’s condition as soon as possible. At this moment, the support of loved ones and work with a psychologist is one of the important stages. HIV-positive people may think that they are now a danger to their environment, although this is absolutely not the case.

Communication with an infectious disease specialist is a mandatory first step for patients. The specialist must clearly explain to the person about the stages of HIV, the upcoming treatment and the rules of behavior for patients. Infecting loved ones is not so easy if you do not do it intentionally – the virus is not transmitted in everyday life, with hugs, communication, and the exchange of clothes. Working with a psychologist or psychiatrist will help you accept – a new self and new foundations of life. Consultation of state specialists is free, so absolutely everyone can afford it.

Together with the patient, relatives should also undergo a consultation with the attending physician and an HIV test. It is important for relatives to understand that the person has not changed, is not dangerous in any way and needs support. After confirming the diagnosis, patients are prescribed therapy, which is important to comply with. Changes will also affect lifestyle, for HIV-positive people a healthy lifestyle is mandatory. It is mandatory, in principle, for everyone, but healthy people often do not think about it.

You only need to report your HIV status to work if the patient is employed in the field:

• catering;
• healthcare (ambulance drivers, nurses, workers in the reception area – they can even work with HIV);
• education and training (not always, you need to discuss your position with an infectious disease specialist);
• spa services (excluding reception and management);
• production of medicines and foodstuffs.

There is only a short list of professions that a “positive” patient cannot do. You will have to give up smoking and alcohol, monitor nutrition and add physical activity. Together with drug therapy, compliance with these rules will become the key to a fulfilling life.

It is recommended to always be in touch with your infectious disease specialist. If you need advice, he will tell you what to do in a given situation. For example, at elevated temperatures, find out which drugs can be used, and so on. In general, HIV-positive people need to understand that they are not outcasts, but life goes on. Through strict adherence to healthy lifestyle and mental health support, patients sometimes begin to live more fully than before the diagnosis. ^[4][13].

Life expectancy with treatment

European scientists have already announced that with the help of advanced drugs they managed to equalize the life expectancy of HIV-positive and HIV-negative people. Subject to the recommendations of the doctor and quality therapy, people live up to 70-80 years. The younger the patient, the more likely it is to extend life to the generally accepted average.

The use of even publicly available therapy prolongs the patient’s life by 20-30 years. Which as a result leads to a life expectancy of approximately 55-60 years. This figure is reduced by one and a half times if the patient smokes. If there are drugs or alcohol among bad habits, even with HAART, the patient’s death is predicted after 10 years on average. In the complete absence of therapy, secondary infections kill a person in 7-9 years. But the absence of stress and all the above rules give a chance to live a full and long life. ^[14].

Help with the threat of HIV infection

There are categories of people who are at risk of infection. These include not only drug addicts and gay people. Most at risk are healthcare workers and those in whose work you may encounter contaminated blood. Emergency situations and preventive measures are prescribed for them. Emergencies include injections, cuts, contact of infected fluids with open wounds and eyes.

In such situations, an urgent HIV test should be performed on someone who is suspected to be infected. If the test is positive, a loading dose of chemotherapy is given to the person who is susceptible to infection. Immediately after confirming HIV status, the incident should be reported to the nearest AIDS center. The council of doctors decides on the dosage of drugs and the appropriateness of their use.

After emergency chemoprophylaxis, the dosage of drugs is reduced to the victim. Prophylactic treatment lasts until a negative test for infection is confirmed. In the case of a positive response, a new treatment regimen is drawn up. Doctors, employees of tattoo parlors and beauty salons and other similar organizations should in no case neglect security measures. Keep 70% ethyl alcohol, iodine, and band-aids at work. At the slightest suspicion, treat the wound, undergo a test and preventive treatment, if necessary ^[15].

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