Anti-retroviral

Anti-retroviral therapy (ART) is a medical treatment used to manage and suppress the HIV virus in individuals who are infected. ART involves the use of several antiretroviral drugs that work by inhibiting the replication of the virus, thereby reducing the viral load in the body to undetectable levels. This helps in preventing the progression of HIV infection to AIDS (Acquired Immunodeficiency Syndrome), improving the quality of life, and reducing the risk of HIV transmission.

Overview

The goal of anti-retroviral therapy is to achieve and maintain viral suppression, which is defined as reducing the amount of HIV in the blood to undetectable levels. This does not mean the virus is completely eradicated from the body, but it helps in significantly reducing the risk of HIV-related complications and transmission to others.

Components of ART

ART typically consists of a combination of at least three drugs from at least two different drug classes. This combination is often referred to as "highly active antiretroviral therapy" (HAART). The main classes of antiretroviral drugs include:

• Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
• Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
• Protease Inhibitors (PIs)
• Integrase Strand Transfer Inhibitors (INSTIs)
• Entry Inhibitors
• Fusion Inhibitors

Each class of drugs targets a different stage in the HIV life cycle, thereby preventing the virus from replicating.

Initiation of ART

The decision to start ART is based on various factors, including the individual's CD4 cell count, viral load, the presence of HIV-related symptoms or illnesses, and the person's readiness to begin therapy. Current guidelines recommend starting ART as soon as possible following an HIV diagnosis.

Adherence

Adherence to the prescribed ART regimen is crucial for its effectiveness. Poor adherence can lead to drug resistance, treatment failure, and the need for more complex and expensive treatment options.

Side Effects

While ART has significantly improved the prognosis for those living with HIV, the drugs can have side effects ranging from mild to severe. Common side effects include nausea, headaches, fatigue, and dizziness. Long-term use of ART can also lead to more serious conditions such as cardiovascular disease, kidney problems, and bone density loss.

Future Directions

Research is ongoing to develop new antiretroviral drugs with fewer side effects, longer-lasting effects, and to overcome drug resistance. There is also significant research focused on finding a functional cure or vaccine for HIV.