Anti-retroviral therapy

Anti-retroviral Therapy

Anti-retroviral therapy (ART) is a medical treatment used to manage and control the infection caused by the Human Immunodeficiency Virus (HIV). ART involves the use of a combination of anti-retroviral drugs to suppress the viral load in a patient's body, thereby improving immune function and reducing the risk of HIV-related complications.

History

The development of anti-retroviral therapy began in the late 20th century, with the first drug, Zidovudine (AZT), approved in 1987. Since then, numerous other drugs have been developed, leading to the highly effective combination therapies used today.

Mechanism of Action

ART works by targeting different stages of the HIV life cycle. The main classes of anti-retroviral drugs include:

• Nucleoside Reverse Transcriptase Inhibitors (NRTIs): These drugs mimic the natural building blocks of DNA, causing premature termination of the viral DNA chain.
• Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): These bind to and inhibit the reverse transcriptase enzyme, preventing the conversion of viral RNA into DNA.
• Protease Inhibitors (PIs): These inhibit the protease enzyme, preventing the maturation of viral proteins necessary for the assembly of new virions.
• Integrase Inhibitors: These prevent the integration of viral DNA into the host cell genome.
• Entry Inhibitors: These block the virus from entering host cells.

Treatment Regimens

ART typically involves a combination of three or more anti-retroviral drugs from at least two different classes. This approach is known as Highly Active Anti-Retroviral Therapy (HAART). The goal is to achieve and maintain an undetectable viral load, which significantly reduces the risk of HIV transmission and progression to Acquired Immunodeficiency Syndrome (AIDS).

Side Effects

While ART is generally well-tolerated, it can cause side effects such as nausea, fatigue, and metabolic changes. Long-term use may lead to complications like cardiovascular disease and bone density loss.

Adherence

Adherence to ART is crucial for its effectiveness. Missing doses can lead to drug resistance, making the virus harder to treat. Patients are encouraged to maintain a strict medication schedule and communicate with healthcare providers about any challenges they face.

Impact

ART has transformed HIV from a fatal disease to a manageable chronic condition. It has significantly reduced HIV-related morbidity and mortality and improved the quality of life for millions of people living with HIV.

Also see

• HIV/AIDS
• Viral Load
• CD4 Count
• HIV Prevention
• HIV Vaccine