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AIDS Management Latest Approaches

AIDS (Acquired immunodeficiency syndrome) is a syndrome caused by a virus called HIV (Human immunodeficiency virus). As the syndrome progresses, the immune system is weakened to the point that it can no longer fight opportunistic infections eventually leading to death.

HIV is found in the body fluids of an infected person (semen, viginal fluids, blood and breast milk). The virus passes from person to person through blood to blood or sexual contact. An infected pregnant woman can pass the infection to her baby during pregnancy or through breast feeding.

Currently, there is no cure for HIV or AIDS. A multipronged approach in research and treatment has mitigated the impact of HIV and slowed down the course of the condition. HIV is now preventable and comparatively, easily treatable chronic infection. Any patient sticking to a treatment regimen and receiving optimal care can look forward to near normal lifespan. Present treatment options are far simpler, effective and less toxic than ever before.

Some of the contributing factors to the positive and significant progress made in managing HIV infection today are:

Advances in prevention

HIV prevention methods today include more than simple abstinence from sex or using condoms. Medical male circumcision goes beyond any religious sensitivities, and is now greatly believed to decrease the chances of HIV transmission and therefore is encouraged in adult males who are not circumcised at birth.

Additionally, researchers have come up with a viginal gel that significantly reduces the chances of a woman being infected with HIV. Aggressive prevention of mother to child HIV transmission has shown impressive results and is found to be very cost effective.

Treatment as prevention also works well in reducing the HIV transmission. Studies have shown that an HIV positive person, who is on antiretroviral therapy (ART), is now less likely to pass on the infection because of the lower viral load – almost to an undetectable level in their body fluids.

Advances in diagnosis and testing

The willingness of governments, medical aids, NGOs and corporations to fund HIV testing bodes well in containing the spread of HIV. Premarital testing is widely encouraged where appropriate. This made a big difference revealing one’s HIV status and creating an open communication between couples about their sexual attitudes.

Tests for HIV diagnosis have evolved over the years from 1st generation to 4th generation ELISAs, reducing the window period from 6 months to 18 days. Further, the battery of simple, accurate, rapid and readily available tests today have mobilized more people to get tested and access care.

Advances in treatment and therapy

Treatment of HIV also became simpler and cheaper because of the availability of fixed dose combinations, new formulations, low cost generic drugs and a host of refinements to existing drugs and clinical profiles. There are many classes of antiretroviral drugs targeting different phases of the HIV lifecycles for managing and preventing the emergence of drug resistant mutations.

The benefits of early ART initiation for HIV infected have caused many to lead stress and disease free life. By decreasing the risk of opportunistic infections early initiation has shifted the fight against HIV from immune restoration to immune preservation.

Synthetic peptides and Env mimic peptide drugs with low systemic toxicities are now evaluated as HIV entry inhibitors for treatment and possible candidates for HIV vaccines.

One major drawback of ART is its inability to act on viral reservoirs necessitating adherence to lifelong treatment. HIV cure now tops HIV research to avoid toxicities and cost of lifelong ART. HIV cure strategies till now include purging of the HIV reservoir by activation in the presence of anti- HIV drugs, bone marrow transplantation and gene therapy.

Efforts for developing effective vaccines and strategies for HIV cure need to be pursued relentlessly by the medical and scientific community for HIV eradication. Behavioral HIV prevention methods along with effective ART has helped stabilize the epidemic worldwide for now. However, there is a great urgency to press further by reinforcing them with biological prevention methods.