Posts tagged Antiretroviral drugs

Alternative HIV Regimens

Alternative HIV Regimens: For Those Unable to Use Efavirenz

The most commonly prescribed HIV therapies includes efavirenz, which is one of the key ingredients in stopping the spread of HIV cells through the body and keeping the immune system functioning and optimal. Efavirenz is never prescribed alone, however in combination with other anti-HIV drugs it has proven to have the greatest overall results in keeping the HIV viral load down and the immune response minimal. Unfortunately, the side effects can prevent some people from taking efavirenz. The adverse effects can include insomnia, nightmares, confusion, memory loss, headaches and depression. Along with these psychiatric disorders, efavirenz has also been known to cause birth defects in children whose mothers used the drug. Because of these consequences, it is highly recommended that anybody who suffers from certain psychiatric conditions, or any woman who believes they are pregnant, or are trying to pregnant, should not take efavirenz. Luckily, for patients who are HIV positive and unable to take efavirenz, there are alternative HIV regimens found to be effective in keeping the virus under control and unable to attack the immune system.

Researchers at the AIDS Clinic Trials Group (ACTG), have conducted a Phase III, randomized study of regimens which do not use efavirenz. They studied three different therapies given to over 1,800 HIV positive adults. The results were uniformly positive. The in-depth study closely followed the participants for 96 weeks. At the end of the study, it was ascertained that all three regimens were effective in keeping the viral loads down and keeping the immune systems healthy. There were variations in how easily patients were able to withstand any negative effects of the drugs while still gaining all of the positive effects. One regimen was clearly superior in this category – the raltegravir-based therapy – but all three were reasonable for lifelong medical regimens. These alternative HIV regimens that are effective in patients not eligible for efavirenz has provided another outlet of hope for first line defense against HIV infection.

HIV Infected Stimulant Users

HIV Infected Stimulant Users: Treatment Benefits

Some studies in the mid 90’s pointed to evidence that stimulants – such as cocaine or methamphetamine – were causing the antiretroviral therapy to be less effective against HIV. For example, HIV infected stimulant users were developing AIDS more frequently than non-using infected. The most recent studies, however, have shown that this evidence was misleading, and that antiretroviral medication does indeed have the same effects on stimulant users and non-users. The evidence was not taking into account the difficulty many stimulant users, especially those who abused these kinds of drugs, have had to obtain their needed medication. Much of this stemmed from a belief that users of these kinds of drugs would also abuse the antiretroviral medication, or would not take the medication properly.

The new data, collected between 1996 and 2012, shows that stimulant users frequently take their medication at the proper intervals, even when they are unable to lessen or stop their respective stimulant substance. This proved that not only do these infected take their medication as directed, the effects of the medication are nearly identical to non-using infected patients. The concern that still lingers concerning HIV infected stimulant users, however, is the spread of the disease due to their drug-related activities. The latest study, out of the Multicenter AIDS Cohort Study (an ongoing study of HIV infected men who have sex with men), has concluded that the biggest focus researchers should now have when dealing with HIV infected stimulant users is education and prevention. One thing the study noticed is that stimulant users are more likely to be open and forthright with their physician—if that doctor is a specialist in HIV and infectious diseases (as opposed to a general physician or one who specializes in drug use and abuse). Even when the patients are not ready to go to a group or doctor for help with their drug habits, they are ready to work with an HIV specialist to ensure their life with HIV is as healthy as possible.

New Anti-HIV Drugs

New Anti-HIV Drugs: Research in Stopping AIDS

In December of 2013, researchers at the University of Minnesota published some very striking and uniformly positive findings in the fight against HIV. They discovered several compounds that uniquely targeted HIV cells. These compounds – ribonucleoside analogs 8-azaadenosine, formycin A, 3-deazauridine, 5-fluorocytidine and 2’-C-methylcytidine – stop HIV replication by blocking DNA synthesis. This is achieved by causing the HIV cells to drop their DNA load before they are ready to and not within blood cells. The compounds also cause the HIV cells to mutate so rapidly that the cells essentially mutate themselves into extinction. The findings were a surprise to most of the anti-HIV research community, because the compounds in question were not on anyone’s radar. In fact, they seemed to have no potential for stopping HIV. Another major benefit to these compounds is the low cost of synthesizing them into new anti-HIV drugs. This is always an important factor, as it lessens the burden for the future prevention and treatment of HIV.

In fact, this is what has been occurring over the past year. The new anti-HIV drugs, which were synthesized version of these compounds, have been introduced in tangent with currently approved HIV medications. So far, the reports have been positive. Although the drugs do not fully eradicate HIV from an infected person’s system, the new drugs can be used along with lower doses of more expensive medications. With this tandem approach, the infection is kept low and extremely manageable. Having a minimal viral load results in low immune activity and prevents the virus cells from spreading throughout the body. Because of this symptoms are virtually absent. This translates into lower costs for a lifelong regimen of anti-HIV medication, both for the individual patients and for health care systems worldwide.

Life After AIDS

Life After AIDS: A Realistic Timetable

Up until 2001 and the advent of antiretroviral (ART) medications, HIV and AIDS was considered an epidemic, with death almost a certainty. Or, at least this was the case for those who were not wealthy or heavily covered by health insurance. AZT, the first popular antiretroviral drug, was extremely expensive. It was also only available in limited quantities, as manufacturers strained to produce enough of the drug for the needs of the worldwide population. This has all changed. Because of new research, a greater awareness of HIV, and insight into what the virus is and how it works, many scientists and doctors are reasonably hopeful in a future life after AIDS. In fact, some are even creating realistic timetables as to when this could be realized.

There is still no known cure for HIV infection. It is this virus – when left untreated – that causes acquired immune deficiency syndrome (AIDS). There are several drugs available today, however, which can either deactivate HIV cells or kill them outright. Through a regimen of these drugs, a person can survive with HIV for many years, even decades, without ever developing AIDS.

Moreover, this new phase of research into anti-HIV medications has resulted in an outpouring of education and understanding about the virus and disease. Certainly, the stigmas that were once attached to AIDS in the 1980’s have lessened. Because of the new treatments and changing attitudes, many have come forward to be tested who, in the past, might have assumed they would die and didn’t come forward for treatment to avoid the ‘shame’ of being HIV positive. Thanks to this domino effect of research and awareness the number of deaths from AIDS, although still unacceptably high, has been drastically reduced to 3 million per year. It has also led to fewer new infections from HIV, which numbers around 3.5 million per year.

In impoverished countries, those without adequate access to drug therapies, medical facilities, and proper HIV education, the number of deaths to AIDS along with new cases of HIV is still on the rise. This is the biggest hurdle to achieving the lofty goal of a life after AIDS. Even so, with the dramatic results in the past 13 years in countries like the United States, many are hopeful that by the later end of the 21st century, it is possible there will be no new infections. This will only happen when drugs have advanced to the point that they can completely sterilize the virus and when said drugs are accessible to everyone in the world.

Computers Against HIV

Computers Against HIV: A Striking Ally

Research into eliminating HIV and AIDS has always been a battle against time. Certain compounds that were once successful in destroying the virus cells, or in causing them to become sterile or inefficacious, are now worthless against the virus. This is a direct result of the ability of HIV to constantly mutate and adapt. Thus, new compounds are continually needed, and new methods of treatment are constantly sought after. One group of researchers, based at the University of Southern Denmark, are exploring methods that would accelerate the very process of finding new compounds that can be used against the HIV cells. What they’ve successfully done is to use computers to find potential compounds against HIV—at a rate magnified by several hundred percent! It might be said, then, that the use of computers against HIV has enlisted a formidable new ally in the war against HIV.

The problem is not the lack of compounds that have the potential to destroy or effectively stop the HIV cells. These days, scientists are able to reproduce almost anything imaginable in their laboratories. The problem is to effectively find and identify those compounds. By using computers based on quantum physics – which speed up processing times by several fold – the researchers at USD were able to pinpoint compounds that have varied effects on the HIV cells.

Many of these compounds do not kill the cells outright but, instead, stop HIV cells from being able to reproduce. ‘HIV is a retrovirus that contains enzymes which make it able to copy itself with the help of host genetic material and thus reproduce. If you can block these enzymes’ ability to replicate itself, the virus cannot reproduce.’ This is according to Vasanthanathan Poongavanam, a member of the research team at Southern Denmark. The group was able to identify 25 promising compounds. When the 25 compounds were then tested using the group’s advanced computer systems the field was narrowed to 14, which inhibited the virus’s ability to reproduce. ‘It took us only a few weeks to find these 14 very interesting compounds, whereas before it would have taken years.’ All of this illustrates that using computers against HIV has brought a daunting new player onto the field.

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