Posts tagged HIV treatment
Neurological issues have been noted in patients who had recently been infected with HIV. There are a host of conditions that are associated with HIV infection and disease progression. Most treating physicians are aware of many of these and keep a close eye on their HIV-positive patients. However, it was recently noted that as early as just a few days after the infection, certain symptoms and issues can present in patients not yet diagnosed or treated for HIV infection. Many have been diagnosed with HIV after presenting with neurological symptoms.
A Study Reveals How Common Neurological Issues Are
In a recent study, a group of individuals was followed to find out more about early HIV infection and its effect on the nervous system. Participants all had recently been infected. For some, it had been only a few days, and for others, it was up to two months since the time of infection. Out of those followed, over half presented with neurological issues, including neuropathy (disease of the nervous system), cognitive trouble, and motor difficulties. In many instances, patients had experienced more than one type of the mentioned issues. In rare instances the conditions were severe.
The Benefits of Treatment in Reducing Neurological Symptoms
Such early stages of infection are generally undetectable by standard HIV testing as the immune response has yet to build. Neurological symptoms were noticed before any others in most cases. Once antiretroviral therapies were started, 90% of the neurological issues were resolved. For some, lingering symptoms were observed even after months of treatment. When researchers compared the lab tests, those with persistent symptoms also had higher viral levels in the blood. These findings show that the virus has a profound effect on the nervous system. The good news, however, is that most of the conditions cleared up with treatment.
Study on the subject is ongoing. Other issues as well are brought to light. For example, in the development of new treatments against HIV, researchers are considering taking into account the role of the brain and nervous system. Some theorize that latent HIV could be lurking in these areas, therefore causing issues early on. So new questions are raised, and delving further into the topic continues.
Around the globe, 37 million individuals are HIV-positive. While that figure is staggering enough, it is estimated that nearly half of all infections are left undiagnosed. Advancements in therapies, preventative education, and a better understanding of how the disease works, all aid in slowing the epidemic. However, if the infection is left undiagnosed, it works against progress, and millions could be at risk for exposure or infection.
With this is mind, researchers have been looking into simple ways to encourage patients to be tested for HIV. They are hoping that what they learn will help medical institutions around the world to be able to convince more people to agree to screening.
Asking Patients the Right Way
It is all in the approach. This is what has been most notable throughout these studies. How a question is phrased can make the difference between someone agreeing to HIV testing—or refusing the exam. Basically, here are three ways to approach:
- Notifying the patient that testing for HIV is available, and that he or she could request the test if they wanted (also called the opt-in approach). This approach yielded the poorest result, with just over one-third of those asked accepting an exam.
- Using the “active choice.” In this instance, a patient was asked directly if he or she would like an exam. This second phrasing came up with better results than the first. Over half of the patients who were asked directly, agreed to the testing.
- The “opt-out” approach simply informed patients that they would be tested for HIV unless they declined. Two-thirds of those who were informed this way were tested, making this approach the most successful.
The Right Method Gets Results
During these trials, patients who were in higher risk categories were more likely to agree to testing than those in lower risk groups. This reaffirms that how a patient is asked can make a big difference in the outcome. It is not completely understood why patient behavior varies with how questions are phrased, but a few simple changes in how healthcare workers ask their questions can do a lot of good.
HIV-positive individuals can lead long, happy lives. They are, however, dependent on the prescription drugs that keep the infection at bay. This dependency is a lifelong one. Current therapies aid the immune system to contain the virus. If left alone, the immune system would soon be overwhelmed by the virus – thus the constant need for assistance. This was the fact that researchers focused on when examining the reaction of the immune system towards the virus when this prescription drug was applied. The results have many hopeful that in the near future, lifelong therapies will not be necessary to fight off or protect against infection.
What Prescription Drug?
The enzyme adenosine deaminase is the prescription drug getting the attention here. It already exists in the pharmaceutical world, and scientists are looking to repurpose it to target HIV. What the studies proved was that exposure to this enzyme empowered the immune system in a couple of different ways.
First, immune response was increased. Important CD4 and T cells hurried to the call and took care of the invading virus. The next observation was also impressive, as it showed an increase in memory for the T cells. Next time they encounter HIV, the cells will remember and be able to eliminate it from the host. This is crucial information for researchers investigating how to reduce treatment length. If the immune system can respond efficiently on its own, and then recall that response when threatened again, lifelong therapies may be done away with.
Should adenosine deaminase be able to boost the immune system to the point researchers have seen, it could mean better control of HIV infection. This control could also rely mostly on the immune system, with little fear of a reoccurring infection. Long-term management of the disease could see less dependency on antiretroviral therapies. It is hoped that further study and advocating for the prescription drug is expedited to help out in this regard.
Until the time comes when such medications are ready for use, though, it is vital for those with HIV to stick to their daily treatment routine in order to halt disease progression.
HIV treatments for children is different from treating adults – particularly, for those under three years of age. Doctors have little in the way of guidelines for such treatment. Studies focus on determining which treatments are the most beneficial, with the least long term damage.
Often HIV positive women who are pregnant are given the pharmaceutical drug nevirapine to protect the fetus from transmission. Unfortunately, the drug prevents HIV transmission by only 50%. However, in the event the child does contract HIV, research indicates that, once born, these children can transition from the common treatment for infants to the drug used to treat adults. The drug used for adults is efavirenz, and is not usually administered to persons under the age of three. For infants, a completely different class of drug is used as HIV therapy. Lopinavir/ritonavir is the recommended choice, thus far, for HIV-positive children under three. However, when little ones– those who had exposure to nevirapine in the womb– were given efavirenz, research yielded favorable results.
Researchers were pleasantly surprised by the effectiveness that the changeover brought about. Viral rebound was similar as with the use of the lopinavir/ritonavir. More promising than those results were the CD 4 T-cell counts. These are immune cells that are targeted by the virus. This deadly attack greatly reduces the number of these important immune cells. In children treated with efavirenz, the CD 4 T-cell count was higher than in children provided with the recommended drugs for their age group. In under a year’s time, liver function also proved better than those on the traditionally used medications.
In conclusion, so far, as long as an infant has their infection under control, HIV treatments for children using nevirapine can safely be transitioned to efavirenz. From the studies completed and research gathered, researchers still need further studies to show more results. At this time, the results appear promising though. Experts also plan to investigate long-term effects. In the meantime, finding gentler and more effective ways to treat little ones is high on the priority list.
As HIV prevention, testing and treatment continue to advance, HIV positive patients on a treatment plan remain healthier, living longer lives. As new information pours in, researchers scramble to further progress their understanding and approach to the disease. Methods used to slow disease progression and curb mortality rates are proving more and more successful. Yet, in spite of such advances, the struggle with HIV is still a slow, tragic war. Why might you ask?
What Is Holding Us Back from Defeating HIV?
More cases are reported every year, and it is estimated that millions have the infection without knowing it. Herein lies the danger. Those unaware HIV carriers often infect others. Spreading of the virus is one of the major roadblocks to its eradication.
Why Individuals Avoid Testing
Studies on why so many people with HIV refuse testing or treatment have come to a simple conclusion: fear. Fear is helping HIV survive the war. Whether it’s fear of the disease or the associated social stigmas, it remains the number one reason people do not get tested.
The psychology behind the behavior needs to change. Any chronic condition carries with it a strong measure of fear. HIV is no exception. However, those advances mentioned earlier are reason for hope. Hope supported by reality. Today, HIV testing can be performed at home. If the result is positive, treatments are available. What once arrived with a death sentence is now a treatable condition. Slowing the progression from HIV to AIDS is now a regular occurrence. HIV positive people can enjoy a long life and enjoy a full and happy one too. And more than every the public needs to understand this new chapter in the war on HIV.
Courage Reaps Benefits
Fear of a diagnosis is no reason to put off testing. Hope lives. Fear kills. Early detection leads to more positive outcomes, like HIV prevention, and management of the viral infection. This is the message healthcare professionals encourage. Educating the public on the facts, rather than the fears of HIV, saves lives, prevents future infections, and will help us to one day eliminate the virus for good.