HIV medicines are not created equal
In the early years of the epidemic, an AIDS diagnosis meant a rapid decline in health and imminent death. Then in 1987, the first antiretroviral drug was approved by the US Food and Drug Administration to slow the progression of HIV disease (Kanabus & Fredricksson, n.d.). This was followed by the approval of other antiretroviral drugs.
In 1996, the use of three antiretroviral medications in combination (referred to as Highly Active Antiretroviral Therapy [HAART], or simply antiretroviral therapy) became the new treatment standard. HAART revolutionized the treatment of HIV/AIDS and improved the outlook for many people with HIV (Omobosola & Henry, 2003; Palella et al, 1998). Combinations of drugs are more effective than individual drugs against HIV/AIDS because HIV's genetic material mutates very quickly and becomes resistant to individual drugs. Combinations of drugs overwhelm HIV, keeping it from multiplying and mutating as quickly.
In 1996, scientists also developed tests that measure the level of HIV-1 RNA (that is, viral load) in the plasma of people with HIV. These tests help clinicians to better monitor how an individual's disease is advancing, and how he or she is responding to antiretroviral medications (Mellors et al, 1997; Riddler & Mellors, 1998).
Many people treating AIDS in the late 1990s adopted the dogma of “hit early, hit hard,” and prescribed HAART right after HIV was diagnosed. Since that time, healthcare providers have learned to wait to prescribe HAART until people enter the more advanced stages of HIV disease, as HAART is often accompanied by many negative side effects (Dybul, Fauci, Bartlett, Kaplan, & Pau, 2002; Hare, 2004; Office of AIDS Research Advisory Council [OARAC], 2006). These side effects range from fatigue and nausea to diabetes and permanent liver damage. Researchers also have developed ways to treat the opportunistic infections that often accompany HIV/AIDS, such as yeast infections and herpes (Omobosola & Henry, 2003). The Department of Health and Human Services makes available regularly updated guidelines that represent the official US treatment standards for the management of HIV infection in adults, adolescents, and children.
Discussion question: How has the development of antiretroviral therapies changed the entire face of HIV? What are the implications of living with HIV from a biological, sexual, psychological, and social standpoint?
Next >> Slowing down HIV