HIV / AIDS
Treatment


Treatment for HIV involves killing the virus and treating the symptoms exhibited by the patient. The progression of drug therapy from monotherapy to dual therapy and now multiple-therapy has greatly increased the complexity of treatment of HIV/AIDS

What treatment is available for AIDS?

Management Of AIDS

  • The aim of management is to provide the best medical care to all HIV-infected individuals and reduce morbidity and avoidance of discriminations.

  • The services for the management of HIV-infected individuals provided by the Malaysian Government are integrated into the existing medical treatment services. Treatment is available in all hospitals. The programme is jointly coordinated by the Medical Division and the AIDS/STD section of the Public Health Division.

  • Treatment, including counseling of HIV-infected persons and AIDS cases are carried out both on outpatient and inpatient basis. Counseling needs to be given before and after a patient is tested for HIV.

  • All HIV-infected persons are seen by the specialist at the nearest hospital. Because of the serious implications of HIV infection/AIDS, the senior Physician/ Paediatrician must be consulted before a diagnosis of HIV infection/AIDS is made. No special hospital or ward is designated for AIDS patients or those suspected of HIV infection. Isolation is advised only if it is medically indicated, such as during the terminal stage of the disease.

  • Patients are given full medical care (including the use of Azidothymidine (AZT) upon recommendation by the attending specialist. A guideline on the use of AZT has been issued by the Ministry of Health.

  • All HIV-infected persons are required to attend regular follow-up treatments every 3-6 months.

  • All HIV-infected persons are given intensive medical counseling by the attending medical doctor.

  • All patients are told of the diagnosis and are advised to take the necessary measures.


Non-Pharmacology

Besides drug therapy, there is another factor that significantly contributes to the longer and healthier lives of people living with HIV - good nutrition. Nutritious foods allow people living with AIDS to preserve their health by offering protection from the complications of HIV-related infections. A high caloric intake, with sufficient protein and complex carbohydrates, defends against malnutrition, malabsorption of nutrients, immunosuppression and muscle wasting. Good nutrition greatly reduces drug side effects and also increases the body's ability to absorb certain medications.

Exercise is another major factor in improving the lives of people living with HIV. In a recent study published by the Journal of the American Medical Association it was found that injecting male hormones and providing an exercise regimen to men suffering from weight loss associated with HIV increases body mass and muscle strength.

Treatment Pharmacology

Post exposure Prophylaxis

In theory, taking antiviral drugs immediately after contact with the human immunodeficiency virus (HIV) allows the immune system time to detect the invader and eliminate it before it takes hold. This may prevent the virus from "seeding" other vulnerable tissues throughout the body. At least among nurses, physicians, and others accidentally exposed to HIV, early drug therapy, called post exposure prophylaxis, appears to work. The federal Centers for Disease Control and Prevention estimates that immediate therapy with a drug called zidovudine (once called AZT, now sold as Retrovir) decreases the odds of infection by 79 percent. No one can say for certain, though, how many of these health care workers actually were infected with the virus in the first place. Despite what you may have seen or heard in the media, post exposure prophylaxis is neither an antidote nor a "morning-after pill" for AIDS. For one thing, it is an expensive, month-long regimen of many pills that cause debilitating side effects. For another, we don't know if sexually transmitted HIV somehow behaves differently in the body than HIV delivered directly into the bloodstream via a cut or needle stick, and thus responds differently to drug therapy.


Drugs used in treatment of HIV:

Treatment for HIV involves killing the virus and treating the symptoms exhibited by the patient. The progression of drug therapy from monotherapy to dual therapy and now multiple-therapy has greatly increased the complexity of treatment of HIV/AIDS. The following drugs are used: Antiretroviral drugs Antiretroviral drugs specifically attack retroviruses, which includes HIV. Over the past several years, researchers have made significant advances in treatment options for HIV/AIDS. Since the late 1980s, medical professionals in the United States have incorporated antiretroviral drugs into the prescribed treatment regimens of infected patients. Combinations of three or more antiretroviral drugs, commonly called "drug cocktails," are effective in reducing the concentration of HIV in infected individuals by slowing the spread of HIV. Protease Inhibitors HIV replicates itself and infects the healthy cells of the person carrying the HIV virus. This process will then lead to the development of AIDS. HIV needs an enzyme called protease in order to replicate. Protease inhibitors effectively inhibit the protease to make the replication impossible. Nucleoside Reverse Transciptase Inhibitors (NRTI) and Non-Nucleoside Transciptase Inhibitors (NNRTI) In order for HIV to replicate, the HIV enzyme must enter the nucleus, which is "the brain" of an infected cell. A process called HIV enzyme reverse transcription allows the HIV enzyme to enter the infected cell's nucleus. Nucleosides and non-nucleosides slow the progression of the HIV infection by stalling the incorporation of the HIV enzyme into the infected cell's nucleus. Combinations of Drugs Protease inhibitors, nucleosides and non-nucleosides each inhibit a different function of HIV. An antiretroviral drug fails to have a lasting effect when administered to patients alone. Therefore, they are administered in a combination.