HIV treatment guidelines

Let’s formulate the main principles of treatment of HIV infection.   

1.Increase in the amount of viral RNA in infected cells damages their immune system and eventually leads to the development of AIDS. If replication of HIV virus is not slowed down (suspended) in time, the immune system of the patient starts weakening. The weakening or absence of immunity makes the patient prone to opportunistic infections and cancer in almost 100% of cases. Moreover, opportunistic pathogens, which normally do not threaten human health, progress rapidly in a body with a weakened immune system and this can lead to death.

2. The speed at which AIDS develops depends on the rate of HIV virus replication in the blood and the rate of CD4 T-lymphocytedestruction, i.e. the protection system of the body. It is possible to estimate the level of damage to the immune system by measuring the number of CD4 lymphocytes. This helps in making reliable conclusions about the development of complications and opportunistic infections. You can calculate the rate at which the disease is developing by comparing the CD4+ count in the current and previous month. By taking a CD4 lymphocyte count and measuring the HIV RNA levels in the body, we actually increase the accuracy of the prognosis of disease severity and time of death.

3. The individual treatment plan foran AIDS patient is preparedaccording to his/her test reports. Theestimation of time when the disease started developing and its approximate duration is made by measuring the viral load and number of lymphocytes as well as considering the rate of development of the disease. It is a known fact that if the treatment of the patient with HIV symptoms (in men or women) is started before there is any evidence of disease progression, the results will appear sooner, they will be more pronounced and prolonged.

4. One of the major factors hindering the treatment of AIDS is the high rate of mutation of the virus, which is how it adapts to the treatment. Therefore, antiretroviral drug therapyis always carried out not with one drug, but several at the same time. Moreover, in order to slow down or completely prevent the development of resistance towards drugs, the used drugs are changed with others that have different mechanisms of action.

5. The main principle of treatment is the concurrent use of multiple, dissimilar to the previous ones and highly active anti-retroviral drugs. The old practice of monotherapy increased the risk of emergence of drug resistant strains of HIV virus. This also led to the virus developing resistance towards drugs with similar composition and not previously used by the specific patient. This type of drug resistance is called cross-resistance.The use of newer and stronger drugs, their successful combination and regular alternations are essentialfor successful treatment.

6. One of the factors of successful therapy and HIV treatment guidelines will always be simultaneous prescription of optimal dosage of the drug, since impotent treatment stretched out over time will contribute to the accumulation of mutations and increase viral resistance. The emergence of a new strain that is much more stable towards drugs is very likely if the drugs are taken irregularly and in insufficient doses. Therefore, it is necessary to sincerely and consistently adhere to the fairly complex regimes of antiretroviral drug therapy. The price ofshowing irresponsibility in this regard can be life itself.

7. There is another difficulty in choosing the treatment for AIDS; as the number of drugs available at this moment is limited, each used drug combination reduces the choice of the remaining options in future. Hence, it is clear that self-administration of drugs is not beneficial; keeping cross-resistance in mind, itsignificantly narrows down the choice of drugs for future use.

8. Treatment of AIDS during pregnancy is defined by the same primary HIV treatment guidelines, although it has few specific characteristics. By the way, screening of pregnant women for HIV infection is compulsory in some states in the USA. The detection of HIV infection in pregnant women has increased due to this screening. The main objective of the treatment of pregnant women with symptoms of HIV infection is to reduce the risk of perinatal transmission from mother to child.

9. Criteria for assessing the incidence of HIV infection (HIV RNA levels in the plasma and CD4 lymphocyte count) in children are different from the ones for adults. The amount of virus in the blood is much higher inchildren during the first few years of life in comparison with adults, even with the same duration of the disease.Moreover, opportunistic infections in children develop with a higher T-lymphocyte count. It can be concluded that the effectiveness ofcombined antiretroviral therapy in a child is higher if it is started early.
10. It is necessary to reduce the viral load in blood plasma as fast as possible during the acute stage of HIV infection. This helps to maintain the function of immune system, and subsequently, improves the prognosis.

11. No matter how successful the treatment is, all people with symptoms of HIV infection are considered contagious, look at the pictures of people with AIDS.

They should take proper precautions while having sex and during parenteral administration of drugs. If they have not changed their way of life, there is always a possibility of re-infection with other strains of HIV. In addition, they can also transmit other diseases: hepatitis B and C, herpes simplex infection, human herpesvirus-8 infection (Kaposi's sarcoma), papilloma, syphilis, gonorrhea, cytomegalovirus etc.