Treatments for HIV/AIDS
Treatments for HIV/AIDS
The list of treatments mentioned in various sources
for HIV/AIDS
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Nucleoside reverse transcriptase (RT) inhibitors - also called nucleoside analogs
- Zidovudine (AZT) - also called ZDV
- Zalcitibine (ddC)
- Didanosine (ddI)
- Stavudine (d4T)
- 3TC (lamivudine)
- Abacavir
- Tenofovir
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) - usually in combination with other antiretroviral drugs.
- Delvaridine (Rescriptor)
- Nevirapine (Viramune)
- Efravirenz (Sustiva)
- Protease inhibitors
- Ritonavir (Norvir)
- Saquinivir (Invirase)
- Indinavir (Crixivan)
- Amprenivir (Agenerase)
- Nelfinavir (Viracept)
- Lopinavir (Kaletra)
- Combination drug treatments - because HIV becomes drug resistent, it is typical to use a combination of drugs.
- Highly active antiretroviral therapy (HAART) - a treatment strategy of aggressive use of medications.
- Treatments for opportunistic infections
- Treatments for complications - each complication needs its own treatment.
- Treatments to prevent mother-infant transmission include:
HIV/AIDS: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for HIV/AIDS may include:
HIV/AIDS: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for HIV/AIDS:
Curable Types of HIV/AIDS
Possibly curable types of HIV/AIDS may include:
- Pneumocystitis carinii pneumonia related HIV
- Tuberculosis related HIV
- Toxoplasmosis related HIV
- Herpes zoster related HIV
- Hemophiliacs related HIV
- more curable types...»
HIV/AIDS: Research Doctors & Specialists
Research all specialists including ratings, affiliations, and sanctions.
Drugs and Medications used to treat HIV/AIDS:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of HIV/AIDS include:
- Didanosine - used as part of a combination treatment.
- Videx - used as part of a combination treatment.
- Videx EC - used as part of a combination treatment.
- Lamivudine
- Combivir
- Epivir
- Epivir HBV
- Trizivir
- Lopinavir and Ritonavir - used as part of a combination therapy
- Kaletra - used as part of a combination therapy
- Amprenavir
- Agenerase
- Indinavir
- Crixivan
- Nelfinavir
- Viracept Ritonavir
- Norvir
- Saquinavir
- Fortovase
- Invirase
- Tenofovir
- Viread
- Stavudine - used as part of a combination therapy
- Zerit - used as part of a combination therapy
- Zalcitabine - used as part of a combination therapy
- HIVID - used as part of a combination therapy
- Abacavir - used as part of a combination treatment
- Abacavir Sulfate - used as part of a combination treatment
- Ziagen - used as part of a combination treatment
- Epzicom - used as part of a combination treatment
- Abacavir and Lamivudine - used as part of a combination treatment
- Trizivar - used as part of a combination treatment
- Atazanavir - used as part of a combination therapy
- Reyataz - used as part of a combination therapy
- Delavirdine - used as part of a combination treatment
- Rescriptor - used as part of a combination treatment
- Efavirenz - used as part of a combination treatment
- Sustiva - used as part of a combination treatment
- Emtricitabine - used as part of a combination therapy
- Emtriva - used as part of a combination therapy
- Emtricitabine and Tenofovir - used as part of a combination therapy
- Truvada - used as part of a combination therapy
- Enflurane - used as part of a combination therapy
- Ethrane - used as part of a combination therapy
- Enfran - used as part of a combination therapy
- Enlirane - used as part of a combination therapy
- Enfuvirtide - used as part of a combination therapy
- Fuzeon - used as part of a combination therapy
- Fosamprenavir
- Lexiva
Hospital statistics for HIV/AIDS:
These medical statistics relate to hospitals, hospitalization and HIV/AIDS:
- 185,000 patients were discharged with HIV in the US 2001 (Health, United States, 2003, NCHS, CDC)
- HIV patients had an average length of stay in hospitals of 7.8 days in the US 2001 (Health, United States, 2003, NCHS, CDC)
- 0.04% (4,589) of hospital episodes were for HIV in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 79% of hospital consultations for HIV required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 69% of hospital episodes for HIV were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: HIV/AIDS
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to HIV/AIDS:
Hospital & Clinic quality ratings » »
Choosing the Best Treatment Hospital:
More general information, not necessarily in relation to HIV/AIDS,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for HIV/AIDS:
The following medical news items
are relevant to treatment of HIV/AIDS:
Discussion of treatments for HIV/AIDS:
Backgrounder - HIV Infection in Infants and Children: NIAID (Excerpt)
NIAID investigators are defining the best
treatments for pediatric patients. Currently there are 16 drug products
approved by the FDA for the treatment of adult HIV infection. Through
major contributions by the Pediatric ACTG, 10 antiretroviral agents have
pediatric label information, including 3 protease
inhibitors.28 While the basic principles that
guide treatment of pediatric HIV infection are the same as for any
HIV-infected person, there are a number of unique scientific and medical
concerns that are important to consider in the treatment of children with
HIV infection. These range from differences from adults in age-related
issues such as CD4 lymphocyte counts and drug metabolism to requirements
for special formulations and treatment regimens that are appropriate for
infants through adolescents. As in adults, treatment of HIV-infected
children today is a complex task of using potent combinations of
antiretroviral agents to maximally suppress viral replication.
(Source: excerpt from Backgrounder - HIV Infection in Infants and Children: NIAID)
HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID (Excerpt)
When AIDS first surfaced in
the United States, there were no medicines to combat the underlying
immune deficiency and few treatments existed for the opportunistic
diseases that resulted. Over the past 10 years, however, researchers
have developed drugs to fight both HIV infection and its associated
infections and cancers.
The U.S. Food and Drug
Administration (FDA) has approved a number of drugs for treating HIV
infection. The first group of drugs used to treat HIV infection,
called nucleoside reverse transcriptase (RT) inhibitors, interrupts
an early stage of the virus making copies of itself. Included in
this class of drugs (called nucleoside analogs) are AZT (also known
as zidovudine or ZDV), ddC (zalcitabine), ddI (dideoxyinosine), d4T
(stavudine), and 3TC (lamivudine). These drugs may slow the spread
of HIV in the body and delay the onset of opportunistic infections.
Health care providers can prescribe non-nucleoside reverse
transcriptase inhibitors (NNRTIs), such as delvaridine (Rescriptor),
nevirapine (Viramune), and efravirenz (Sustiva), in combination with
other antiretroviral drugs.
More recently, FDA has approved
a second class of drugs for treating HIV infection. These drugs,
called protease inhibitors, interrupt virus replication at a later
step in its life cycle. They include
- ritonavir (Norvir)
- saquinivir (Invirase)
- indinavir (Crixivan)
- amprenivir (Agenerase)
- nelfinavir (Viracept)
- lopinavir (Kaletra)
Because HIV can become resistant
to any of these drugs, health care providers must use a combination
treatment to effectively suppress the virus.
Currently
available antiretroviral drugs do not cure people of HIV infection
or AIDS, however, and they all have side effects that can be severe.
Some of the nucleoside RT inhibitors may cause a depletion of red or
white blood cells, especially when taken in the later stages of the
disease. Some may also cause an inflammation of the pancreas and
painful nerve damage. There have been reports or complications and
other severe reactions, including death, to some of the
antiretroviral nucleoside analogs when used alone or in combination.
Therefore, health care experts recommend that people on
antiretroviral therapy be routinely seen and followed by their
providers.
The most common side effects associated with
protease inhibitors include nausea, diarrhea, and other
gastrointestinal symptoms. In addition, protease inhibitors can
interact with other drugs resulting in serious side effects.
Researchers have credited highly active antiretroviral
therapy, or HAART, as being a major factor in reducing the number of
deaths from AIDS in this country by 47 percent in 1997. HAART is a
treatment regimen that uses a combination of reverse transcriptase
inhibitors and protease inhibitors to treat patients. Patients who
are newly infected with HIV as well as AIDS patients can take the
combination.
While HAART is not a cure for AIDS, it has
greatly improved the health of many people with AIDS and it reduces
the amount of virus circulating in the blood to nearly undetectable
levels. Researchers have shown that HAART cannot eradicate HIV
entirely from the body. HIV remains present, lurking in hiding
places such as the lymph nodes, the brain, testes, and the retina of
the eye, even in patients who have been treated.
A number of
drugs are available to help treat opportunistic infections to which
people with HIV are especially prone. These drugs include
- foscarnet and ganciclovir to treat cytomegalovirus eye
infections
- fluconazole to treat yeast and other fungal infections
- trimethoprim/sulfamethoxazole (TMP/SMX) or pentamidine to
treat Pneumocystis carinii pneumonia (PCP)
In
addition to antiretroviral therapy, health care providers treat
adults with HIV, whose CD4+ T-cell counts drop below 200, to prevent
the occurrence of PCP, which is one of the most common and deadly
opportunistic infections associated with HIV. They give children PCP
preventive therapy when their CD4+ T-cell counts drop to levels
considered below normal for their age group. Regardless of their
CD4+ T-cell counts, HIV-infected children and adults who have
survived an episode of PCP take drugs for the rest of their lives to
prevent a recurrence of the pneumonia.
HIV-infected
individuals who develop Kaposi's sarcoma or other cancers are
treated with radiation, chemotherapy, or injections of alpha
interferon, a genetically engineered naturally occurring protein.
(Source: excerpt from
HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID)
HIV Infection in Adolescents, NIAID Fact Sheet: NIAID (Excerpt)
Adolescents tend to think they are invincible, and
therefore, to deny any risk. This belief may cause them to engage in
risky behavior, to delay HIV testing, and if they test positive, to
delay or refuse treatment. Doctors report that many young people,
when they learn they are HIV-positive, take several months to accept
their diagnosis and return for treatment. Health care professionals
may be able to help these adolescents by explaining the information
slowly and carefully, eliciting questions from them, and emphasizing
the success of newly available treatments.
The U.S.
Department of Health and Human Services (DHHS) has developed two
documents that address the standard of care for the treatment of
HIV, including information about how to treat HIV in adolescents.
The documents, Guidelines for the Use of Antiretroviral Agents
in HIV-Infected Adults and Adolescents and Guidelines for
the Use of Antiretroviral Agents in Pediatric HIV Infection are
available from the National Prevention Information Network and the
HIV/AIDS Treatment Information Service (telephone numbers are listed
in the resources section). These documents also can be downloaded
from the Internet at http://www.hivatis.org/.
According
to the Guidelines for the Use of Antiretroviral Agents in
HIV-Infected Adults and Adolescents, adolescents who were
exposed to HIV sexually or via injection drug use appear to follow a
clinical course that is more similar to HIV disease in adults than
in children. At this time, most adolescents with sexually acquired
HIV are in a relatively early stage of infection and are ideal
candidates for early intervention. Adolescents who were infected at
birth or via blood products as young children follow a unique
clinical course that may differ from other adolescents and long-term
surviving adults. Health care workers should refer to the treatment
guidelines for detailed information about the treatment of
HIV-infected adolescents. (Source: excerpt from HIV Infection in Adolescents, NIAID Fact Sheet: NIAID)
Treatment of HIV Infection: NIAID (Excerpt)
Sixteen drugs have been approved for treating HIV infection. They
are called antiretroviral drugs because they attack HIV, which is a
retrovirus. Once inside the cell, HIV uses specific enzymes to
survive. Antiretroviral drugs work by interfering with the virus'
ability to use these enzymes. They fall into two categories.
- Reverse transcriptase inhibitors
interfere with an enzyme called reverse transcriptase or RT that
HIV needs to make copies of itself. There are two main types of RT
inhibitors and they each work differently.
- Nucleoside/nucleotide drugs provide faulty DNA building
blocks, halting the DNA chain that the virus uses to make copies
of itself.
- Non-nucleoside RT inhibitors bind RT so the virus cannot
carry out its copying function.
- Protease inhibitors interfere with the
protease enzyme that HIV uses to produce infectious viral
particles.
Drugs Approved for HIV
Infection
|
Nucleoside/Nucleotide
RT
Inhibitors
- abacavir
- ddC
- ddI
- d4T
- 3TC
- ZDV
- tenofovir
|
Non-nucleoside
RT
Inhibitors
- delavirdine
- nevirapine
- efavirenz
|
Protease
Inhibitors
- ritonavir
- saquinavir
- indinavir
- amprenavir
- nelfinavir
- lopinavir
|
Do antiretroviral drugs cure HIV infection?
No, the currently available drugs cannot cure HIV infection. This
is because HIV can become resistant to any one drug. Researchers
initially attacked this problem by using a combination of
antiretroviral drugs to suppress the virus. By combining both RT
inhibitors and protease inhibitors, NIAID-supported research groups
and drug companies developed the potent and effective combination
therapy called highly active antiretroviral therapy or HAART.
Although the use of HAART has greatly reduced the number of
deaths due to AIDS, this powerful combination of drugs cannot
suppress the virus indefinitely. In addition, while people with HIV
are living longer, new medical problems are surfacing. These new
problems have not been seen before in people who have been infected
with the virus for a long time. (Source: excerpt from Treatment of HIV Infection: NIAID)
Women and HIV-AIDS: NWHIC (Excerpt)
Currently, there is no known cure for HIV/AIDS. The best treatment
right now seems to be prescription "cocktails," or combinations of
prescription drugs. These medications include those for antiviral
treatment and other drugs, like oral antifungals to combat yeast
infections, which fight diseases that take advantage of the weakened
immune response of HIV-infected people. It is also important for
HIV-infected women and their physicians to watch for pelvic inflammatory
disease or other STDs through screening. Similarly, cervical cancer may be
more common and progress more quickly in infected women; for this reason,
women with HIV should have Pap Smears twice a year to make sure cancer is
detected and treated early. (Source: excerpt from Women and HIV-AIDS: NWHIC)
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Hearing Loss – Acquired:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Cerumen removal
-
Tympanostomy tube placement for chronic MEE lasting >3 months if bilateral, >6 months if unilateral
-
Tympanoplasty for TM perforation
-
Tympanomastoidectomy for cholesteatoma
–Effort to keep external auditory canal wall intact, with second look procedure planned for 6 months later
-
Ossicular chain reconstruction (OCR, ossiculoplasty) with prosthesis or incus graft for ossicular anomalies
–Including after cholesteatoma resection
-
Exploratory tympanotomy for suspected PLF
–If present, seal off oval and round windows
-
Resection of CPA tumor
-
Steroids for autoimmune SNHL (systemic or intratympanic)
-
Cochlear implants for profound pre- or postlingual deafness
-
Habilitation of any post-treatment hearing loss
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Kaposi's sarcoma:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment isn't indicated for all patients. Indications include cosmetically offensive, painful, or obstructive lesions of rapidly progressing disease.
Radiation therapy, chemotherapy, cryotherapy, and biotherapy with biological response modifiers are treatment options. Radiation therapy alleviates symptoms, including pain from obstructing lesions in the oral cavity or extremities and edema caused by lymphatic blockage. It may also be used for cosmetic improvement.
Chemotherapy includes combinations of doxorubicin, vincristine, etoposide, paclitaxel, bleomycin, and dacarbazine.
Biotherapy with interferon alfa-2b may be prescribed for AIDS-related Kaposi's sarcoma. The treatment reduces the number of skin lesions but is ineffective in advanced disease.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Acquired immunodeficiency syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
There is no cure for either HIV or AIDS. However, significant advances have been made to help patients control signs and symptoms and impair disease progression. Because HIV can become resistant to any drug, health care professionals use combination treatments and multiple drug regimens to suppress the virus. Patients on medication remain infectious.
An effective method of treatment is highly active antiretroviral therapy (HAART). HAART aims to reduce the number of HIV particles in the blood as measured by viral load, thus increasing T-cell counts and improving the immunologic system’s functioning. A regular and vigilant medication regimen is critical or resistance will develop because HIV strains mutate and can become resistant to HAART relatively easily.
The nucleoside analogues (sometimes called reverse transcriptase inhibitors) have been the mainstay of AIDS therapy in recent years. These drugs interfere with viral reverse transcriptase, which impairs HIV’s ability to turn its ribonucleic acid into deoxyribonucleic acid for insertion into the host cell.
Antiretroviral therapy typically begins when the patient’s CD4+ T-cell count drops to less than 500/µl or when the patient develops an opportunistic infection. Most clinicians recommend starting the patient on a combination of these drugs in an attempt to gain the maximum benefit and to inhibit the production of resistant mutant strains of HIV. The drug combinations and dosages are then altered, depending on the patient’s response.
Increasingly, physicians are basing changes in therapy on the patient’s viral load rather than on his CD4+ T-cell count. Because the CD4+ count is influenced by the total white blood cell count, changes in the CD4+ count may have nothing to do with changes in the patient’s HIV status. Many physicians suggest that patients on antiretroviral therapy have their viral load checked every 3 months.
The increasing use of protease inhibitors (PIs) has greatly increased the life expectancy of patients with AIDS. These drugs block the enzyme protease, which HIV needs to produce virions, the viral particles that spread the virus to other cells. The use of PIs dramatically reduces viral load — sometimes to undetectable levels — while producing a corresponding increase in the CD4+ T-cell count and, because they act at a different site than nucleoside analogues, the PIs don’t produce additional adverse effects when added to a patient’s regimen.
Antiviral therapy includes the use of multiple combined drug therapies that suppress the replication of the HIV virus in the body. After antiviral therapy is initiated, treatment should be aggressive. Initially, highly active antiviral therapy, consisting of a triple drug therapy regimen — a PI and two non-nucleoside reverse transcriptase inhibitors — is recommended. In addition to these primary treatments, anti-infectives are used to combat opportunistic infections (some are used prophylactically to help patients resist opportunistic infections), and antineoplastic drugs are used to fight associated neoplasms. Supportive treatments help maintain nutritional status and relieve pain and other distressing physical and psychological symptoms.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Kaposi's sarcoma:
Treatment
(Handbook of Diseases)
Treatment isn’t indicated for all patients with Kaposi’s sarcoma. Indications include cosmetically offensive, painful, or obstructive lesions of rapidly progressing disease.
Radiation therapy, chemotherapy, and biotherapy with biological response modifiers are treatment options. Radiation therapy alleviates signs and symptoms, including pain from obstructing lesions in the oral cavity or extremities and edema caused by lymphatic blockage. It may also be used for cosmetic improvement.
Combinations of three or more anti-HIV drugs may control HIV as well as flatten, shrink, or fade Kaposi’s sarcoma lesions.
A new treatment uses 9 cis retinoic acid, a derivative form of vitamin A that can be applied directly to skin lesions.
Chemotherapy includes combinations of doxorubicin, vinblastine, vincristine, and etoposide to treat internal, widespread Kaposi’s sarcoma. Paclitaxel may be used when other chemotherapeutic drugs fail. Liposomal drugs may also be used.
Biotherapy with interferon alfa-2b may be administered for HIV-related Kaposi’s sarcoma. The treatment reduces the number of skin lesions, but is ineffective in patients with advanced disease.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Human immunodeficiency virus infection:
Treatment
(Handbook of Diseases)
No cure has yet been found for the disorder; however, primary therapy for HIV infection includes three different types of antiretroviral agents:
❑ protease inhibitors (PIs), such as ritonavir, indinavir, nelfinavir, and saquinavir
❑ nucleoside reverse transcriptase inhibitors (NRTIs), such as zidovudine, didanosine, zalcitabine, lamivudine, and stavudine
❑ nonnucleoside reverse transcriptase inhibitors (NNRTIs), such as nevirapine and delavirdine.
These agents, used in various combinations, are designed to inhibit HIV viral replication. Other potential therapies include immunomodulatory agents designed to boost the weakened immune system and anti-infective and antineoplastic agents to combat opportunistic infections and associated cancers; some are used prophylactically to help patients resist opportunistic infections.
Current treatment protocols combine three agents in an effort to gain the maximum benefit with the fewest adverse reactions. Such regimens include one PI and are considered the most effective treatment. Many variations and drug interactions are under study. Combination therapy helps inhibit the production of resistant, mutant strains. Supportive treatments help maintain nutritional status and relieve pain and other distressing physical and psychological symptoms.
Many pathogens respond to anti-infective drugs but tend to recur after treatment ends. For this reason, most patients need continuous anti-infective treatment, presumably for life or until the drug is no longer tolerated or effective.
UNDER STUDY: Once-daily dosing with antiretroviral drugs, such as didanosine, efavirenz, lamivudine, and tenofovir, to increase treatment adherence to drug-resistant variants of HIV is under investigation. A combination of amprenavir, a protease inhibitor, boosted with ritonavir has been approved, and other new antiretroviral drugs are currently in development for new dosing schedules.
Zidovudine
Treatment with zidovudine has proven effective in slowing the progression of HIV infection, decreasing opportunistic infections, and prolonging survival. However, it commonly produces serious adverse reactions and toxicities. The drug is typically combined with other agents (such as lamivudine) but has also been used as a single agent for pregnant HIV-positive women.
The current recommendation is to take 100 mg every 4 hours for a total daily dose of 600 mg, or 500 mg if the patient doesn’t want to interrupt sleep. Other NRTIs, such as didanosine and zalcitabine, may also be used in combination regimens for patients who can’t tolerate or no longer respond to zidovudine.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Chronic fatigue and immune dysfunction syndrome:
Treatment
(Handbook of Diseases)
Treatment is aimed at the cause, if one can be found. Supportive therapy includes an anti-inflammatory, an antihistamine, and rest.
Treatment of symptoms may include a tricyclic antidepressant (doxepin), a histamine2-blocker (cimetidine), and an anxiolytic (alprazolam). In some patients, avoidance of environmental irritants and certain foods may help to relieve symptoms.
Experimental treatments include the antiviral acyclovir and selected immunomodulators, such as I.V. gamma globulin, ampligen, and transfer factor.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Community-acquired Pneumonia:
Management
(Pediatric Infectious Disease)
The management of the febrile tachypneic neonate suspected of having pneumonia
is similar to that of neonatal fever. Empiric intravenous antibiotics are
started until culture results are final. Empiric treatment usually consists of
ampicillin combined with gentamicin or a third-generation cephalosporin.
Treatment of
C. trachomatis is with oral erythromycin, 50 mg/kg per day in four divided doses for 2 weeks.
In the past, erythromycin was given to neonates exposed to
C. trachomatis at the time of delivery. Recently, there has been an association reported
between oral erythromycin and the subsequent development of hypertrophic
pyloric stenosis in infants younger than 6 weeks of age. The current
recommendation is to treat with oral erythromycin, 50 mg/kg per day in four
divided doses for 14 days all infants with chlamydial conjunctivitis and
pneumonia. Patients who are exposed at the time of delivery are not
presumptively treated, but rather monitored closely for the development of
disease. Routine screening of all pregnant women for sexually transmitted
disease is helpful in reducing disease by
C. trachomatis.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
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