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CURRENTS
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Significant progress has been made in producing HIV medication and treatment during the past 20 years. Today, thanks to powerful antiretroviral drugs, a person infected with HIV can live a long and productive life. Thanks to the success of antiretroviral therapy, HIV is now classified as a chronic illness in the developed world, where there is universal access to treatment. However, in the developing world where drug treatment is costly and widely unavailable, HIV is still considered a fatal disease. Without antiretroviral treatment, HIV progresses to AIDS in an average of 10 years. Therefore, it is imperative that universal access to these life-saving medications is available. Antiretroviral medication slows HIV’s ability to reproduce itself within the body and improves T-cell count (white blood cells of the immune system). By reducing the amount of HIV in the body, T-cells no longer fight a losing battle against HIV. The T-cells focus on strengthening themselves and prolong life expectancy. Although these medications weaken the ability of the virus to replicate, they do not eradicate it. HIV enters the body and attacks the T-cell (also known as a CD4 cell because of the CD4 protein on its surface). The virus needs this protein in order to enter the cell and infect it. Once in the T-cell, the HIV replicates and kills the cell so to know what stage the virus is in, a CD4 count is taken. This test measures the amount of CD4 in the blood. The lower the count, the weaker the immune system and the greater the risk that the individual will become ill with an opportunistic infection. A viral load count is also taken at this time to determine the amount of HIV in the body. For most people, a high viral load means also having a low CD4 count. When a person’s CD4 count becomes too low, doctors usually recommend that the individual starts a course of antiretroviral treatment. There are four types of antiretroviral medications: non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside analogues, protease inhibitors, and entry inhibitors. Doctors usually recommend a combination of drugs from the first three categories, known as combination therapy, depending on the stage of the virus, the person’s viral load, their CD4 count, and the virus’s level of resistance. Despite its ability to keep HIV-positive people healthy, antiretroviral treatment is not foolproof. In order for HIV medications to work properly, a person must have good adherence, meaning they must take all of their doses of medication and get regular checkups. Also, they can not abuse substances (which increases the rate of HIV replication in the body) and must maintain a healthy lifestyle (good nutrition and exercise). Otherwise, the person can become resistant to the medications. Viral resistance means that the HIV in the body has found a way to replicate around the parameters of the medications, often by mutating itself, rendering the medications useless and forcing the person to find a new group of drugs. For those who develop resistance due to poor adherence, drug use, or a highly resistant and active strain of HIV, entry inhibitors are often a last resort. New antiretroviral medications are coming out all of the time and research is constantly being conducted about new drugs. While antiretroviral medications have allowed many HIV-positive people in the
developed world to live long and productive lives, these treatments are not
readily available in the developing world. Antiretroviral medications are extremely
expensive, and thus not available to most PLWHAs (people living with HIV/AIDS)
in poorer nations. Lack of economic resources, as well as poor medical facilities,
strong HIV/AIDS-related stigmas, and traditional beliefs mean that only 12%
of those in need of medication in the developing world receive it. As a result,
many developing nations have been fighting to get generic versions of HIV medications
produced, which can be sold to the public at drastically lower prices than their
brand name counterparts can. However, pharmaceutical companies have refused
to release the patents on the brand-name drugs, waging a fierce debate between
the two. Regardless of the outcome of the debate, antiretroviral medication
must be made affordable and available to all.
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