Wednesday, January 28, 2009

Drug treatments

As medical understanding about how the virus invades the body and multiplies within cells has increased, drugs to inhibit its growth and slow its spread have been developed. Drug treatment for HIV/AIDS is complicated and expensive, but highly effective in slowing the replication (reproduction) of the virus and preventing or reducing some effects of the disease.

Drugs to treat HIV/AIDS use at least three strategies:

  1. interfering with Hive's reproduction of its genetic material (these drugs are classified as nucleotide or nucleotide anti-retrovirus)
  2. interfering with the enzymes HIV needs to take over certain body cells (these are called protease inhibitors)
  3. interfering with Hive's ability to pack its genetic material into viral code — that is, the genetic "script" HIV needs to be able to reproduce itself (these are called non-nucleotide reverse transcription inhibitors )

Because these drugs work in different ways, doctors generally prescribe a "combination cocktail" of these drugs that are taken every day. This regimen is known as HEART treatment (HEART stands for highly active antiretroviral therapy). Doctors may also prescribe drugs to prevent certain opportunistic infections — for example, some antibiotics can help prevent PCP, especially in kids.

Although a number of medicines are available to treat HIV infection and slow the onset of AIDS, unless they are taken and administered properly on a round-the-clock schedule, the virus can quickly become resistant to that particular mix of medications. HIV is very adaptable and finds ways to outsmart medical treatments that are not followed properly. This means that if prescribed medicines are not taken at the correct times every day, they will soon fail to keep HIV from reproducing and taking over the body. When that happens, a new regimen will need to be established with different drugs. And if this new mix of medicines is not taken correctly, the virus will likely become resistant to it as well and eventually the person will run out of treatment options.

Aside from the difficulty of getting young children to take their medication on a timed schedule, the medications present other problems. Some have unpleasant side effects, such as a bad flavor, whereas others are only available in pill form, which may be difficult for kids to swallow. Parents who need to give their child these medications should ask the doctor or pharmacist for suggestions on making them easier to take. Many pharmacies now offer flavoring that can be added to bad-tasting medicines, or your doctor may recommend mixing pills with applesauce or pudding.

Because the number of drugs described above is still limited, doctors are concerned that if children fail to take their medicines as prescribed (even missing just a few doses), the virus could eventually develop resistance to existing HIV drugs — making treatment difficult or impossible. It is then doubly important that kids take their medications as directed. One of the most important home treatment messages for any parent or caregiver that the child should take all medications consistently, at the time the prescription indicates. This can be difficult — but many HIV/AIDS family support groups and experienced medical providers can help families with practical suggestions to help them be successful with the many day-to-day challenges they face.

Many of the new medications that fight HIV infection are expensive. One of the major challenges facing individuals, families, communities, and nations is how to make these medications easily available to all that need them.

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