Posts tagged HIV healthcare
Low Risk of Birth Defects
Low Risk of Birth Defects: HIV and Antiretroviral Medication
With new compounds and therapies expanding what can be done for individuals living with HIV, more and more infected women are looking towards pregnancy and childbirth. The combination of pregnancy and the latest antiviral medications is always a cause of concern, as we often don’t have enough data to make a definitive decision on whether a certain medicine should be given to an individual while pregnant. We also need to know when it is most likely for a mother to infect her infant, and which medicines are best at keeping the rate of infection low. Certainly, many antiretroviral drugs developed in the fight against HIV have been thought to increase the potential of birth defects in the unborn children. A new study, however, shows the opposite. Indeed, it confirms a low risk of birth defects by antiretroviral medications used during pregnancy.
This study – the Pediatric HIV/AIDS Cohort Study (PHACS) Surveillance Monitoring of ART Toxicities (SMARTT) study – released its findings on 10 November 2014. Atazanavir was the only antiretroviral drug that was shown to increase the otherwise low risk of birth defects among HIV-positive women. This medication showed a 2-fold increase in the risk of birth defects, particularly musculoskeletal and skin anomalies. However, another study confirmed that at least three varied regimens of anti-HIV medications—that did not include atazanavir—was safe for women who are expecting. In fact, all other antiretroviral, anti-HIV medications tested in these studies showed no increase in the risk of birth defects. This is great news for HIV infected women who still want to become mothers. With the risks of infecting their child minimal, and the side effects almost non-existent, the hopes of researchers are high that we will find ways to altogether eliminate the transfer of HIV between mother and child.
HIV Infected Individuals and Age Related Diseases
HIV Infected Individuals and Age Related Diseases: Appear at Similar Age as in Uninfected Adults
Heart attacks, cancer, and kidney failure among HIV-infected individuals has been thoroughly researched and the data shows that infected individuals are more likely to develop one of these diseases than people who are not HIV positive. This research began to be compiled in the mid-1990s, when those infected with HIV were starting to live longer thanks to new antiretroviral medications. Before these drugs were created, contracting HIV was almost certainly a death sentence. When HIV/AIDs first came onto the scene, the HIV cells would eradicate the immune system, the person would develop AIDS, and common diseases like the cold or influenza would ravage the body and kill the host. In the years since, however, antiretroviral drugs have been developed and continually improved upon, and HIV has become a manageable disease. In fact, many HIV-positive individuals have been able to live out their lives with the infection and, in the U.S. and other developed countries, are now dying of non-HIV related circumstances. With the numbers of older HIV-positive individuals growing, the amount of research on those in this group has increased. The latest studies now suggest that among HIV infected individuals, age-related diseases appear at similar ages, as compared with uninfected individuals.
Researchers at the Johns Hopkins Bloomberg School of Public Health used data from almost 100,000 individuals, both infected and uninfected, who suffered from age-related diseases between 2003 and 2010. The results confirmed that those who are HIV-infected tend to develop heart attacks, cancer, and kidney failure much more commonly than in uninfected adults. However, it also showed that the ages of those developing heart attacks and cancer were the same in both infected and uninfected patients. Moreover, kidney failure seemed to only have a six-month gap between infected patients and patients who were not HIV positive. This news, that among HIV infected individuals age-related diseases appear at similar ages regardless of HIV status, shows that the timeline of getting checked for these diseases does not have to be significantly altered. However, the importance of checkups is still much greater for HIV-infected adults.
HIV Infected Stimulant Users
HIV Infected Stimulant Users: Treatment Benefits
Some studies in the mid 90’s pointed to evidence that stimulants – such as cocaine or methamphetamine – were causing the antiretroviral therapy to be less effective against HIV. For example, HIV infected stimulant users were developing AIDS more frequently than non-using infected. The most recent studies, however, have shown that this evidence was misleading, and that antiretroviral medication does indeed have the same effects on stimulant users and non-users. The evidence was not taking into account the difficulty many stimulant users, especially those who abused these kinds of drugs, have had to obtain their needed medication. Much of this stemmed from a belief that users of these kinds of drugs would also abuse the antiretroviral medication, or would not take the medication properly.
The new data, collected between 1996 and 2012, shows that stimulant users frequently take their medication at the proper intervals, even when they are unable to lessen or stop their respective stimulant substance. This proved that not only do these infected take their medication as directed, the effects of the medication are nearly identical to non-using infected patients. The concern that still lingers concerning HIV infected stimulant users, however, is the spread of the disease due to their drug-related activities. The latest study, out of the Multicenter AIDS Cohort Study (an ongoing study of HIV infected men who have sex with men), has concluded that the biggest focus researchers should now have when dealing with HIV infected stimulant users is education and prevention. One thing the study noticed is that stimulant users are more likely to be open and forthright with their physician—if that doctor is a specialist in HIV and infectious diseases (as opposed to a general physician or one who specializes in drug use and abuse). Even when the patients are not ready to go to a group or doctor for help with their drug habits, they are ready to work with an HIV specialist to ensure their life with HIV is as healthy as possible.
Life After AIDS
Life After AIDS: A Realistic Timetable
Up until 2001 and the advent of antiretroviral (ART) medications, HIV and AIDS was considered an epidemic, with death almost a certainty. Or, at least this was the case for those who were not wealthy or heavily covered by health insurance. AZT, the first popular antiretroviral drug, was extremely expensive. It was also only available in limited quantities, as manufacturers strained to produce enough of the drug for the needs of the worldwide population. This has all changed. Because of new research, a greater awareness of HIV, and insight into what the virus is and how it works, many scientists and doctors are reasonably hopeful in a future life after AIDS. In fact, some are even creating realistic timetables as to when this could be realized.
There is still no known cure for HIV infection. It is this virus – when left untreated – that causes acquired immune deficiency syndrome (AIDS). There are several drugs available today, however, which can either deactivate HIV cells or kill them outright. Through a regimen of these drugs, a person can survive with HIV for many years, even decades, without ever developing AIDS.
Moreover, this new phase of research into anti-HIV medications has resulted in an outpouring of education and understanding about the virus and disease. Certainly, the stigmas that were once attached to AIDS in the 1980’s have lessened. Because of the new treatments and changing attitudes, many have come forward to be tested who, in the past, might have assumed they would die and didn’t come forward for treatment to avoid the ‘shame’ of being HIV positive. Thanks to this domino effect of research and awareness the number of deaths from AIDS, although still unacceptably high, has been drastically reduced to 3 million per year. It has also led to fewer new infections from HIV, which numbers around 3.5 million per year.
In impoverished countries, those without adequate access to drug therapies, medical facilities, and proper HIV education, the number of deaths to AIDS along with new cases of HIV is still on the rise. This is the biggest hurdle to achieving the lofty goal of a life after AIDS. Even so, with the dramatic results in the past 13 years in countries like the United States, many are hopeful that by the later end of the 21st century, it is possible there will be no new infections. This will only happen when drugs have advanced to the point that they can completely sterilize the virus and when said drugs are accessible to everyone in the world.
HIV Requires Early Treatment
HIV Requires Early Treatment: B Cells Are the Key in Infected Subjects
It was very clear early on in HIV research that the earlier treatment for the disease begins, the better a person will respond to the antiretroviral medications. However, the exact reason for this has eluded researchers. A recent study of the blood of nearly 100 treated and untreated HIV-infected volunteers has provided a possible explanation as to why HIV requires early treatment. The study underscored the need to begin treatment as close to viral exposure as possible, as it not only means saved lives but it also can ensure a healthier and better quality of life for those living with HIV.
B cells are immune system cells that produce antibodies to viruses like HIV. However, in the above mentioned study, some previously unknown characteristics of B cells were discovered. The researchers found that the antibodies the B cells produced in infected but untreated people were abnormal. These B cells were more activated, more unstable and unresponsive to further stimulation as compared to normal B cells. This may explain why HIV antibodies naturally produced in the body are unable to clear the infection.
The research further discovered that those who were HIV infected—but had undergone early antiretroviral treatment—had B cell responses that were dramatically different from those who had not received treatment. In the treated patients their antibodies were normal, although there were less of them than in the untreated volunteers. The treated patient’s antibodies were also stronger and more effective on the HIV cells. This resulted in a lower amount of virus in the blood, known as a viral load. It also meant a low level of immune activation, which results in a stronger and healthier immune system. All of this underscores the fact that HIV requires early treatment. Antiretroviral medication, when prescribed during the early stages of the infection can stabilize the mutation of any cells – T cells or B cells. This means that the infected person’s natural immune defenses will be robust and better able to defend against HIV for the long run.