hivaids

Antiretroviral Therapy and Medications to Help Fight HIV

Although there is no cure for HIV/AIDS today, there is antiretroviral therapy (ART).  ART has been proven effective in prolonging the lives of those infected with HIV if taken as prescribed.  ART therapy is a combination of antiretroviral (AR) drugs that work against HIV to slow its reproduction speed throughout the body.  After many years of research scientists have found it to be most effective if one or more AR drugs are taken at a given time, as the body may become resistant to drugs after a certain time period.

Today there are over twenty-five approved AR drugs to help treat HIV and many more in the works.  These drugs work to not only lower the amount of the virus within the body but also to help fight other infections that one may be exposed to and to improve one’s quality of life.  Have you ever heard of “combination therapy”?  Combination therapy is when you take more than one AR drug at a time.  There is also Highly Active Antiretroviral Therapy (HAART), which is when you take three or more AR drugs at a time.  HAART also helps decrease the rate of opportunistic infections (OIs).

Antiretroviral Therapy

Each and every day researchers and scientists are creating new drugs to help fight HIV/AIDS and prolong the lives of those infected.  Today there are five classes of AR drugs: protease inhibitors (PI), fusion inhibitors, entry inhibitors, integrase inhibitors, and reverse transcriptase (RT) inhibitors.  RT inhibitors have two types: non-nucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs).  Each of these classes perform a different function in the role of protecting the body against HIV.  These functions are as shown below:

Class Function
Protease Inhibitors Interfere with the protein protease, which HIV uses to create infectious viral particles of itself
Fusion Inhibitors Help block HIV from entering healthy non-infected CD4/T-cells
Entry Inhibitors Help block HIV from entering healthy non-infected CD4/T-cells
Integrase Inhibitors Block the insertion of viral DNA into host cell DNA by disabling the protein integrase
Reverse Transcriptase Inhibitors Help block a vital step in the HIV life cycle
       NNRTIs Bind to the protein of RT to disable it, resulting in HIV not being able to copy itself
       NRTIs Stall the reproduction speed of HIV by forcing the virus to use “faulty” building blocks

When Should Treatment Start

As we all know HIV can be very serious and sometimes fatal if left untreated, so beginning proper treatment as soon as possible is crucial.  Guidelines suggest that treatments begin once your body’s CD4/T-cell count falls below 500 cells/mm3, you become pregnant, you are being treated for Hepatitis B, you suffer from severe symptoms, or you have kidney disease related to HIV.  Many people live without even knowing they are HIV positive, if you think that you may be infected please see your physician or visit a clinic where HIV tests are given.  The sooner treatment begins to better your chances are at prolonging your life and becoming the new healthy you.

Some Tips to Remember

When taking HIV/AIDS drugs it is very important to follow the EXACT rules and guidelines you are given by your physician.  Even if you miss just one dose you could potentially develop resistant strains of HIV which may make your AR drugs no longer effective.  To reduce certain side effects of AR drugs talk to your physician or even your local pharmacist to see whether your AR drugs should be taken on a full or empty stomach.  Also, make sure to inform your physician and pharmacist of any additional dietary supplements you may be taking as some may interact with your HIV/AIDS AR drugs making them ineffective.

Remember, taking AR drugs is a lifestyle change that will need to be made in order to successfully fight HIV and improve your quality of life.  Once starting ART you will forever be on ART, so being able to integrate this therapy into your life through a life style change is in fact very important.  Your physician will be more than willing to help you in any and all ways possible.  There are also HIV support groups that can help you adjust to the new lifestyle and be a support team through your journey.  You should not be in any way embarrassed if you are HIV positive, but if you are nervous about being around strangers or prefer to stay anonymous, there are also many wonderful HIV/AIDS support groups and chat rooms online free of charge.

Exercise

Opportunistic Infections and HIV

Over the course of time we are all exposed to bacteria, parasites, and viruses no matter how safe and precautious we are, right?!  If you are a healthy individual it is possible that you will never even know that you were exposed because you will never become infected.  However, those with human immunodeficiency virus (HIV) are at a much higher risk of not only becoming infected with these bacteria, parasites, and viruses they are also faced with more serious health threats as well.  These bacteria, parasites, and viruses are known as opportunistic infections (OIs) because they take advantage of a weak immune system and have the ability to cause potentially devastating illnesses.

OIs are the most common cause of death for those with HIV/ AIDS.  If someone who is HIV positive is diagnosed with any of the twenty AIDS-defining OIs they will be given a diagnosis of AIDS.  OIs are life threatening; signs and symptoms associated with OIs, prevention, as well as treatment should not be taken lightly.

What exactly are OIs?

OIs as mentioned above are named for their ability to attack an already weakened immune system.  OIs can be localized to one body part or they can be systemic and spread through multiple parts of the body.  So, when are you at risk of becoming infected with OIs?  Most of the time your body’s CD4 or T-cell count will determine whether or not you are susceptible.  For example the body’s normal CD4/T-cell count is roughly 500-1,600 cells/mm3.  The table below shows you a quick description of what your body is susceptible to with certain CD4/T-cell counts.

CD4/T-cell count: Susceptible to: Symptoms:
>500 cells/mm3 Usually for those with counts over 500 cells/mm3 being at risk is unlikely.  However for those with counts hovering around 500 cells/mm3, yeast infections and vaginal thrush are possible. See thrush symptoms in the box below
200-500 cells/mm3 Candidiasis (Thrush) 

 

 

 

 

 

 

 

 

Kaposi’s Sarcoma (KS)

Oral: loss of appetite, pain in the mouth and/or throat, difficulty swallowing, white patches on the tongue, lining of mouth, or gums 

Vaginal: itching, burning, irritation, white thick discharge

 

Purplish lesions on the skin or in the mouth, rare cases may also experience GI trouble

100-200 cells/mm3 Progressive Multifocal Leukoencephalopathy (PML) 

Pneumocystis Jirovecii Pneumonia (PCP)

 

Histoplasmosis/

Coccidioidomycosis

Dementia, difficulty walking and speaking, confusion, seizures 

Dry cough, fever, shortness of breath, chest pain

 

Headache, coughing, weight loss, fatigue, shortness of breath, chest pain, fever

50-100 cells/mm3 Cryptococcal infection/Cryptococcosis

 

 

 

 

Toxoplasmosis

 

 

 

Cryptosporidiosis

 

 

 

 

Cytomegalovirus (CMV)

Fever, neck stiffness, headache, and fatigue.  Memory loss and mood change may also be possible 

Fever, seizures, confusion, headaches, motor weakness

 

Nausea and vomiting, stomach cramps, weight loss, chronic watery diarrhea

 

Fever, fatigue, swollen glands, and sore throat.  Those with extremely low levels of CD4 can also experience abdominal pain, blurred vision, diarrhea, and swelling that is painful

<50 cells/mm3 Mycobaterium Aviam Complex (MAC) Night sweats, fatigue, diarrhea, abdominal pain

How to Prevent OIs

We know that germs are everywhere and in the case of OIs the infection is so widespread that is may be very difficult to avoid completely.  Like any other infection or illness there are always ways to help avoid OIs.  Keeping your CD4 counts above 500 cells/mm3 will make becoming infected with OIs less likely.  Below is a list of ways to help prevent becoming infected with OIs.

  • Take your HIV drug treatment as prescribed
  • Manage your stress well and get a good night’s rest
  • Quit smoking or doing other recreational drugs
  • Practice safe sex
  • Avoid drinking or cooking with contaminated/unsafe water
  • Get vaccinated
  • If you exercise you different towels to wipe your sweat off yourself and the equipment you use
  • Thoroughly wash all fruits and veggies
  • Thoroughly cook all foods and avoid raw meats, eggs, and unpasteurized dairy products
  • Exercise regularly
  • Eat a healthy diet
  • Use gloves to pick up your pets waste
  • If you are a cat lover, keep your cats indoor to help prevent them from carrying in germs that may put you at risk of becoming ill

This may look like a long list of things to do, but like any other individual who is HIV positive this is part of the lifestyle change.  Becoming aware of where your body is most susceptible and removing yourself for those situations is key.  Over time it will become almost natural to avoid areas and situations that will put you at risk of becoming infected with an OIs.

Healthy-eating-for-a-healthy-body

Staying Healthy When HIV Positive

Nutrition is a very important part of life for those infected with HIV.  Once infected with HIV the body begins to go through numerous changes making good nutrition vital.  Those who are HIV positive are more likely to also experience other infections, loss of appetite, as well as nausea and vomiting and/or diarrhea which may result in extreme weight loss.  Fat distribution syndrome or lipodystrophy may also occur which results in the body changing shape and rising levels of cholesterol.  Each of these bodily changes makes having a healthy diet and lifestyle essential.

The Basics to a Healthy Life

Healthy Diet

Healthy Diet

Anyone who is infected with HIV knows that it is important to have a healthy lifestyle and most likely visits a registered dietitian at least a few times a year in order to make sure their diet is fulfilling their bodies needs.  There is no specific HIV/AIDS diet out there today; however those infected do require more calories, vitamins/minerals, and certain food groups which can be discussed with your physician and registered dietitian.

The basic healthy diet consisting of lean, low-fat proteins, limited amounts of sweets and sugary foods, high consumption of vegetables, whole grains, legumes, and fruits that is suggested to everyone is also suggested to those with HIV/AIDS.  As well as incorporating the daily amount of recommended water intake and consuming meals and snacks with proteins, carbohydrates, and a small amount of good fats.  All of these basic diet guidelines will help keep the body regulated and working properly.  With a properly functioning body, one’s life expectancy is increased.

Vitamins and minerals are also very important to those infected with HIV as they need extra vitamins and minerals in order to help repair and heal any and all damaged cells in the body.  Consuming foods with higher amount of immune boosting vitamins and minerals is important.  These vitamin and minerals include:

  • Zinc: which is found in peanuts, milk and dairy products, beans, fish, poultry, and meat
  • Vitamin E: which is found in peanuts, vegetable oils, and green lefty veggies
  • Selenium: which is found in fish, eggs, peanut butter, nuts, whole grains, and poultry
  • Vitamin A: which is found in milk, whole eggs, liver, dark green, yellow, red, or orange fruits/veggies
  • Vitamin C: which is found in citrus fruits
  • B Vitamins: which is found in green leafy veggies, white beans, nuts, grain, fish, meat, chicken, broccoli, and avocados

Being able to get the recommended about of vitamins and minerals may be difficult through diet alone, especially since higher amounts are recommended to those infected with HIV.  Physicians and registered dietitians may recommend including a good multivitamin into your diet, such as the Health Beacon Multivitamins. http://healthbeacon.co.uk/articles/featured/health-beacon/2013/07/optimum-nutrition-complex-what-is-it.aspx

Food Safety

Food safety is also very important to those infected with HIV as they are at a much higher risk of contracting a food-borne illness due to a weakened immune system.  Protecting your body not only from the foods you eat but the preparation of foods is also very important.  These basic guidelines will help keep your body healthy and less at risk.

  • Use separate cutting board for your veggies, fruits, and raw meats (I use a different color for each!)
  • Thoroughly wash all fruits and veggies before consumption
  • Avoid consuming raw eggs, seafood, or meats (this includes sushi, shellfish, and oysters)
  • Thoroughly wash your hands, as well as cutting boards and utensils’ with hot water and soap after each use
  • Drink bottled water if unfamiliar with the area/traveling abroad, as well as ice
  • Avoid unpasteurized juices
  • Only used boiled water for drinking and cooking
  • Do not drink water from natural areas such as ponds, streams, etc.
  • Choose filtered or bottled water just to be on the safe side

Some Inspiration!

Look at Magic Johnson for example; he was diagnosed with HIV during his prime basketball career with the LA Lakers which lead him to early retirement in 1991, at the young age of 32.  Johnson came out of retirement twice within the next few years and finally retired for good in 1996.  Now over twenty years later he has controlled the HIV virus to undetectable levels through a life style change of diet, treatment (medication), and exercise.  Today, he is just like any other healthy man of his age doing what he loves.  Yes he will always be HIV positive as there is no cure, but he is a true inspiration to all.

Hepatitis

What is Hepatitis B?

Did you know that approximately 600,000 people die every year from hepatitis B (Hep B) related consequences?  Or that more than 240 million people suffer from chronic liver infections?  Hep B is a potentially fatal disease that is caused by the hepatitis B virus (HBV) and can affect the liver in numerous ways.  The virus has the ability to cause chronic liver infection and/or disease, putting those infected as at a much higher risk of fatality due to cancer and/or cirrhosis (a chronic liver disease).

Hepatitis B

Hepatitis B

Why is the liver so important to us?  The liver acts as the “factory” of the body performing countless jobs that are crucial to maintaining everyday life.  The liver performs jobs such as processing, then removing toxins, drugs, and alcohol; storing glycogen which we use for our short-term energy needs, making bile which helps us digest the fats that we consume on a daily basis, and produces substances that help clot our blood.  We all know that we only have one liver, but he/she is a true champ!  The liver will continue to fight and repair itself day in and day out until it is too badly damaged to longer fight, at which point it slowly stops working all together.

How Do You Get Hep B?

Hep B is most commonly spread through infected blood and other bodily fluids (i.e. semen, open sores, and vaginal secretions).  An infected Hep B woman who is pregnant can also infect her baby with the virus at the time of birth.  Hep B can even be spread through the sharing of toothbrushes and razors of those who are infected, how crazy is that?!  Of those who are infected, Hep B can either be acute or chronic (life-long).  Acute infections can however become chronic over time.

Symptoms

During the initial or acute stage after being firstly infected with Hep B, some people may have and/or show little symptoms while others may be seriously ill for several weeks.  Possible symptoms of Hep B include: jaundice (when the skin become a yellow color or the whites of the eyes turn a orange/brownish color), fever, abdominal pain, unusual urine and/or bowel color, nausea and vomiting, as well as being fatigue without reason.  These symptoms will usually occur within one to six months after becoming infected with HBV.

Testing

Hep B testing is done through a variety of one or more blood tests by your physician or local sexually transmitted infection/disease center.  Today there are seven different types of blood tests available to diagnose Hep B.  Anyone who is at high-risk or thinks they have been infected with Hep B should be tested.

Is There A Treatment?

Unfortunately today there is no cure for Hep B, the main focus of those infected is put on a healthy diet and comfort.  For those suffering from chronic Hep B there are medications used to help prolong life but often these medications are not readily available.  However chemotherapy, liver transfusions, and surgeries are used in higher income countries in order to help prolong the life of those infected.

Healthy adults who are infected with HBV will fight the infection, recover, and completely get rid of the virus more 90% of the time.

Prevention

Since 1982, there has been a vaccination available that has been proven to be 95% effective in preventing the Hep B infection.  Practicing safe sex (using protection and limiting the number of partners), using protection against transmission, and not sharing needles or equipment with others are also ways to help prevent becoming infected with Hep B.  If you have came in contact with a Hep B positive individual through unprotected sex or sharing of other bodily fluids, it is possible to prevent your body from becoming infected by receiving the Hepatitis B immune globulin (HBIG) vaccine within 24 hours of contact with that infected individual.  After 24 hours the vaccine is no longer proven efficient.

How to Protect Others

If you or someone you know is infected with Hep B, precautions should be taken to protect others from becoming infected.  To protect others from Hep B do not donate blood or organs as the infected blood and organs are still able to spread the virus, tell your sex partners that you are infected, use protection during sexual intercourse, do not share your toothbrush or razors with others, do not share any syringes or needles with others, and if pregnant tell your doctor you are infected so that precautions can be made for your child after birth.

hiv

What is HIV/AIDS?

Do you or someone you know suffer from the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)?  Are you at high-risk of becoming infected with HIV?  Princess Diana once said “HIV does not make people dangerous to know, so you can shake their hands and give them a hug: Heaven knows they need it.”

The first cases of HIV/AIDS were reported in 1981, with over 25 million people dying from the virus since.  According to the World Health Organization (WHO) and Joint United Nations Programme on HIV/ AIDS (UNAIDS), there were 35.3 million people living with HIV in 2012, with 2.3 million people becoming newly infected, and 1.6 million people dying from AIDS related causes.  In the UK alone, there were approximately 98,000 people living with HIV in 2012.  That is about 1 in every 650 people.  It was found that the majority of these 98,000 people were infected through unprotected sex (53,000 heterosexuals and 41,000 gay and bisexual men).

What is HIV/AIDS?

HIV/AIDS

HIV is a retrovirus that is spread through bodily fluids and infects ones immune system cells (specifically the CD4 or T-cells), impairing or destroying their function.  Once infected with HIV, your body is unable to get rid of the infection making it difficult to fight other diseases or infections.  HIV is seen in three stages: the acute infection/seroconversion period, the asymptomatic/dormant period, and AIDS.

AIDS is the occurrence of any of the twenty or more infections of HIV-related cancers.  AIDS is also diagnosed once CD4 or T-cells drop below 200.  In a normal healthy body CD4 counts are on average between 500-1,600 cells/mm3.

Stages of HIV

AIDS

Stage one the acute infection/seroconversation period, is normally seen within two to six weeks of becoming infected and presents flu like symptoms.  During this stage the body is attempting to fight the virus but the virus is using the CD4 or T-cells to copy itself, producing a larger amount of HIV.  With such a high amount of HIV in blood, one’s ability to spread the virus to others is highest during this time.

Stage two the asymptomatic/dormant period, HIV is producing at a much slower pace but is still active of course.  During this stage it is possible to feel healthy with little to no symptoms until the middle/end of the stage when the body is becoming weak.  This stage may last up to a decade for those who are not receiving antiretroviral therapy (ART) and up to several decades for those who are receiving ART.  Remember that it is still possible to transmit HIV during this stage even when being treated.

Stage three AIDS, is when the body has become so badly damaged that it is not longer able to fight infections or disease and becomes very vulnerable.  During this stage medical treatment is a must, without treatment life expectancy is around one year.

Who is at Risk?

If you are having unprotected sex, sharing sex toys, sharing needles, or sharing any type of injection equipment, you are putting yourself at high-risk for being infected with HIV.

Testing for HIV

The only way to know if you are infected with HIV is to get tested which is done through a blood test or series of blood tests.  If you believe that you have or have put yourself at high-risk of being infected seek medical attention immediately.  The quicker HIV is detected, the more likely treatment will be successful.

Living with HIV and Treatment

Although once infected you will always have HIV, today’s treatments are very effective and allow those infected to live happy, healthy, long lives.  Today there are emergency HIV medications (Post-exposure prophylaxis PEP) that can be administered within 72 hours (3 days) of being infected.  This medication however is only effective if taken within those 72 hours, the longer you wait the less effective the medication becomes.  This treatment lasts one month and has been known to provide serious side effects.

Antiretrovirals (ARVs) are also used to help treat HIV, which slow the spreading process of the virus through the body.  Once HIV treatment begins, it is likely that you will have to continue treatment for the remainder of your life.  Today the trend of using more natural remedies is becoming more and more popular.  However, what many people do not realize is that medication and natural remedies may interact with one another making medications (the one’s used to keep you healthy and alive) ineffective.  ARVs can interact with St. John’s Wort (a herbaceous plant/shrub with yellow flowers (5 pedals)), over-the-counter medications, and recreational drugs (i.e. cocaine).  You should never take other medications or recreational drugs along with ARVs (or any other medication) unless you have discussed with your physician first.

A healthy diet, exercise, as well as good hygiene will of course also help provide you with a healthy body to prolong life.