AIDS is still not curable, thanks to various medications but now usually treat well. The drugs prevent the HI virus, which triggers the immune deficiency, in the multiplication. By taking regular medication, the concentration of viruses can be kept so low that the disease itself hardly or not at all noticeable. However, the treatment itself can cause side effects. Learn more about the various AIDS drugs, possible side effects of the therapy and the cost of treatment.
HIV positive and AIDS - what's the difference?
HIV positive and AIDS are often used interchangeably - but this is not quite correct. HIV positive only means that there is an infection with the HI virus. Only when the disease breaks out, AIDS is talked about. The abbreviation stands for the English term "Acquired Immune Deficiency Syndrome", which means something like "Acquired Immunodeficiency Disease".
Years can pass between the infection and the onset of the disease - in about 50 percent of those affected, it takes 10 years or longer until the disease breaks out.
When is a treatment needed?
Treatment of HIV is usually not necessary from the beginning. Regular checks can determine exactly how many HI viruses are in the body and how much the immune system has already been attacked by the virus. For a while, the body usually gets along well with the virus itself.
However, if the doctor finds out during a check that the virus has proliferated, treatment should be started. When exactly the optimal start for a therapy, is still controversial among experts.
Propagation of the HI virus
Like other viruses, the HI virus also needs host cells to multiply. The host cells include, among others, the CD4 helper cells of the immune system. The HI virus docks on the host cells and penetrates into them. It infiltrates its own DNA into the cell so that it no longer produces immune cells but produces viruses.
If the affected immune cell dies, the HI virus seeks a new host cell. As a result, the immune system is weakened more and more, in the worst case, it can lead to a collapse of the immune system. Due to the weakened defense pathogens can be life-threatening for AIDS patients, causing little or no harm to healthy people.
Medicines for AIDS
For the treatment of HIV there are several drugs, which are usually used in combination. The AIDS drugs are divided into different groups depending on where they intervene in the multiplication process. In general, the following five groups are distinguished:
- Entry inhibitors
- Nucleosidic Reverse Transcriptase Inhibitors (NRTIs)
- Non-Nucleosidic Reverse Transcriptase Inhibitors (NNRTIs)
- Integrase inhibitors
- Protease inhibitors
Treatment with the AIDS drugs decreases the number of HI viruses in the body and the immune system can recover. Ideally, the drugs completely prevent the formation of new HIV viruses. If the number of HI viruses in the body decreases, the risk of infection also decreases. This factor plays an important role in the prevention of mother-to-child transmission.
Entry inhibitors ensure that the HI viruses can not even penetrate into the host cells. Unlike the other AIDS drugs, they do not act in the cell, but on their surface. A subset of entry inhibitors - the so-called fusion inhibitors - prevent the virus envelope from being able to fuse with the cell membrane of the host cell.
In addition to the fusion inhibitors, there are other entry inhibitors (attachment inhibitors), which are currently still in the research phase. They prevent the HI viruses from ever being able to dock on the cell surface of the host cells. This happens because the corresponding receptors are artificially occupied by the drug.
Active ingredients: Enfuvirtide, Maraviroc
Nucleosidic Reverse Transcriptase Inhibitors (NRTIs)
For the HI virus to incorporate its genetic information into that of the host cell, it must first change it: it must transform its genetic information from single-stranded RNA to double-stranded DNA. This process requires a specific enzyme called reverse transcriptase.
By taking NRTI, a building block is introduced into the host cells, which resembles the genome building blocks of the virus. If this building block is incorporated into the genetic information by the enzyme, then the DNA chain can no longer be extended. As a result, the activity of the enzyme is inhibited and no further viral DNA can be formed.
Active ingredients: zidovudine, lamivudine, abacavir, didanosine, stavudine, emtricitabine
Non-Nucleosidic Reverse Transcriptase Inhibitors (NNRTIs)
NNRTIs as well as NRTIs attack the enzyme "reverse transcriptase". In contrast to NRTI, however, the ingestion does not introduce any wrong building blocks into the viral genetic information. Instead, NNRTIs directly inhibit the effect of the enzyme: they attach themselves to the "reverse transcriptase" and prevent it from being able to rearrange the genetic information of the HI virus.
Active ingredients: nevirapine, efavirenz
If the genetic information of the virus could be rewritten by the "reverse transcriptase", it must be introduced in the next step in the nucleus of the host cell. This is where the integrase inhibitors come in: They prevent the genetic information from being able to be incorporated into the host cell, thus preventing further spread of the virus.
Active ingredients: Raltegravir, Elvitegravir
Protease Inhibitors (PI)
If the genetic information of the HI virus has already been introduced into the cell, new building blocks for further viruses are produced there and then assembled. The individual components are initially still connected to each other. In order for them to be properly assembled, they must first be separated by the enzyme protease.
Protease inhibitors inhibit this enzyme in its action. As a result, no further viruses can be produced and the virus can no longer multiply.
Active substances: forsamprenavir, indinavir, nelfinavir, ritonavir