Human immunodeficiency virus 1 is the viral infection which leads to acquired immunodeficiency syndrome, or AIDS. Antiretrovirals can slow HIV progression to AIDS, reduce the spread of disease and reduce the incidence of opportunistic infections. According to the World Health Organization, there are estimated to be 33.4 million people living with HIV/AIDS; there were 2.7 million new HIV infections acquired and 2 million deaths in 2008. HIV/AIDS is thought to have caused 25 million deaths since the HIV/AIDS pandemic was identified in the early 1980s.
Access to antiretrovirals
Of the 33.4 million people living with HIV/AIDS, 3 million live in developed countries and have access to antiretroviral drugs. For 30.4 million HIV-infected individuals living in low or middle income countries access can be more difficult. As antiretroviral use is not routinely prescribed for early HIV infections, WHO estimates that there are 9.7 million people in low to middle income countries in need of antiretroviral drugs. By the end of 2008, WHO estimates that around 4 million people in these countries had access to antiretroviral drugs.
Goals for Antiretroviral Use
Millennium Development Goal 6 aims to halt and reverse the spread of HIV/AIDS. There is a long way to go, but WHO Director-General Margaret Chan recently provided encouraging news that "the number of people in low- and middle-income countries receiving antiretroviral therapy for AIDS moved from under 200,000 in late 2002, to 3 million, then beyond 4 million [in 2008]." There was around a 10-fold increase in antiretroviral access between 2003 and 2008. The WHO/UNAIDS 2009 AIDS epidemic update estimates that 2.9 million lives have been saved by use of antiretrovirals.
How is HIV Targeted by Antiretrovirals?
Antiretroviral therapies which include a combination of 2 or more drugs are termed combination therapies, those which use more than 3 drugs are considered as highly active antiretroviral therapies. There are 5 classes of antiretroviral drugs which act to inhibit HIV in different ways. One class of drugs stops the virus making new copies of itself. Another class inhibits the virus from binding to and entering into immune cells. Another class stops the virus from inserting its own genetic material into the immune cell. Two more classes stop the virus from replicating within immune cells after it has entered the cells.
Antiretroviral therapies do not provide a cure for HIV/AIDS, but combinations of drugs with different functions can slow disease progress, thus providing better quality of life and longer life expectancy for HIV/AIDS patients.
