According to the "5-Minute Clinical Consult" textbook, in 2006 there were 56,300 new cases of HIV infection in the United States. Also in 2006, there were 14,627 deaths of people with AIDS. Worldwide in 2007, 32.2 million people are living with HIV infection. Treatment for AIDS-related symptoms and HIV infection are available.
HAART Therapy
HAART stands for "highly active antiretroviral treatment," the standard of care for HIV infection. This is usually a combination of three or more drugs. The main goal of HAART is to decrease the viral load or amount of virus that a patient has in order to delay immune suppression. Immunity is important to prevent opportunistic infections, which are infections that people with compromised immunity get. Also, to prevent drug resistance, triple or more therapy was introduced, which allowed therapy to continue for much longer periods of time. Most of these drugs block the enzymes necessary for HIV to replicate. Some examples of therapy are: abacavir plus zidovudine plus lamivudine, or zidovudine plus lamivudine plus efavirenz.
Opportunistic Infections
A patient receives an AIDS diagnosis when their CD4 count is less than 200 or they acquire an opportunistic infection such as pneumocystis pneumonia. Cytomegalovirus, toxoplasmosis and histoplasmosis are types of opportunistic infections requiring specialized treatments. When patients' CD4 counts or T-lymphocyte counts drop below 200, they do not have immune function to fight off infection. This makes them very susceptible to opportunistic infections. Opportunistic infections are so called because people with functioning immune systems do not usually get these diseases. The pathogens that cause these diseases recognize the "opportunity" to infect a host that will not reject them. Treatment varies depending on the infection. For those who are HIV positive and have not been taking HAART therapy, an opportunistic infection is a signal to begin. Many patients will start prophylactic therapy or preventative therapy with sulfamethoxazole and trimethoprim, commonly known as Bactrim or Septra. According to the international AIDS charity Avert, sulfamethoxazole and trimethoprim has been shown to significantly reduce mortality among patients who are starting HAART therapy.
Nutrition
Nutrition plays an important role in treating HIV/AIDS patients. Weight loss, wasting syndrome and malnutrition are common problems in HIV/AIDS patients and can contribute to disease progression, according to Tufts University. To help maintain a healthy immune system, a healthy diet is required. The multiple medications that patients take require good nutrition for some of them to work. Nausea, diarrhea, fat redistribution, high blood sugar, high blood pressure and fatigue can be helped with a good diet and exercise program.
References
- "5-Minute Clinical Consult, 2010." Frank J. Domino, MD, Editor. 2009
- Avert: Introduction to HIV and AIDS Drug Treatment
- Avert: HIV related opportunistic infections.
- Tufts University: Why is Good Nutrition Important in HIV
