A couple of decades after AIDS exploded, a cure is still a mirage. At best, medications slow the disease and keep debilitating infections at bay. Early detection and timely intervention are still the best recourse. The focus of most treatments is to boost the immune system, reduce stress, ensure healthy nutrition and a regular exercise regimen.
Increasingly, however, voices are ricocheting in the medical fraternity that conventional medications do more harm than good. As is well known, while subjugating targeted diseases, antibiotics and steroids damage the body`s immune system. More and more people are now taking recourse to alternative therapies that take a holistic view of the disease and seek to rejuvenate the body`s natural defenses. Many are also utilizing alternative therapies in conjunction with allopathy.
Although the hunt for a vaccine is hotting up, presently there is no cure for AIDS. Current treatments, however, seek to improve the quality of life of people with AIDS (PWAs). A current popular treatment involves a "triple-cocktail" approach, also known as the highly active antiretroviral therapy (HAART), which uses three different drugs to combat the infection. These medications are two nucleoside analog drugs, such as AZT and 3TC, and a protease inhibitor, such as Crixivan or Ritonavir. Protease is an enzyme needed for HIV replication; a protease inhibitor stops protease from working. The drugs reduce the concentration of viruses in the bloodstream to low, even undetectable levels.
So far, the combination HAART treatment is the closest thing medical science has to an effective therapy. The key to its success in some patients lies in the drug combination`s ability to disrupt HIV at different stages in its replication. Reverse transcriptase inhibitors, which usually make up two drugs in the HAART regimen, restrain an enzyme crucial to an early stage of HIV duplication. Protease inhibitors hold back another enzyme that functions near the end of the HIV replication process. The combination can be prescribed to those newly infected with the virus, as well as AIDS patients.
FDA approved the first drug specifically to combat HIV and AIDS in 1987. Commonly known as AZT (zidovudine), it is in the family of reverse transcriptase inhibitors called nucleoside analogs. Protease inhibitors, the last part of the triple cocktail, have only been on the market about three years. FDA approved the first one, Invirase (saquinavir), in late 1995. Others approved since include Norvir (ritonavir), Crixivan (indinavir), Viracept (nelfinavir), and Agenerase (amprenivir). Viracept was the first of its class to be labeled for use in children and adults. Norvir and Agenerase are now approved for children as well. FDA also has approved Fortovase, a new formulation of saquinavir that comes in a soft gelatin capsule that allows more drug to be absorbed into the body than the earlier version.
Drawbacks of the Regimen
Though the use of protease inhibitors with other AIDS drugs has had a drastic impact on the health of HIV and AIDS patients, there are drawbacks. The HAART treatment is not an AIDS cure, says FDA`s Klein. Though HIV, the virus that causes AIDS, may not be detectable in the blood following successful HAART treatment, experts generally feel that the virus is still present, lurking in hiding spots such as the lymph nodes, the brain, testes, and the retina.
"The improved sense of well-being, and the belief that lower viral load means they will not transmit the virus, has translated, in some communities, to a lapse in certain prevention practices," Klein says. He adds that this is dangerous because infected people, even with diminished viral counts, can spread the virus.
Another concern is that the combination therapy, besides being very expensive, requires a much more complicated treatment regimen. "Patients need to stay aware of and adhere to their dosing schedule," says Klein. "If not taken on a strict regimen, protease inhibitors can result in the emergence of HIV strains that are resistant to treatment." Numerous studies also h