Human Immunodeficiency Virus (HIV) treatments have evolved greatly over the past three decades. Early on, a diagnosis was a deadly prognosis, and HIV treatment options were limited. Since the first cases were discovered, an estimated 35 million people have died globally from HIV-related illnesses. Though new infection rates have decreased by 47% since 1998, in 2020 almost 37 million people were living with HIV/AIDS (globally) and treatment options continued to advance. Of the dozens of drugs that have been developed for HIV treatment, many present challenges like inconvenient pill dosing, unrealistic adherence requirements, and high toxicity levels. 

 

How Does HIV affect the body?

HIV weakens the body’s defenses against infection and disease by targeting the immune system and destroying immune cells. Diseases like cancer become increasingly harder to survive for an HIV-infected person. Once HIV advances to AIDS, cancer, and infection rapidly take hold of the infected body, and morbidity increases. Antiretroviral Therapies were developed as treatments to better fight off infections and decrease the risk of developing chronic conditions. Most HIV medications aim to control the growth of the virus, improve the immune system, slow or stop symptoms, and prevent transmission to others.

 

Early HIV Treatments

Some of the earliest HIV treatments came with multiple complications and required no less than 95% adherence protocols in order to achieve treatment success. In the mid-1990s, combination antiretroviral therapies quickly reduced morbidity for HIV-infected patients in the developed world, but multiple medications and stringent food requirements made guidelines hard to achieve adherence. Today, there are six categories of antiretroviral therapies (ARTs) working in different ways- some therapies prevent HIV cells from replicating, bind to a specific protein so the virus can’t replicate itself, block a protein that allows DNA to transfer into healthy cells, block healthy cells from becoming infected, or prevent HIV cells from spreading to healthy cells. Patients who miss a few doses of medication allow the virus to replicate dramatically and can allow drug-resistant strains of HIV to develop, so drug adherence is still a very important part of a therapy’s success. 

 

Hope For The Future

There is promise for the future of HIV treatment. In 2020, there were over 27 million people accessing antiretroviral therapies to treat HIV, which is almost three times more than those in 2010.  Though HIV/AIDS-related deaths have continued to decrease significantly, the virus is nowhere near being irradicated. With fixed-dose combinations now an option, specific medications can be combined into one pill, making adherence easier and drug-resistant strains more preventable. While HIV medications help prevent the transmission of HIV and can improve the quality of life, they are not a cure for the disease. But, with a greater understanding of the genetic makeup of the disease and ever-increasing global health initiatives, treatments focus on preventing and eradicating HIV.  

Pre-exposure prophylaxis (PrEP) medications also help to prevent a person from contracting HIV at the time of exposure. Though these drugs do not work 100% of the time, they are helpful for the partners of an HIV-infected person. Women who become pregnant from an HIV-infected partner are better protected and can pass protection to their child. 

Though efforts to find successful HIV treatments have been lengthy and, at times, presented little hope, the future is promising for new treatments, like vaccines, to make even bigger strides to irradicating HIV altogether. 

 

PFSP Specialty Pharmacy provides patients and their physicians an exceptionally high standard of care with our growing team of specialized pharmacists and staff.  Our dedicated team of pharmacists focuses on improving adherence for patients and works to find an approach that works best for them. Bringing a fresh take on what a Specialty Pharmacy can and should be, we are committed to the care of our patients.  We take pride in being an ethical resource within our community and strive each day to help our patients live enriching and full lives.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309625/
https://www.unaids.org/en/resources/fact-sheet
https://www.webmd.com/hiv-aids/aids-hiv-medication