AIDS: Is there no cure?

The HIV (Human Immunodeficiency Virus) virus infects human beings and causes them to lose the ability to protect themselves against infections. This crippling of natural immunity results in an increased risk of infections due to bacteria and other microorganisms which may eventually lead to dreadful circumstances.

Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by an infection with the HIV virus. Without early detection and treatment, HIV positive (infected) individuals may exhibit AIDS symptoms such as sudden weight loss, frequent fevers, inflamed lymph nodes, and lung inflammation.

According to the World Health Organization (WHO), risk factors for HIV infection include unprotected sexual intercourse with HIV positive individuals, needle sharing with HIV positive individuals, blood transfusions (of which the donor is HIV positive), organ transplants with tainted blood and mother to child disease transmission (a child being infected with the HIV virus prior to birth, due to a HIV positive mother).

Is there no cure for this disease? For now, HIV infections cannot be completely cured but can be controlled with positive approaches. Current treatments for HIV infections aim to extend the lifespan of HIV positive individuals and increase their quality of life by suppressing the HIV virus proliferation. Treatment approach is with the hope that these affected individuals can lead to a healthy and relatively normal life as long as they remain adherent to the treatment.

Before initiating treatment, HIV positive individuals must undergo several laboratory tests, this includes (but are not limited to) CD4 count, viral load, hepatitis screening, liver function and renal function tests.

A CD4 cell is a type of white blood cell, which acts as an important part of the body’s defence mechanism to fight infections, thus a CD4 count laboratory test determines the amount of CD4 white blood cells are present in the body. A viral load test, on the other hand, is done to quantify the extent of HIV genetic material present in an infected individual. These tests are routinely conducted to monitor the efficacy of the ongoing treatment.

The treatment regimen used for HIV infections is known as the “Highly Active Antiretroviral Therapy” (HAART). Currently, the World Health Organization (WHO) recommends initiating HAART for all HIV positive individuals, regardless of clinical stage of infection. An effective treatment regimen usually comprises a combination of three medicines from at least two pharmacologic drug classes (There are currently 7 pharmacologic drug classes available). Commonly used medicines include tenofovir, emtricitabine, zidovudine, lamivudine, efavirenz and nevirapine.

In order to ensure optimal outcomes for patients receiving treatment, patients are advised to take their medicines at the same time every day and to be present at all their follow-up appointments with healthcare professionals. Before the onset of treatment, patients are given several counselling sessions by doctors, pharmacists or counsellors educated in the treatment of HIV infections. These counselling sessions are crucial to ensuring that patients are truly ready to begin a lifelong course of therapy and adhere to their treatment. Any form of non-compliance to their prescribed medicines will almost certainly result in treatment failure.

HAART may cause several side effects during the early stages of treatment such as nausea, vomiting, diarrhoea, gastrointestinal discomfort, dizziness, headache, vivid dreams, and rashes. During their counselling sessions with pharmacists, patients will be taught to identify and overcome any possible side effects that may occur whilst undergoing therapy. However, not all patients will encounter side effects and most patients that do will only experience it for a short period. These undesirable effects will decrease and cease over time once the body has acclimatized to the medicines.

Although AIDS may have no cure, it can certainly be controlled. The Ministry of Health implores HIV positive individuals (or anyone with risk factors) to get tested and treated as soon as possible so that they can experience a better quality of life.

Please call the National Pharmacy Call Centre (NPCC) at the toll-free line 1800-88-6722, weekdays from 8 am to 5 pm if there are any inquiries regarding the use of medicines.

Prepared by:                                                                                                                                                          Audrey Lim                                                                                                                                                      Pharmacist                                                                                                                                                            Ministry of Health Malaysia