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HAART Therapy. Christine Ashton Christy Naylor Katherine Tompkins. What is HAART?. Highly active antiretroviral therapy used for HIV treatment Usually consists of a combination of two nucleoside analogues and a protease inhibitor. Why use HAART?.
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HAART Therapy Christine Ashton Christy Naylor Katherine Tompkins
What is HAART? • Highly active antiretroviral therapy used for HIV treatment • Usually consists of a combination of two nucleoside analogues and a protease inhibitor
Why use HAART? • Can still potentially work even if one or two of the drugs fail (b/c it is a triple therapy) • Can help fight against strains that have become resistant to other antiretrovirals that don’t completely stop the virus from growing
HAART and CD4 On HAART, the CD4 count can increase, the function of the white blood cells (especially lymphocytes) improves, the lymph nodes become more active and many infections will get better. The important white blood cells in HIV (the lymphocytes) exist in many different forms. There is a shift in some of these forms which may be beneficial. One paradox of HAART therapy is that sometimes, perhaps because the immune system is working better, some infections which are present in a quiet form may become active again; however, this does not seem to be a major problem when compared with all of the clinical benefits which do occur with HAART therapy.
Benefits of HAART • Suppression of viremia and virus shedding in semen and vaginal secretions • Increased CD4+ T cell count • Reduced immune activation • Restoration of lymph node architecture • Clinical improvement • Prolonged survival • Fewer O.I.s and HIV-associated malignancies • Ability to discontinue O.I. prophylaxis and maintenance therapy
Disadvantages • Doesn’t work in all cases • Doesn’t clear the latently infected cell pool • Doesn’t restore HIV-specific immunity • Doesn’t prevent relapse • Offer an affordable therapy for 95% of HIV-infected people in the world (can cost $10,000-$12,000 per year) • Prevent spread of infection, even if HIV is not present in blood tests anymore
Toxicities associated with HAART • Lipoatrophy • Abnormal fat accumulation • Hyperlipidemia • Insulin resistance • Bone loss • Marrow suppression • Pancreatitis • Hepatitis • Nephropathy • Neuropathy
Effects of protease inhibitors in the form of body deformations and mutilations From:http://www.virusmyth.net/aids/news/bodydeform.htm
References • http://www.fda.gov/ohrms/dockets/ac/00/slides/3652s1_01/tsld002.htm • Improving HIV Therapy, John Bartlett and Richard Moore, Scientific American