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Treatment of AIDS. “Antiretroviral therapy & vaccines”. HAART(Highly active antiretroviral therapy). In HAART we use antiretroviral drugs which interfere with the life cycle of HIV and inhibit there growth. In HAART there are 4 different kinds of antiretroviral drugs are used-.

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Treatment of aids

Treatment of AIDS

“Antiretroviral therapy & vaccines”


Haart highly active antiretroviral therapy
HAART(Highly active antiretroviral therapy)

In HAART we use antiretroviral drugs which interfere with the life cycle of HIV and inhibit there growth


In haart there are 4 different kinds of antiretroviral drugs are used
In HAART there are 4 different kinds of antiretroviral drugs are used-

NRTI( nucleotide reverse transcriptase inhibitor):-

NRTI are similar to structure of normal DNA bases except 3 prime –OH group and phosphate group.NRTI is activated inside the cell by the additon of three phosphate groups to their deoxyribose moiety, to form NRTI triphosphate.This phosphorylation step is carried out by cellular kinase enzyme


Treatment of aids

Examples of NRTI: are used-

Didanosine

Stavudine


Treatment of aids


Ntrti nucleoide reverse transcriptase inhibitor
NtRTI(Nucleoide reverse transcriptase inhibitor):- are used-

It is similar to structure of normal DNA bases except 3 prime –OH group so the NtRTI is incorporated into the growing chain and terminates the chain elongation during replication.


Examples
Examples:- are used-

Tenofovir

Adefovir


Nnrti non nucleoside reverse transcriptase inhibitors
NNRTI(Non nucleoside reverse transcriptase inhibitors):- are used-

These drugs act via non-competetive binding to a hydrophobic pocket close to the reverse transcriptase enzyme of HIV


Examples of nnrtis are
Examples of NNRTIS are- are used-

  • Nevirapine

  • Efavirenz

  • Delavirdine


Protease inhibiors pi
Protease Inhibiors(PI):- are used-

Processing of large HIV precursor protein encoded by gag ang gag-pol genes of HIV into structural proteins of the viral core is performed via proteolytic cleavage by HIV encoded aspartic protease and is necessary for maturation of immature virus particle. These drugs are synthetic analogues of the HIV protein and block the action of HIV protease. Protease inhibitors also decrease CD4 apoptosis through decreased CD4 interleukin-1beta-converting enzyme(ICE or caspase 1)


Examples of protease inhibitors includes
Examples of protease inhibitors includes- are used-

Nelfinavir

Saquinavir


Treatment of aids

Ritonavir are used-

Indinavir


Inhibition of fusion of hiv with target cell
Inhibition of fusion of HIV with target cell:- are used-

This type of drug prevents the fusion of HIV to the target cells. This type of drug corresponds to 36 amino acids within C-terminal hapted repeat region(HR2) of HIV1 gp41 subunit of the viral envelope (env) protein. This prevents the conformational changes to form a stable complex required membrane fusion to target cell.


Haart regimens
HAART Regimens:- are used-

  • HAART regiments may include combinations of one or more of NRTI/NtRTI,NNRTI and PI

    The standard combination of drugs may be as follows according to clinical trails, adverse effect, efficacy-

  • NRTI+NRTI+PI

  • NRTI+NRTI+NNRTI

  • NRTI+NRTI+PI+PI


Mutidrug rescue therapy mdrt
Mutidrug rescue therapy(MDRT):- are used-

  • This therapy is the combination of 9 antiviral drugs. This is used to treat the patients infected with several drug resistant strain of HIV


Result of haart therapy
Result of HAART therapy:- are used-

  • CD4 count typically increases

  • Increases the life of treated patients by decreasing the frequency and severity of opportunistic infection

  • It reduces HIV1 RNA levels in plasma

  • Without treatment, the net median survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype . The development of HAART as effective therapy for HIV infection and AIDS reduced the death rate from this disease by 80%, and raised the life expectancy for a newly diagnosed HIV-infected person to about 20 years


Disadvantage of haart
Disadvantage of HAART:- are used-

  • It causes some unhealthy condition in patients who cannot tolerate the regimen

  • The unhealthy condition include lactic acidosis, abdominal pain, nousa, vomiting, headache, bone marrow suppression with anemia, panceatitis, peripheral neuropathy and sometimes myopathy also

  • In appropriate treatment with HAART regimen also give rise to drug resistant strains of HIV which is the major clinical problem


Vaccine
Vaccine :- are used-

Several approaches are taken to develop vaccine against HIV, These include-

  • Use of pox virus such as vaccinia as recombinant vector for vaccination with HIV envelope protein

  • Gene therapy

  • Vaccine development targeting on HIV gp120 and gp160 envelope protein to induce humoral response.

  • Blocking the HIV entry into the cell.


Difficulties of vaccine development
Difficulties of Vaccine development— are used-

  • HIV epitope variability

  • HIV avoidance of immune response through cell to cell transmission

  • Lack of effective neutralizing antibody response and induction of adverse immune reactions through HIV homology to endogenous human proteins.


Treatment of aids

Although several researches are going on there is no particular treatment which can cure HIV. HAART therapy can increase the life span of infected persons but can not cure the disease. So, it is better to avoid all the chances of HIV infection though the maintenance of safety healthcare guidelines regarding to AIDS.


Treatment of aids

Stay Safe , Live Long particular treatment which can cure HIV. HAART therapy can increase the life span of infected persons but can not cure the disease. So, it is better to avoid all the chances of HIV infection though the maintenance of safety healthcare guidelines regarding to AIDS.

Subhabrata Dev