Modern treatment of HIV infection. Clinics offering HIV therapy

Many years have passed since the invention of the first version of antiretroviral therapy (zidovudine monodrug) in 1985. Scientists had high hopes for this drug, but the results were not as good as we would like. Many years have passed since then, and modern scientists have been able to reach such a level in the treatment of the immunodeficiency virus that, with proper therapy, the life expectancy of an HIV-positive person is no different from any person with a negative HIV status.

But despite all the successes, a way to completely rid the body of this virus has not yet been found. Modern antiretroviral therapy is similar to the principles of treating any chronic disease, for example, diabetes - the patient needs to take drugs for life to control the level of the viral load.

Basic principles of modern treatment of HIV infection

Due to the fact that there are no means to completely rid patients of HIV infection, all treatment is based on preventing or slowing the progression of the disease. There are three components to fighting the virus:

• Antiretroviral therapy;
• Prevention and treatment of opportunistic infections;
• Pathogenetic treatment of some syndromes.

Thus, successful treatment of patients with HIV infection requires:

Among the basic principles of the use of antiretroviral therapy are:

• The need to prescribe treatment before the development of immunodeficiency, followed by lifelong use of drugs aimed at suppressing HIV replication.
• Combining the prescription of three or four antiretroviral drugs. This method is called highly active antiretroviral therapy (HAART for short).

We hope that very soon scientists will find a way to completely rid the human body of HIV infection and then another terrible disease will remain a thing of the past.

Let us remind you that you can read the history of the development of antiretroviral drugs in.

November 17-18, 2016 specialists from the AIDS Center took part in the First Scientific and Practical Conference “Modern aspects of the prevention, diagnosis and treatment of HIV infection” (St. Petersburg)

Scientists, experts, health officials, medical professionals and community leaders attended the conference and shared experiences on best HIV strategies and practices. Only by consolidating the efforts of all specialists affected by this problem is it possible to further combat the epidemic.

The conference was organized by: the Government of St. Petersburg, the Health Committee of St. Petersburg, the St. Petersburg State Budgetary Healthcare Institution “Center for the Prevention and Control of AIDS and Infectious Diseases”

At the grand opening, a welcoming speech was read from the Vice-Governor of St. Petersburg O.A. Kazan, which noted the importance of the conference, since HIV infection poses a serious threat to the life, health and well-being of the population, state and public security not only in our country, but throughout the world. The current epidemiological situation with HIV infection requires an integrated, interdisciplinary approach involving the widest range of specialists, analysis of all accumulated knowledge and best practices. The Vice-Governor expressed confidence that the conference events will become an effective platform for close interaction between various specialists: doctors, healthcare organizers and social workers.
At the opening of the conference, the Chairman of the Health Committee of the Government of St. Petersburg, V.M., spoke. Kolabutin, who noted the relevance of a broad discussion of the HIV/AIDS problem in Russia and the need for new organizational solutions to stabilize the epidemiological situation in St. Petersburg.

Chief freelance specialist of the Health Committee of the Government of St. Petersburg, Professor Yu.V. Lobzin noted in his welcoming speech that despite the achievements of modern medicine and it is still difficult to reverse the negative trends in the spread of HIV infection, therefore the fight against the HIV epidemic is recognized by the Government of the Russian Federation as one of the priority areas of its activities.

Head of the Federal AIDS Center V.V. Pokrovsky expressed the opinion that the spread of HIV in Russia is largely due to the fact that less and less attention is paid to primary HIV prevention, and this despite the fact that last year the number of newly identified cases of HIV exceeded the number of officially registered cases of influenza.

Regional Director of the Joint UN Program on HIV/AIDS in Eastern Europe and Central Asia, Vinay Patrick Saldana, in his welcoming speech, noted that today a special situation has developed in Russia, since Russia has the largest HIV/AIDS epidemic of all countries in Eastern Europe and Central Asia . Therefore, it is in Russia that the key strategy for the Government should be the UNAIDS “90-90-90” strategy, which is to achieve three goals by 2020: 90% level of diagnosis of HIV-infected persons, 90% access to antiretroviral therapy among all identified persons and achievement undetectable viral load in 90% of individuals.

Director of the charitable foundation "Humanitarian Action" S.G. Dugin especially emphasized the uniqueness of the conference, which consisted in the fact that the discussion of issues of combating the HIV epidemic was carried out within the framework of tripartite communication between the professional community, the patient movement and non-profit public organizations.

After the first plenary session, the opening ceremony of HIV testing week in St. Petersburg took place.
In just two days, 2 plenary and 18 sectional sessions were held.

The Conference was attended by 589 people, including famous scientists, international experts, practitioners, activists, and representatives of the patient community. Exhibitions of pharmaceutical campaigns and the possibility of rapid testing in the mobile laboratory of the charitable foundation “Humanitarian Action” were organized. A number of working meetings took place, new contacts were acquired and cooperation was planned. All reports will be published in the collection of conference materials.

Treatment of HIV infection is currently an important problem in modern medicine. The number of HIV-infected people around the world is growing steadily. Current HIV/AIDS treatment slows the progression of the disease, but does not cure patients completely. Today, the search for drugs is intensively carried out in many countries around the world. New treatment regimens are being developed. A search is underway for drugs that restore immunity, and issues of combating the development of infectious complications and tumors in AIDS patients are being studied.

Rice. 1. The photo shows the moment of budding when new virions leave the target cell.

Main goals of antiretroviral therapy for HIV patients

Timely prescription of antiretroviral therapy, the use of optimal treatment regimens and the creation of a protective psychological regime can prolong and improve the patient’s quality of life, delay the development of life-threatening complications, and achieve longer remissions. The main goal of antiretroviral therapy is to reduce the viral load to a level where it cannot be detected by laboratory testing and to increase the number of CD4 lymphocytes.

Rice. 2. For the first time, people started talking about AIDS in large numbers since the mid-80s.

Basic principles of treatment for HIV patients

The basic principles of treating HIV patients are:

• creation of a protective psychological regime;
• timely initiation of highly active antiretroviral therapy (HAART);
• prevention, early detection and treatment of secondary diseases.

Treatment of HIV/AIDS should be combined and include antiviral therapy, pathogenetic and symptomatic treatment. Treatment of patients at the stage of AIDS, when the development of opportunistic diseases is noted, is of the same importance as the use of HAART.

Antiretroviral therapy slows down the progression of the disease and its transition to the AIDS stage for 10 - 20 years. It is necessary to take into account the fact that any treatment regimen may become ineffective after 6-12 months due to mutations of viruses and their acquisition of resistance (resistance) to antiviral drugs. In addition, in some cases, individual intolerance to HIV medications is recorded. 40% of patients in the later stages of HIV infection develop neutropenia and anemia as a result of taking antiretroviral drugs.

Taking antiretroviral drugs should only be carried out as prescribed by a doctor. The need for daily intake is dictated by the course of the disease itself and is a great challenge for the patient. Antiviral drugs that can be injected twice a month are in the trial phase, but in the meantime, antiviral drugs must be taken daily and at the same time. Indications for taking antiviral drugs are a high viral load and a significant decrease in the number of CD4 lymphocytes.

Antiretroviral drugs are taken in combination. The doctor takes into account the patient’s general condition, viral load, concomitant diseases and a number of other factors. The HIV/AIDS treatment regimen includes 3 or more drugs.

Use of immunomodulators may open up new prospects in the treatment of HIV infection.

Primary prevention involves preventing the development of opportunistic diseases that develop when the level of CD4 lymphocytes is below the critical level - 200 per 1 mm 3.

Secondary prevention involves prescribing chemotherapy drugs to AIDS patients to prevent relapse of the disease.

Supporting the health of people living with HIV is an important factor in the treatment process. Proper nutrition, avoiding stress, healthy sleep and a healthy lifestyle, and regular visits to the doctor are the main components of maintaining health.

Psychosocial care for a patient with HIV infection is an integral part of comprehensive treatment of the disease.

Rice. 3. With HIV infection, herpetic lesions of the mucous membranes become severe.

Features of the course of HIV/AIDS against the background of HAART

When using HAART, the viral load in patients decreases (in 50 - 70% of them it decreases to 50 or less RNA copies/ml) and the number of CD4 lymphocytes increases. Against the background of improved immune status, the development of opportunistic diseases and cancer pathology is prevented, and the duration and quality of life of patients increases. You should know that some patients with HIV/AIDS may experience progression of the disease while on HAART for a number of reasons.

• HIV-1 is the most pathogenic, virulent and widespread among all. Minor changes in its genome lead to the emergence of a large number of new strains, which allows the pathogen to evade the patient’s immune system and acquire drug resistance to antiviral drugs.
• Some patients with HIV/AIDS develop intolerance to antiretroviral drugs.

Preventing and delaying the development of life-threatening conditions is the main goal of HIV therapy.

Rice. 4. Shingles. A severe relapsing course of the disease is observed in HIV infection.

Indications for the use of antiretroviral drugs

The World Health Organization recommends treating all infected patients. The situation in the Russian Federation is somewhat different. Treatment of patients begins only when the immune status decreases, which is determined by the number of CD4 lymphocytes. In HIV-negative individuals, their amount in the blood is from 500 to 1200 per 1 mm3.

Any new antiretroviral therapy initiated must be potent and aggressive to ensure maximum suppression of HIV replication.

Rice. 5. Candidiasis of the esophagus (photo on the left) and genital candidiasis in women in the AIDS stage. (photo on the right).

Antiretroviral drugs are the main cures for HIV/AIDS

Today there is no cure for HIV that can completely cure the patient. Treatment of HIV infection is carried out with antiviral drugs, with the help of which it is possible to slow down the progression of the disease and significantly (by 10 - 20 years) prolong the patient’s life. In the absence of HAART, the patient's death occurs 9 to 10 years from the moment of infection.

The effect of antiviral treatment in patients with HIV/AIDS is achieved by suppressing HIV replication in target cells. It is necessary to take such drugs for a long time, preferably constantly.

1 group represented by nucleoside reverse transcriptase inhibitors (NRTIs). These include: Azidotimidine (Zidovudine, Retrovir, Timazid), Didanosine, Zalcitabine, Lamivudine (Epivir), Stavudine, Abacovir, Adefovir, Zalcitabine. Combination drugs Combivir (Azidothymidine + Lamivudine), Trizivid (Azidothymidine + Lamivudine + Abacovir).

2nd group includes non-nucleoside reverse transcriptase inhibitors (NNRTIs). These include: Nevirapine (Viramune), Delavirdine (Rescriptor), Ifavirenz (Stacrine), Emitricitabine, Loviridine.

3 group represented by protease inhibitors (PIs). These include: Saquinavir (Fortovase), Indinavir (Crixivan), Nelfinavir (Viracept), Ritonavir (Kaletra), Indinavir, Amprenavir, Lopinavir and Tipranavir.

4 group represented by receptor inhibitors. This includes the drug Maraviroc(Celzentry).

5 group represented by fusion inhibitors. This includes Enfuvirtide (Fuzeon).

Rice. 6. Lamivudine and Zidovudine are medicines for HIV/AIDS.

Treatment regimens for HIV infection

Initial therapy with antiviral drugs for HIV/AIDS patients should be combined. The following schemes are the most optimal:

• Scheme 1: 2 drugs from the NRTI group + 1 from the PI group.
• Scheme 2: 2 drugs from the NRTI group + 1 from the NNRTI group.
• Scheme 3: 3 drugs of the NRTI group.

The first scheme is the most optimal. An alternative to replacing it is regimen 2. A regimen that includes only 2 NRTI drugs is inferior in effectiveness to a regimen that includes 3 NRTI drugs. Monotherapy with any of the drugs is ineffective. The exception is cases of pregnancy and the impossibility of using alternative treatment regimens.

It is better to use drugs in treatment regimens for HIV/AIDS patients in different groups, in maximum doses and at the same time, which significantly reduces the likelihood of developing drug resistance in HIV, allows you to reduce doses of drugs, act simultaneously on many parts of the infectious process, and penetrate into different tissues and organs. This method of using HAART makes it possible to reduce the concentration of HIV to values ​​undetectable by modern test systems.

Antiretroviral therapy must be continued for a long time (possibly lifelong). Stopping treatment leads to a resumption of HIV replication.

Combination therapy according to the rules of HAART increases the effectiveness of treatment to 80 - 90%, monotherapy - up to 20 - 30%.

Rice. 7. AIDS patients in the development stage of opportunistic diseases: lymphoma (photo on the left) and Kaposi's sarcoma (photo on the right).

Interruption of antiretroviral therapy and change of treatment regimen

There is an opinion among experts that if it is necessary to interrupt therapy for a long period, it is better to stop all drugs than to switch to monotherapy or therapy with 2 drugs. This will reduce the level of development of HIV resistance.

The reason for prescribing a new treatment regimen is insufficient virological and immunological effect, intercurrent infection or vaccination, side effects and intolerance to antiretroviral drugs.

The ineffectiveness of treatment for HIV/AIDS patients is indicated by an increase in the viral load, and the number of CD4 lymphocytes in this case is not taken into account.

• If the side effect of the drug is pronounced, it must be replaced with another of the same group with a different intolerance and toxicity profile.
• If inadequate therapy is prescribed (for example, only 2 NRTI drugs), but an adequate response is obtained (suppression of HIV replication), it is necessary to add other drugs. Inadequate therapy will still result in an inadequate response.
• It is recommended to completely replace an inadequate initial treatment regimen.
• A high probability of developing cross-resistance dictates the condition for prescribing 2 drugs of the same group. This is especially true for protease inhibitors.

There are side effects from antiretroviral drugs, but there are more positive aspects to antiretroviral therapy.

When treating a patient with HIV infection, great importance is attached to the prevention and treatment of opportunistic infections and malignant tumors. Immunocorretive and immunoreplacement therapy facilitates the course of the disease and prolongs the life of the patient. For many years, a number of countries around the world have been searching for new antiretroviral drugs and vaccines. Of the 10 drugs recommended by WHO for HIV infection, 8 generics will be produced in the Russian Federation in 2017 and 2 more in 2018.

Rice. 8. Antiretroviral therapy slows the progression of HIV infection and the transition to the AIDS stage for up to 10 - 20 years.

The difficulty in obtaining effective drugs for HIV infection is complicated by the great variability of immunodeficiency viruses, which, under the influence of external factors, quickly develop resistance and previously effective drugs become ineffective.

To date, scientists do not yet know what treatment for HIV infection will help completely cleanse the human body of this virus. The modern tactics of existing therapy are to slow down the progression of the infection and not allow the disease to progress to the AIDS stage. By adhering to this tactic, a person with such a disease will be able to lead a full life for decades.

Treatment of this disease requires the intervention of qualified specialists. When treating HIV-infected patients, the most important thing is to maintain the health and stable condition of the patient. The best ways to fight this virus are to avoid stress, eat right, maintain a healthy lifestyle and regularly visit the doctor with whom you are registered.

Many people very often ask themselves the question, how does HIV infection manifest itself? Initially, the virus weakens the body, and against the background of this weakening, a person increasingly begins to be haunted by various colds. This happens because the person’s immunity becomes noticeably weakened. You should also know that after the first test, it is not always possible to determine HIV and make an accurate diagnosis, since there is a high percentage of false negative and false positive results.

Viral disease HIV

HIV stands for human immunodeficiency virus. This disease is a type of retrovirus. They are also called slow viruses. This type of disease is specific because it does not appear immediately after infection, but may occur several years later.

Penetrating into a person’s blood, HIV infection selectively attaches to blood cells that are responsible for the state of immunity. This process of attachment is determined by the presence on the surface of cells of peculiar molecules that are identified specifically by this disease. Inside these cells, the disease starts the process of reproduction of a similar virus even before the human immune system has time to react to its presence, as a result of which the entire body is quickly infected. The first thing this virus attacks is the lymph nodes, because they have a large number of immune cells. How to recognize HIV? It is quite difficult to determine it in the first stages. The signal is only the appearance of weakness and weakening of the immune system, manifested by an increase in the development of acute respiratory infections and acute respiratory viral infections.

With the development of the human immunodeficiency virus, lymphocytes become increasingly infected, which leads to their significant reduction and ultimately the disease progresses to a more severe stage - AIDS.

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There are many different ways of contracting this very unpleasant disease:

1. Infection through sexual contact. This type of infection is the most common throughout the world. The patient's semen contains a large number of viral cells. Their increase occurs mainly in inflammatory diseases such as urethritis and epididymitis. In these diseases, there is a huge number of inflammatory cells of the immunodeficiency virus. The risk of infection may increase in cases of the presence of concomitant diseases.
2. Infection through the use of the same needles and syringes. Often, this method of HIV infection is transmitted among drug addicts, since they use the same syringes and needles for a larger number of people, among whom there may be an infected patient.
3. Blood transfusion. HIV disease can be present in donor blood and in 80-100% leads to infection of the person who received such blood. Infection can be avoided by administering immunoglobulin. After the procedure for testing donors for HIV was introduced, infections decreased significantly, but the risk still remained. The “blind period” is to blame. This is the moment when a person is already sick, but antibodies have not yet appeared.
4. Infection of a child during childbirth. This type of transmission usually occurs due to the presence of a virus in the mother, which is most often passed on to her baby. This can happen both during childbirth and pregnancy. The risk of this type of disease transmission is no more than 12% in European countries and almost 70% among residents of Africa. The percentage of infection directly depends on the correctness of observations during pregnancy.
5. A child can also become infected from his mother through breastfeeding. Doctors have discovered that HIV can be present in the colostrum and breast milk of mothers infected with the disease. Therefore, if a mother has been diagnosed with an infection of this kind, then she is contraindicated to feed her baby breast milk.

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HIV treatment

The symptoms of this disease are quite varied. Modern medicine still does not know the answer to the question of how to get rid of HIV infection, but there are many different drugs that help normalize the life of an infected patient. The manifestation of the virus in the human body is direct immunodeficiency. Therefore, many medications are based on ingredients that help maintain its normal condition and include them in effective treatments.

The principles of treating HIV infection are to take antiretroviral drugs to the patient. Before you start taking them or your doctor prescribes you a new treatment regimen, you will need to undergo a series of blood tests. Your healthcare provider will refer you for a test to determine your compatibility with antiretroviral medications. During the treatment process, the patient is constantly under the supervision of doctors, which makes it possible from time to time to evaluate the effectiveness of treatment with certain drugs.

When signs of HIV appear, the doctor prescribes ARV drugs to fight the disease. Before taking them, the patient must undergo a study of the performance and functioning of the kidneys and liver. When undergoing treatment for HIV infection, it is very important to try not to skip taking medications and to strictly follow all doctor’s orders. If you neglect treatment and alternate between taking medications and then not, then the virus may become resistant to these medications and they will become ineffective.

There are cases when human viral immunodeficiency is quite resistant to certain drugs. But there is good news about this. More recently, scientists have developed antiretroviral drugs that are potent and acceptable to almost all patients. The main thing in taking medications is the schedule. If for some reason you cannot take your medication on time, contact your doctor and discuss a new dosage plan with him. There are quite a few different methods that will make it easy to take medications and comply with its regimen.

HIV treatment is a series of treatment and preventive measures aimed at maintaining a normal standard of living for the patient. Medicine continues to carefully study both the immunodeficiency virus itself and ways to combat it. Despite the lack of a single cure, science has made great progress in controlling the infection. New generations of drugs make it possible to equalize the life expectancy of HIV-positive and HIV-negative people. But the treatment process still requires a lot of effort from the patient, his family and doctors.

Is it possible to be completely cured?

It is impossible to completely get rid of the virus. In 2010, at a conference at Johns Hopkins University, scientists reported that they were able to completely cure an infant of HIV infection. A Mississippi girl was born with the virus in her blood. Typically, HIV-positive children undergo active therapy from the 4th week of life, and she was prescribed a course of potent drugs in the first day after birth.

Aggressive treatment was followed by a standard course of treatment for one and a half years. After this, the mother of the girl from Mississippi refused therapy for the child. All tests during treatment and after 10 months gave negative results. The child was named one of the first cured patients. However, another year later, the Associated Press announced that a pathogen was again found in the baby’s blood.

Before the girl from Mississippi became aware of Timothy Brown. While studying in Berlin, he learned that he was HIV positive. Brown also developed leukoencephalopathy, a disorder of the white matter of the brain. The disease is fatal, and the patient underwent a complex operation for hematopoietic stem cell transplantation. Among Brown's donors was a person with two copies of the cell receptor. This rare phenomenon occurs in 10% of Europeans and gives a person resistance against HIV.

After the operation, doctors found no traces of the virus or antibodies to it in Timothy. Even after stopping antiretroviral therapy, tests showed a negative result. Scientists believe that the donation of a person with a mutation in cell receptors led to the cure. However, this treatment comes with many risks and cannot be used for everyone. These two cases indicate that scientists still have to study the infection. So far, the disease is considered incurable.

Methods to combat HIV

HIV infection is rapidly sweeping the world. From the middle of the last century to the present day, it has affected tens of millions of people all over the planet. Today, the fight against HIV includes prevention for the healthy and treatment for the sick. As a preventative measure, public awareness is the main weapon. According to WHO data for 2016, the number of new infections is decreasing every year. The only regions where the epidemic is gaining momentum are Africa and Eastern Europe.

Treating infected people is painstaking work. For people with reduced immunity, it is important to especially carefully protect themselves from secondary infections, poor nutrition, and bad habits. The main essence of treatment is antiretroviral therapy, which is aimed at suppressing the virus. Also, reduced immunity should be supported with the help of immunomodulators.

An individual course of therapy is selected for each patient. It consists of drugs aimed against the virus and to maintain immunity. Symptomatic therapy and treatment of secondary manifestations are carried out. Unfortunately, an infected person is forced to undergo treatment for the rest of his life. But well-chosen therapy is relatively easy to tolerate, and the most important medications are provided free of charge.

Antiretroviral therapy

The main hope for treatment relies on antiretroviral drugs (ARVs). Treatment with ARVs is called ART. Medicines in this group, unfortunately, do not destroy the pathogen, but suppress its development. Suppressing the virus also means controlling the progress of the infection. Today, 4 types of drugs are registered that have different effects on the virus:

1. The first group is nucleopreparations. They attack the virus at the fourth stage of the disease, that is, when the pathogen is transformed into DNA. Today, 11 types of nucleopreparations are registered, which are included in complex treatment.
2. The second group is NNRTIs or non-nucleoside reverse transcriptase inhibitors. They also block the fourth stage of pathogen development, but in a different way. Only 3 such products are registered. To prevent the virus from developing resistance to treatment, the patient may be prescribed the first and second groups of drugs alternately.
3. The third group is protease inhibitors. Unlike the previous two, this type of medicine blocks the 10th stage of development of the pathogen. At this stage, new HIV cells are formed from the protease enzyme.
4. The fourth group is fusion inhibitors. These are new generation drugs; they attack the virus at the second stage of its development. At this stage, the pathogen attaches itself to the cell of an infected person.

The latest generation of drugs is considered more successful and less toxic for the patient. But so far only one type of fusion inhibitor has been registered - Enfuvirtide (T-20, Fuzeon®). Antiretroviral therapy consists of prescribing several drugs to the patient at once. This tactic is aimed at preventing pathogen resistance.

The virus, entering the blood, gradually multiplies. Moreover, its mutation rate is very high, so each new genome is slightly different from its predecessor. Because of this feature, the infectious agent quickly develops resistance to drugs. If a patient is prescribed ART with one drug, it will be more difficult for the pathogen to develop. It’s even more difficult to cope with two types of medications. If you use three types of agents simultaneously that attack the microorganism at different stages of development, the likelihood of resistance is very low.

Treatment using 3-4 groups of drugs with different effects is considered the most effective. Until recently, patients were forced to take handfuls of tablets 5 times a day at precise times. Today, pharmaceuticals combine drugs into one medicine. Therefore, the therapy process is becoming more and more simplified. But, unfortunately, the most advanced and effective means remain inaccessible to a large number of infected people due to the high price.

Strengthening the immune system

When infected, the pathogen develops rapidly and the patient experiences a sharp decrease in immune cells with CD4 (T-helper cells). In a healthy person, the number of T cells reaches 1500-1600 units per microliter of blood. For someone who is sick with another infectious disease, during the latent period of HIV infection, this figure may be halved. In fact, the whole complexity and danger of infection lies in the reduced barrier function of the body; a person cannot resist even primitive diseases. The impact on the virus should be accompanied by an increase in immunity and an “increase” in the number of T-helper cells.

To support the body, the patient may be periodically prescribed immunomodulators. But the main role here is still played by the diet and quality of food, living conditions. For HIV infection you need:

• eat regularly, preferably in small portions;
• consume more: flour, porridge, etc.;
• diversify the menu to get more benefits from all products;
• drink pure and juices;
• introduce proteins into the diet: butter, nuts, meat and dairy products.

In general, during an infection, it is recommended to eat well and consume more calories, this helps the body fight the disease on its own. It is also important for HIV-positive people not to give up sweets, or (if there is no allergy) they can be added to cereals, drinks, and desserts. As the disease progresses, the patient is advised to eat high-calorie foods high in carbohydrates and lipids.

Immune support tactics also include physical activity. They must be feasible for the patient and regular. Fresh air and walks are very important. A positive mood also improves the body's strength. You can take immunomodulators, vitamin complexes and nutritional supplements only with the permission of a doctor and in a clearly established dose.

Symptomatic treatment

The addition of infections is a very common occurrence for HIV. The pathogen itself does not cause illness or death, but opportunistic diseases do. These are common infections that do not pose a danger to a person with a strong immune system. However, against the background of reduced barrier function, fungi and bacteria cause complications. Therefore, in addition to direct effects on the virus, symptomatic treatment is often indicated for HIV-positive people.

Symptomatic therapy is a complex of therapeutic and preventive techniques to eliminate the manifestations of secondary diseases. Most often, “positive” patients encounter infections of a bacterial, viral and fungal nature. These include:

• candidiasis;
• papilloma;
• pneumonia;
• tuberculosis;
• herpes;
• toxoplasmosis and others.

To maintain normal well-being and a full standard of living, treatment of such manifestations must begin immediately. Therapy is selected taking into account the patient’s condition, viral load, and the degree of damage to the secondary disease. Particular attention is paid to the prevention of opportunistic infections: personal hygiene, immune support, timely and professional treatment.

Self-medication is contraindicated for HIV carriers. The attending physician must prescribe therapy against the symptoms and pathogens of associated diseases. It is better if even the headache is eliminated with the help of pills prescribed by the doctor. Any new symptoms that worry the patient should be discussed with a specialist. All diseases associated with HIV are treatable up to the last stage.

Aggressive treatment is used to suppress the development of the virus. Chemotherapy is usually used in the early stages of infection and when the virus is particularly advanced. There is also an opinion that in the first hours of infection, effective chemoprophylaxis can neutralize the pathogen. Today, the main hope is placed on four drugs:

• Zalcitabine;
• Didanosine;
• Zidovudine;
• Stavudin.

Treatment begins with a “loading dose”, gradually reducing the amount of drugs. In parallel with specific antiviral therapy, the patient is prescribed symptomatic treatment. The use of chemotherapy makes it possible to sharply reduce the activity of the virus, and then carefully control it. However, such drugs are associated with side effects, so they are used only in extreme cases. The use of chemotherapy gives a chance to delay the onset of the terminal stage as much as possible.

Gene therapy

The joint work of scientists to study the virus and its characteristics is bearing fruit. Not long ago, genetic engineers proposed a completely new approach to the treatment of HIV infection. With the help of artificially engineered DNA cells, it is possible to prevent a pathogen from attaching to a cell. Also, introducing new artificial information into the cell makes it possible to stop the appearance of viral proteins, due to which the disease stops progressing.

The fight against the pandemic will presumably be carried out using cell immunization. That is, when a special cell design is introduced, they will become resistant to the virus. This innovation is very promising. Compared to chemotherapy and antiretroviral drugs, the genetic engineering solution appears to be safer. However, research on the topic of cell immunization is still underway. There are still doubts about whether the new transformation will change the normal life cycle of the cell.

Drugs used

Complex treatment allows the patient to maintain good health and a full life. Along with a healthy lifestyle, self-improvement and sports, medications are, of course, used. Medicines are periodically replaced to better influence the virus. Also, HIV-positive people often need to use other medications for symptomatic treatment.

These drugs are intended for chemotherapy and antiretroviral therapy. They are used at different stages of the disease and in various combinations. If the virus is particularly resistant, 3-4 drugs may be prescribed simultaneously. Also, to prevent the pathogen from becoming resistant to treatment, the patient’s treatment tactics are periodically changed.

Medicines and external agents are added to the main treatment to prevent secondary infections. Methods of protection against bacteria, viruses and fungi are especially important. To disinfect mucous membranes and skin, it is recommended to use Miramistin, Citeal and other similar products. If a secondary infection has already occurred, only a doctor prescribes treatment.

Treatment at different stages

At the first stage of the disease, antiviral and “severe” therapy is usually not prescribed. Emergency prevention is indicated for people whose work involves a risk of infection - medical staff, employees of beauty salons and tattoo parlors, etc. In the first three days after the suspected infection, chemoprophylaxis of HIV infection is prescribed.

The second stage is the period when the infection can be laboratory confirmed and the viral load can be established. Antiviral therapy is prescribed from the moment when the level of T-helper cells decreases to 0.2x10/l. From the moment the pathogen is detected in the blood, the patient is selected for effective ART using several drugs. This makes it possible to prolong the latent period and asymptomatic course of the disease. General rules of behavior for HIV-positive people must be added to ART.

In the third stage, highly active antiretroviral therapy (HAART) is most often started. It includes the use of chemotherapy and ART, sometimes they are forced to add symptomatic treatment. This set of measures is aimed at suppressing a sharp increase in viral replication and maintaining acceptable immunity.

In the fourth stage, antiviral therapy is used when the proportion of pathogen RNA is more than 100 thousand copies per microliter of blood. In the progression stage, HAART is indicated regardless of CD4 and HIV RNA levels. “Heavy” therapy is not stopped until resistance is identified or the patient’s condition improves. Children are given ART regardless of the phase of infection.

Is traditional medicine strong?

Traditional medicine has its own answer to all cases of any disease. Considering that traditional medicine does not yet have a 100% effective medicine, it is not surprising that alternative medicine is looking for its own ways to combat HIV infection. Today you can find recipes and recommendations for treating HIV infection and even AIDS using “improvised” products. For example, it is a blood purifier; it is recommended to chew it 3 times a day for 15 minutes before meals and bedtime.

To increase immunity, it is recommended to boil in a ratio of 1:5, dilute the strained with and boil. This remedy is drunk warm three times a day. There are a lot of recipes for fighting infection. Almost all of them are aimed at increasing the body’s defenses and replenishing nutrients. This can be very useful in cases of immunodeficiency, so traditional medicine can adequately complement drug treatment.

Using any methods or recipes without the approval of your doctor is life-threatening.

What should an infected person do?

The moment a person first learns about his HIV status, he will inevitably face psychological trauma. Since stress is very dangerous for "positive" patients, it is important to stabilize the person's condition as soon as possible. At this moment, supporting loved ones and working with is one of the important stages. HIV-positive people may feel that they are now dangerous to their environment, although this is absolutely not the case.

Communication with an infectious disease specialist is a mandatory first step for patients. The specialist must clearly explain to the person about the stages of HIV, the upcoming treatment and the rules of conduct for patients. It is not so easy to infect loved ones if you do not do it intentionally - the virus is not transmitted in everyday life, through hugging, communicating, or exchanging clothes. Working with a psychologist will help you accept a new self and new ways of life. Consultation with government specialists is free, so absolutely everyone can afford it.

Together with the patient, relatives should also consult with the attending physician. It is important for relatives to understand that the person has not changed, is not dangerous and needs support. After the diagnosis is confirmed, patients are prescribed therapy, which is important to follow. Changes will also affect lifestyle; for HIV-positive people, a healthy lifestyle is mandatory. It is mandatory, in principle, for everyone, but healthy people often don’t think about it.

You only need to report your HIV status to work if the patient is employed in the following areas:

• catering;
• healthcare (ambulance drivers, orderlies, reception workers - they can even work with HIV);
• education and training (not always, your position needs to be discussed with);
• spa services (excluding reception and management);
• production of medicines and food.

There is only a short list of professions that a “positive” patient cannot engage in. You will have to give up smoking and alcohol, watch your diet and add physical activity. Together with drug therapy, compliance with these rules will be the key to a fulfilling life.

It is recommended to always be in touch with your infectious disease specialist. If you need advice, he will tell you what to do in a given situation. For example, at elevated temperatures, find out what medications can be used, and so on. In general, HIV-positive people need to understand that they are not outcasts, and life goes on. Through strict adherence to healthy lifestyle habits and mental health support, patients sometimes begin to live fuller lives than before diagnosis.

Life expectancy with treatment

European scientists have already announced that, with the help of advanced drugs, they have managed to equalize the life expectancy of HIV-positive and HIV-negative people. Provided that the doctor's recommendations and quality therapy are followed, people live up to 70-80 years. The younger the patient, the greater the likelihood of extending life to generally accepted averages.

The use of even generally available therapy prolongs the patient’s life by 20-30 years. Which results in a life expectancy of approximately 55-60 years. This figure decreases by one and a half times if the patient smokes. If bad habits include drugs or alcohol, even with HAART, the patient’s death is predicted within 10 years on average. In the complete absence of therapy, secondary infections kill a person within 7-9 years. But the absence of stress and all the above rules give you a chance to live a full and long life.

Help with the threat of HIV infection

There are categories of people who are at risk of infection. These include not only drug addicts and gay people. Health care workers and those whose work may expose them to contaminated blood are most at risk. Emergency situations and prevention methods are prescribed for them. Emergency situations include injections, cuts, and contact of contaminated liquids with open wounds and eyes.

In such situations, it is urgent to conduct a rapid HIV test for someone who is suspected of being infected. If the test is positive, a loading dose of chemotherapy is prescribed for the person who is susceptible to infection. Immediately after confirmation of HIV status, the incident must be reported to the nearest AIDS center. A council of doctors decides on the dosage of drugs and the advisability of their use.

After emergency chemoprophylaxis, the patient's dosage of medication is reduced. Preventive treatment lasts until a negative test for infection is confirmed. If the answer is positive, a new treatment regimen is drawn up. Doctors, employees of tattoo parlors and beauty salons and other similar organizations should under no circumstances neglect safety measures. Keep 70% ethyl alcohol, iodine and plasters at your workplace. At the slightest suspicion, treat the wound, undergo a test and preventive treatment, if necessary.