Browse Medications by Medical Condition: HIV/AIDS

HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, specifically targeting CD4 cells (T cells), which are critical for fighting infections. Left untreated, HIV reduces the body's ability to combat diseases and infections, progressing to AIDS (Acquired Immunodeficiency Syndrome), the most severe stage of HIV infection. AIDS is diagnosed when the immune system is severely compromised, marked by a CD4 count below 200 cells per cubic millimeter of blood or the presence of specific opportunistic infections or cancers. While there is no cure, effective antiretroviral therapy (ART) can control the virus, allowing people with HIV to live long, healthy lives.

The first recognized cases of AIDS were reported in the United States in 1981, but the virus is believed to have originated from non-human primates in Central Africa in the early 20th century. By the mid-1980s, scientists identified HIV as the causative agent. The development of antiretroviral therapy (ART) in the 1990s transformed HIV from a fatal diagnosis to a manageable chronic condition. Public health campaigns have since focused on prevention, treatment access, and reducing stigma, with ongoing research aimed at achieving a cure or vaccine.

HIV is caused by the human immunodeficiency virus, which spreads through certain body fluids such as blood, semen, vaginal fluids, rectal fluids, and breast milk. Common transmission routes include unprotected sexual contact, sharing needles, mother-to-child transmission during childbirth or breastfeeding, and, less commonly, blood transfusions in settings without proper screening. HIV infects and destroys CD4 cells, weakening the immune system over time and increasing vulnerability to opportunistic infections, which define AIDS.

Risk factors for acquiring HIV include engaging in unprotected sex, particularly anal or vaginal sex, with an HIV-positive partner without using pre-exposure prophylaxis (PrEP) or condoms. Sharing needles or syringes for drug use is another major risk. Babies born to HIV-positive mothers without appropriate treatment are at risk of mother-to-child transmission. Healthcare workers may face exposure through needlestick injuries. Additionally, having another sexually transmitted infection (STI) increases susceptibility due to compromised mucosal barriers.

HIV prevention involves a combination of behavioral, medical, and public health strategies. Practicing safe sex using condoms consistently and correctly reduces the risk of transmission. Medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are highly effective in preventing HIV when used appropriately. Avoiding needle sharing and using sterile injection equipment reduces risk among people who inject drugs. For HIV-positive individuals, adherence to ART lowers viral load to undetectable levels, effectively eliminating transmission risk (known as U=U: Undetectable = Untransmittable). Routine testing and counseling are essential for early detection and prevention.

HIV symptoms vary depending on the stage of infection. In the acute phase, individuals may experience flu-like symptoms, such as fever, fatigue, swollen lymph nodes, rash, and sore throat, within 2-4 weeks of exposure. During the chronic stage, which can last for years, symptoms may be mild or absent. As HIV progresses to AIDS, symptoms include severe weight loss, persistent fever, chronic diarrhea, night sweats, recurrent infections, and opportunistic illnesses like pneumonia or certain cancers. Without treatment, AIDS is life-threatening.

HIV is diagnosed through blood or saliva tests. Initial screening often involves antigen/antibody combination tests, which detect both HIV antibodies and the p24 antigen. Confirmatory tests, such as nucleic acid tests (NAT), detect viral RNA and confirm active infection. CD4 cell counts and viral load tests assess immune function and the extent of infection. AIDS is diagnosed based on a CD4 count below 200 cells/mm? or the presence of specific opportunistic infections or cancers.

The cornerstone of HIV treatment is antiretroviral therapy (ART), a combination of medications that suppress the virus and prevent progression to AIDS. ART typically includes drugs from different classes, such as integrase inhibitors, protease inhibitors, or reverse transcriptase inhibitors, which target various stages of the HIV life cycle. Treatment reduces viral load to undetectable levels, preserving immune function and preventing transmission. Early initiation of ART is critical for optimal outcomes. Supportive care, including treatment for opportunistic infections, is essential for those with advanced disease.

Common medications for HIV include:

• Integrase inhibitors: Such as dolutegravir and bictegravir, block viral integration into host DNA.
• Protease inhibitors: Such as atazanavir and darunavir, inhibit viral protein processing.
• Nucleoside reverse transcriptase inhibitors (NRTIs): Such as tenofovir and emtricitabine, prevent viral RNA from converting to DNA.
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs): Such as efavirenz, disrupt reverse transcription. Fixed-dose combinations simplify treatment, improving adherence and effectiveness.

Living with HIV requires a holistic approach to health. Adherence to ART is critical for suppressing viral load and preventing progression. A balanced diet, regular exercise, and adequate sleep support overall well-being and immune function. Avoiding smoking, excessive alcohol, and recreational drugs reduces strain on the body. Mental health care, including counseling or support groups, helps individuals cope with the emotional impact of an HIV diagnosis. Safe practices, like condom use, protect partners from transmission.

The economic impact of HIV/AIDS includes direct costs for medications, regular laboratory testing, and medical visits, as well as treatment for opportunistic infections or complications. Indirect costs stem from lost productivity, disability, and caregiver responsibilities. Public health initiatives to promote prevention, early detection, and access to ART reduce the long-term financial and societal burden of the disease.

With effective ART, individuals with HIV can live long, healthy lives. Routine medical care ensures optimal management of the condition and early detection of complications. Open communication with healthcare providers and support networks helps navigate challenges. Education about HIV reduces stigma and empowers individuals to advocate for their health. Maintaining an undetectable viral load not only preserves immune function but also eliminates the risk of transmitting the virus to sexual partners (U=U).

Resources for individuals with HIV/AIDS include organizations like the National AIDS Trust, UNAIDS, and local HIV clinics, which offer education, advocacy, and support services. Online communities and local support groups provide emotional and practical assistance. Healthcare providers, including infectious disease specialists and counselors, are key partners in managing the condition. Access to affordable medications and preventive tools like PrEP and PEP is critical for comprehensive care.

HIV/AIDS research is advancing rapidly, focusing on achieving functional cures, improving prevention, and reducing barriers to care. Studies on gene editing, such as CRISPR, aim to eliminate latent reservoirs of the virus. Long-acting injectable therapies and implants are simplifying treatment and prevention. Vaccine development efforts, including mRNA-based approaches, show promise for reducing new infections. Research into addressing disparities in care and access remains a priority for global eradication efforts.

Innovations in HIV care include long-acting injectable ART, such as cabotegravir and rilpivirine, which reduce the need for daily pills. Advances in pre-exposure prophylaxis (PrEP) formulations, including long-acting injectables, are enhancing prevention. AI and mobile health technologies are improving adherence and enabling personalized care. Efforts to integrate HIV services with broader healthcare systems are expanding access to diagnosis, treatment, and support. These advancements bring us closer to controlling and potentially eradicating HIV/AIDS.