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The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.
Sir Peter Karel, Baron Piot, is a Belgian-British microbiologist known for his research into Ebola and AIDS.
Nevirapine (NVP), sold under the brand name Viramune among others, is a medication used to treat and prevent HIV/AIDS, specifically HIV-1. It is generally recommended for use with other antiretroviral medications. It may be used to prevent mother to child spread during birth but is not recommended following other exposures. It is taken by mouth.
Emtricitabine/tenofovir, sold under the brand name Truvada among others, is a fixed-dose combination antiretroviral medication used to treat and prevent HIV/AIDS. It contains the antiretroviral medications emtricitabine and tenofovir disoproxil. For treatment, it must be used in combination with other antiretroviral medications. For prevention before exposure, in those who are at high risk, it is recommended along with safer sex practices. It does not cure HIV/AIDS. Emtricitabine/tenofovir is taken by mouth.
Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual may not notice any symptoms, or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged incubation period with no symptoms. If the infection progresses, it interferes more with the immune system, increasing the risk of developing common infections such as tuberculosis, as well as other opportunistic infections, and tumors which are rare in people who have normal immune function. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS). This stage is often also associated with unintended weight loss.
HIV drug resistance occurs when microevolution causes virions to become tolerant to antiretroviral treatments (ART). ART can be used to successfully manage HIV infection, but a number of factors can contribute to the virus mutating and becoming resistant. Drug resistance occurs as bacterial or viral populations evolve to no longer respond to medications that previously worked. In the case of HIV, there have been recognized cases of treatment resistant strains since 1989, with drug resistance being a major contributor to treatment failure. While global incidence varies greatly from region to region, there has been a general increase in overall HIV drug resistance. The two main types of resistance, primary and induced, differ mostly in causation, with the biggest cause of resistance being a lack of adherence to the specific details of treatment. These newly created resistant strains of HIV pose a public health issue as they infect a growing number of people because they are harder to treat, and can be spread to other individuals. For this reason, the reaction to the growing number of cases of resistant HIV strains has mostly been to try to increase access to treatment and implement other measures to make sure people stay in care, as well as to look into the development of an HIV vaccine or cure.
Anita Rachlis, M.D. is a Canadian HIV/AIDS researcher and is the principal author of the HIV treatment guidelines in Canada. She is an associate scientist at the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, in Toronto, Ontario, Canada.
Sir Alimuddin Zumla,, FRCP, FRCPath, FRSB is a British-Zambian professor of infectious diseases and international health at University College London Medical School. He specialises in infectious and tropical diseases, clinical immunology, and internal medicine, with a special interest in HIV/AIDS, respiratory infections, and diseases of poverty. He is known for his leadership of infectious/tropical diseases research and capacity development activities. He was awarded a Knighthood in the 2017 Queens Birthday Honours list for services to public health and protection from infectious disease. In 2012, he was awarded Zambia's highest civilian honour, the Order of the Grand Commander of Distinguished services - First Division. In 2022, for the fifth consecutive year, Zumla was recognised by Clarivate Analytics, Web of Science as one of the world's top 1% most cited researchers. In 2021 Sir Zumla was elected as Fellow of The World Academy of Sciences.
The co-epidemic of tuberculosis (TB) and human immunodeficiency virus (HIV) is one of the major global health challenges in the present time. The World Health Organization (WHO) reports 9.2 million new cases of TB in 2006 of whom 7.7% were HIV-infected. Tuberculosis is the most common contagious infection in HIV-Immunocompromised patients leading to death. These diseases act in combination as HIV drives a decline in immunity while tuberculosis progresses due to defective immune status. This condition becomes more severe in case of multi-drug (MDRTB) and extensively drug resistant TB (XDRTB), which are difficult to treat and contribute to increased mortality. Tuberculosis can occur at any stage of HIV infection. The risk and severity of tuberculosis increases soon after infection with HIV. A study on gold miners of South Africa revealed that the risk of TB was doubled during the first year after HIV seroconversion. Although tuberculosis can be a relatively early manifestation of HIV infection, it is important to note that the risk of tuberculosis progresses as the CD4 cell count decreases along with the progression of HIV infection. The risk of TB generally remains high in HIV-infected patients, remaining above the background risk of the general population even with effective immune reconstitution and high CD4 cell counts with antiretroviral therapy.
Julio S. G. Montaner, is an Argentine-Canadian physician, professor and researcher. He is the director of the British Columbia Centre for Excellence in HIV/AIDS, the chair in AIDS Research and head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia and the past-president of the International AIDS Society. He is also the director of the John Ruedy Immunodeficiency Clinic, and the Physician Program Director for HIV/AIDS PHC. He is known for his work on HAART, a role in the discovery of triple therapy as an effective treatment for HIV in the late 1990s, and a role in advocating the "Treatment as Prevention" Strategy in the mid-2000s, led by Myron Cohen of the HPTN 052 trial.
Elioda Tumwesigye is a Ugandan politician, physician, and epidemiologist who has served as minister of science, technology and innovation in the cabinet of Uganda since June 2016. From March 2015 until June 2016, he served as the minister of health.
Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al. The term is often used to talk about treating people that are currently living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) to prevent illness, death and transmission. Although some experts narrow this to only include preventing infections, treatment prevents illnesses such as tuberculosis and has been shown to prevent death. The dual impact on well-being and its 100% effectiveness in reducing transmission makes TasP the most important element in the HIV prevention toolkit. In relation to HIV, antiretroviral therapy (ART) is a three or more drug combination therapy that is used to decrease the viral load, or the measured amount of virus, in an infected individual. Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners but also improve their current health to increase their lifespans. Other names for ART include highly active antiretroviral therapy (HAART), combination antiretroviral therapy (cART), triple therapy and triple drug cocktail. When taken correctly, ART is able to diminish the presence of the HIV virus in the bodily fluids of an infected person to a level of undetectability. Undetectability ensures that infection does not necessarily have an effect on a person's general health, and that there is no longer a risk of passing along HIV to others. Consistent adherence to an ARV regimen, monitoring, and testing are essential for continued confirmed viral suppression. Treatment as prevention rose to great prominence in 2011, as part of the HPTN 052 study, which shed light on the benefits of early treatment for HIV positive individuals.
Pontiano Kaleebu is a Ugandan physician, clinical immunologist, HIV/AIDS researcher, academic and medical administrator, who is the executive director of the Uganda Virus Research Institute.
Alash'le Grace Abimiku is a Nigerian executive director of the International Research Centre of Excellence at the Institute of Human Virology Nigeria and a Professor of Virology at the University of Maryland School of Medicine.
Elizabeth Lucy Corbett is a British epidemiologist who is Professor of Tropical Epidemiology at the London School of Hygiene & Tropical Medicine. Her research investigates the regulation of tuberculosis in HIV prevalent populations and improving access to HIV self-testing.
Andrew Ddungu Kambugu is a Ugandan physician who serves as The Sande-McKinnell Executive Director at Uganda Infectious Disease Institute and a Honorary Senior lecturer at Makerere University College of Sciences. He is also an Adjunct Associate Professor at the University of Minnesota. In July 2020, he was appointed to the United Nations 2021 Food System Scientific Group.
Etheldreda Nakimuli-Mpungu is a professor, researcher, epidemiologist and psychiatrist at the Department of Psychiatry in the Faculty of Medicine, Makerere University in Uganda. Her research is particularly focused on supportive group psychotherapy as a first-line treatment for depression in people with HIV. She is one of only five recipients of the Elsevier Foundation Award for Early Career Women Scientists in the Developing World in Biological Sciences, as well as listed at one of the BBC's 100 Women in 2020.
Damalie Nakanjako, is a Ugandan specialist physician, internist, immunologist, infectious diseases consultant, academic and researcher, who serves as the Principal and Professor of Medicine at Makerere University College of Health Sciences. Immediately prior to her present position, she served as Dean of Makerere University School of Medicine, from 2019 until 17 February 2021.
Charles Williams Flexner is an American physician, clinical pharmaceutical scientist, academic, author and researcher. He is a Professor of Medicine at the Johns Hopkins University School of Medicine.
Judith Aberg is an American physician who is the George Baehr Professor of Clinical Medicine at Mount Sinai Hospital. She was appointed Dean of System Operations for Clinical Sciences at the Icahn School of Medicine at Mount Sinai. Her research considered infectious diseases, including HIV/AIDS and COVID-19.
References
- ↑ "Jean B. Nachega, MD, PhD, MPH, FRCP, FAAS | AME". academicmedicaleducation.com. Retrieved 2022-10-28.
- 1 2 "Hooked on ID with Jean B. Nachega, MD, PhD, MPH, FRCP, FAAS". www.healio.com. Retrieved 2022-10-24.
- ↑ IMEA. "IMEA - Jean B Nachega". www.imea.fr (in French). Retrieved 2022-10-28.
- ↑ "Jean B Nachega | School of Public Health". www.sph.pitt.edu. Retrieved 2022-10-28.
- ↑ Nachega, Jean B. (2008). "Antiretroviral therapy adherence and effectiveness in a private sector disease management programme in Southern Africa".
{{cite journal}}: Cite journal requires|journal=(help) - ↑ "Jean Nachega | Johns Hopkins | Bloomberg School of Public Health". publichealth.jhu.edu. Retrieved 2022-10-24.
- 1 2 "Nachega Jean | The AAS". www.aasciences.africa. Retrieved 2022-10-24.
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