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The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt 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.
HIV/AIDS denialism is the refusal to acknowledge that human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS), despite the conclusive evidence. Some of its proponents reject the existence of HIV, while others accept that HIV exists but argue that it is a harmless passenger virus and not the cause of AIDS. Insofar as they acknowledge AIDS as a real disease, they attribute it to some combination of sexual behavior, recreational drugs, malnutrition, poor sanitation, haemophilia, or the effects of the medications used to treat HIV infection (antiretrovirals).
The spread of HIV/AIDS has affected millions of people worldwide; AIDS is considered a pandemic. The World Health Organization (WHO) estimated that in 2016 there were 36.7 million people worldwide living with HIV/AIDS, with 1.8 million new HIV infections per year and 1 million deaths due to AIDS. Misconceptions about HIV and AIDS arise from several different sources, from simple ignorance and misunderstandings about scientific knowledge regarding HIV infections and the cause of AIDS to misinformation propagated by individuals and groups with ideological stances that deny a causative relationship between HIV infection and the development of AIDS. Below is a list and explanations of some common misconceptions and their rebuttals.
Matthias Rath is a controversial doctor, businessman, and vitamin salesman. He earned his medical degree in Germany. Rath claims that a program of nutritional supplements, including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS. These claims are not supported by any reliable medical research. Rath runs the Dr. Rath Health Foundation, has been closely associated with Health Now, Inc., and founded the Dr. Rath Research Institute.
Indinavir is a protease inhibitor used as a component of highly active antiretroviral therapy to treat HIV/AIDS. It is soluble white powder administered orally in combination with other antiviral drugs. The drug prevents protease from functioning normally. Consequently, HIV viruses cannot reproduce, causing a decrease in the viral load. Commercially sold indinavir is indinavir anhydrous, which is indinavir with an additional amine in the hydroxyethylene backbone. This enhances its solubility and oral bioavailability, making it easier for users to intake. It was synthetically produced for the purpose of inhibiting the protease in the HIV virus.
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 a person may not notice any symptoms, or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged 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 otherwise 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/AIDS is one of the most serious health concerns in South Africa. The country has the highest number of people afflicted with HIV of any country, and the fourth-highest adult HIV prevalence rate, according to the 2019 United Nations statistics.
Armenicum is a drug invented in Armenia in 1998 that its developers claim is an effective treatment for HIV infection and a number of associated diseases. No rigorously monitored clinical trials of Armenicum have been published, and most HIV experts outside of Armenia do not endorse its use.
Salvage therapy, also known as rescue therapy, is a form of therapy given after an ailment does not respond to standard therapy. The most common diseases that require salvage therapy are HIV and various cancers. The term is not clearly defined; it is used both to mean a second attempt and a final attempt. Salvage therapy drugs or drug combinations have, in general, much more severe side effects than the standard line of therapy. This is often true of a drug of last resort.
Rilpivirine, sold under the brand name Edurant among others, is a medication, developed by Tibotec, used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency, longer half-life and reduced side-effect profile compared with older NNRTIs, such as efavirenz.
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 a HIV vaccine or cure.
Traditional African medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, midwives, and herbalists. Practitioners of traditional African medicine claim to be able to cure a variety of diverse conditions including cancer, psychiatric disorders, high blood pressure, cholera, most venereal diseases, epilepsy, asthma, eczema, fever, anxiety, depression, benign prostatic hyperplasia, urinary tract infections, gout, and healing of wounds and burns and even Ebola.
Whoonga is a form of black tar heroin, possibly mixed with other substances, that has come into widespread use in South Africa since 2009. Its use is concentrated in the impoverished townships of Durban, although it is claimed to be appearing in other places in South Africa as well.
The Berlin patient is an anonymous person from Berlin, Germany, who has exhibited prolonged "post-treatment control" of HIV viral load after HIV treatments were interrupted.
HIV/AIDS research includes all medical research that attempts to prevent, treat, or cure HIV/AIDS, as well as fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.
Cabotegravir, sold by itself as a tablet under the brand name Vocabria and as an injection in combination with rilpivirine injection as Cabenuva, is a medication used for the treatment of HIV/AIDS in adults.
In South Africa, HIV/AIDS denialism had a significant impact on public health policy from 1999 to 2008, during the presidency of Thabo Mbeki. Mbeki criticized the scientific consensus that HIV does cause AIDS beginning shortly after his election to the presidency. In 2000, he organized a Presidential Advisory Panel regarding HIV/AIDS including several scientists who denied that HIV caused AIDS. In the following eight years of his presidency, Mbeki continued to express sympathy for HIV/AIDS denialism, and instituted policies denying antiretroviral drugs to AIDS patients. The Mbeki government even withdrew support from clinics that started using AZT to prevent mother-to-child transmission of HIV. He also restricted the use of a pharmaceutical company's donated supply of nevirapine, a drug that helps keep newborns from contracting HIV. Instead of providing these drugs, which he described as "poisons", shortly after he was elected to the presidency, he appointed Manto Tshabalala-Msimang as the country's health minister, who promoted the use of unproven herbal remedies such as ubhejane, garlic, beetroot, and lemon juice to treat AIDS, which led to her acquiring the nickname "Dr. Beetroot." These policies have been blamed for the preventable deaths of between 343,000 and 365,000 people from AIDS. Since 2008, Mbeki has been silent about his views and policies on AIDS; according to The New York Times, his spokesman, Mukoni Ratshitanga, said Mr. Mbeki would not discuss his thinking on HIV and AIDS, explaining that policy decisions were made collectively by the cabinet and so questions should be addressed to the government. Upon becoming president in 2008, Mbeki's successor, Kgalema Motlanthe, appointed Barbara Hogan as health minister to replace Tshabalala-Msimang on the first day of his presidency. Hogan told The New York Times, "The era of denialism is over completely in South Africa."
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 only 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, ARVs are 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.
Covid-Organics (CVO) is an Artemisia-based Ayurvedic drink that Andry Rajoelina, president of Madagascar, claims can prevent and cure Coronavirus disease 2019 (COVID-19). The Ayurvedic drink is produced from a species under the Artemisia genus from which artemisinin is extracted for malaria treatment.
References
- 1 2 3 4 McGreal, Chris (14 September 2008). "No drugs, just take vitamins: the dangerous advice to cure HIV". The Guardian. Retrieved 2 March 2015.
- 1 2 Specter, Michael (12 March 2007). "The Denialists". New Yorker. Retrieved 2 March 2015.
- ↑ Bateman, Chris (May 2006). "Taking Ubhejane by the Horns". South African Medical Journal. p. 382. Retrieved 2 March 2015.
- 1 2 3 Nattrass, N. (16 February 2008). "AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa". African Affairs. 107 (427): 157–176. doi: 10.1093/afraf/adm087 .
- 1 2 3 Calvert, Scott (20 August 2006). "For some in Africa, it's 'magic' over pills". Baltimore Sun. p. 2. Retrieved 6 March 2015.
- ↑ Geffen, Nathan (2010). Debunking Delusions: The Inside Story of the Treatment Action Campaign. Jacana Media. p. 85.
- 1 2 Cullinan, Kerry (2009). The Virus, Vitamins and Vegetables: The South African HIV/AIDS Mystery. Jacana Media. p. 149.
- ↑ Calvert, Scott (20 August 2006). "For some in Africa, it's `magic' over pills". Baltimore Sun. p. 1. Retrieved 6 March 2015.