The Mainstay of HIV-AIDS Treatment

Human Immunodeficiency Virus (HIV) is a virus that damages the immune system, destroying immune cells (limfosit-T/CD4) which acts against the disease. A person living with HIV, the body's defense against disease is reduced.

However, a person with HIV is not necessarily AIDS. With regular treatment, appropriate, and always monitored, a person with HIV can still live a normal life and not waking up to the stage of AIDS. Conversely, if a person with HIV do not get proper treatment, regular, and monitored, only a few months he could get to the stage of AIDS (Acquired Immuno Deficiency Syndrome). AIDS is a condition in which the body T/CD4 lymphocyte cell count was below 200 cells/mms and the amount of HIV virus in their body more than 55,000 copies/ml with the emergence of a number of infections in the body (opportunistic infections).

HIV is a virus whose genetic material is RNA (ribonucleic acid), which is wrapped by a matrix composed mostly of protein. To grow multiply, it needs to change its genetic material into the DNA (deoxyribonucleic acid) with the help of the enzyme reverse transcription (RT), which is integrated into the host DNA in the body of the patient, and then undergo a continuous process, producing protein. The resulting protein is still not active. To activate it, the protein should be cut at certain places on the chain, with the help of the enzyme protease.

"New" protein cuts protease results will be virus matrix protein constituent of the new (structural protein or functional protein). And so on, the multiplication of HIV in the body. By consider the propagation of HIV, the drugs currently used, it leads to the inhibition of these systems. If the work of these enzymes inhibited by an inhibitor, HIV-expected growth will be hampered.

The replication cycle of HIV. (Picture from: http://www.biology.arizona.edu/)

The replication cycle of HIV:

• HIV binds to CD4 cell surface molecules, entry into the cell also requires binding to co-receptorsCXCR4 and CCR5). This step can be inhibited by fusion/entry inhibitors.
• HIV is uncoated inside the cell and reverse transcriptase copies genomic RNA into DNA, making errors at a frequence of about one per replication cycle. Reverse transcriptase inhibitors were the first class of HIV inhibitors to be used as drugs.
• Viral DNA can integrate into DNA and become a part of the cellular genome. This step makes the infection irreversible, and may mean that eliminating the virus from an infected individual is not possible. Integrase inhibitors are designed to block this step of infection.
• The virus uses cellular machinery to synthesize viral proteins. Several of these are long amino acid chains which must be cleaved by a specific viral protease before new viral particles can become active. Protease inhibitors block viral maturation at this step.

The use of these drugs did not kill the HIV in the body 100 percent, but it is quite effective in suppressing the growth of new viruses so hopefully with the right treatment, regular, and always monitored, the amount of HIV in the body can be reduced to as low as possible, in addition to the patient is well balanced with good nutrition and enough to increase body resistance.

Medicines for HIV are known as antiretrovirals group, which consists of a combination of class Nukleoside Reverse Transcriptase Inhibitors (NRTIs), Non-Nukleoside Reverse Inhibitor (NNRTD and Protease Inhibitor (PI). NRTIs and NNRTIs used in combination, so that the body is getting stronger inhibit the development of (replication) virus. Also to be protected from HIV incidence is more resistant. Both types of drugs work in the early stages of development of the virus, which is the process of change RNA into DNA.

NNRTIs inhibit the formation of RNA, whereas the PI group, serves to inhibit the formation of new proteins. NRTI and NNRTI class of drugs commonly used are lamivudine, zidovudine, and Nevirapin. Classes are commonly used PI Indinavir, Nelfinafir, Ritonavir and Saquinavir. In addition to these drugs, people with HIV were given drugs for opportunistic infections, the cure for a disease that appears as a side effect of immune damage. This administration is usually adjusted to infection arising, for example medicines anti-tuberculosis, anti-fungal, and so on.

Antiretroviral Drugs

Although now rife testimonies of people living with HIV that reveal successful experience in using herbal ingredients to control HIV, most of these materials only increase the immune function of the patient. Herbal ingredients that have not been able to kill HIV. Therefore, the medical community still recommends the use of anti ¬ retroviral drugs, to control the progression of HIV.

Antiretroviral drugs are not drug-free, its use should be based on prescription and its impact must be monitored constantly watching action-RNA levels in blood plasma, CD4 cell count and liver enzyme levels in order to avoid the emergence of drug-resistant HIV mutants. If the use of a particular drug is not effective and the side effects can no longer be tolerated, should be a combination of other antiretroviral drugs. *** [YAYI ZAKIAH | PIKIRAN RAKYAT 06122012]
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