Finding Lasting Solution to HIV/AIDS by Medicinal Treatment: Its History and Recent Developments

1. Introduction:
It is reported that India is the AIDS capital of the world and is retaining the number one position for the past several years, as per a joint report on the Global AIDS scenario by UNAIDS and WHO. Likewise it is reported by U.S Food and Drug Administration (FDA) that every year about 50,000 U.S adults and adolescents are diagnosed with HIV infection.

Hence there is an imperative need for finding a lasting solution to totally eradicate this menace.

Attack on AIDS is three pronged as follows:

a) Social approach.
b) Psychological approach and
c) Clinical approach.

In all the pandemics, the above three approaches need attention. Especially in AIDS intervention, the three are inter-related and are equally important. The Indian Government, with the aid of International organisations like US AIDS is spending huge amount in AIDS awareness. Today in India, even a rickshaw puller is aware of the basic precautions like condom usage, blood tests like ELISA etc.

But medicinal applications belong to different category. Medicines should be administered only on the advice of a qualified medical practitioner. Yet, a social worker should be aware of the latest developments in medicinal treatment and vice-versa.

It is with that idea in mind, the undersigned author, though a psychological counsellor kept a close watch on developments in anti-HIV drugs. The article given below is coverage of AIDS drugs from 1987. The sources are from various medical bulletins, Press releases and discussions with medical practitioners in various seminars. Reference is given where ever possible. It is hoped that the readers will be benefited by knowing the latest developments in anti HIV drugs.

2. The Discovery in 1987:
The first weapon to fight against spread of HIV inside a human body was discovered in 1987. Its name is AOP-RANTES which inhibited HIV entry not only into lymphocytes but also into macrophages. They interfere with white blood cells which protect the body against viruses and bacteria. AOP-RANTES blocks HIV entry blood cells. (Based on a study by Glaxo Wellcome collaboration) Scientists believe that by attacking HIV in early stage, they can delay or stop progression to disease. That was a new approach targeting host cells i.e. CD4 (white blood cells) to prevent HIV entry.

This is the beginning of the new sophisticated fight against HIV. We shall see here below further advances starting from 1987 up-to-date with the latest developments in the medical History in man's fight against HIV/AIDS.

3. First Ten Years of Battle 1987-1997:

On 03.3.87, Retrovir, the first drug licensed for the treatment of HIV/AIDS was launched in the UK. Till then, doctors were powerless to fight against advancement of HIV to AIDS leading to death. In 1995, new data revealed that taking a combination of Retrovir with one of the most powerful drugs Epivir TM, (3TCTM, lamivudine), reduces the amount of HIV in the blood by 99% Since then, other studies have shown that addition of a third drug, a member of a new class of drugs called protease inhibitors which attack the virus in a different way, reduces the amount of virus even further to undetectable levels in some patients.

Since Retrovir was launched and in less time than it normally takes to bring just one drug from laboratory to the patient, another 8 drugs have been licensed to treat HIV and there are dozens of potential new drugs in the pipeline.

In 1997, Professor Joep Lange, Director, National AIDS Therapy Evaluation Centre at the Academic Medical Centre, University of Amsterdam declared that:

"Even if we cannot eradicate the virus, we will continue to develop treatment strategies that suppress the infection and prevent disease progression for longer and longer until HIV becomes a manageable non-life-threatening condition".

So this is the situation in 1997. ART on one side and progress in research on the other side marked the developments from 1987 to 1997

4. A New Combination of Drugs to Cure AIDS in 1999:

In a major development in the area of AIDS treatment Prof. Anthony Fauci of the National Institute for Allergy and infectious diseases in US announced a new combination of drugs that promised of a cure for AIDS. Prof Fauci, who is an internationally renowned AIDS expert, made the above announcement at the tenth International Conference on immunology.

The new combination held out the hope for a potential cure for the disease as it had been found to clear out the AIDS virus completely from the blood stream. Specifically, it was found to remove the virus from specific cells of the immune system (CD4 cells).

The new combination he announced was ART drugs, AZT (Azidothymidine) and an enzyme protease (three drug therapy), along with the inclusion another new drug by adding interluekins, a class of proteins secreted by immune cells completely eliminated the virus from CD$ cells that circulated in blood.

The new drug, though might be successful, it may not be of much use to developing countries, as the therapy would be costlier than the existing one, which itself was beyond the reach of most of them.

5. TRUVADA: the 21st Century Drug:

Truvada is known chemically as a fixed-dose, daily in-take combination of emtricitabine and tenofovir disoproxil fumarate. Since 2004, it has been marketed as a treatment to those already affected with HIV. However, beginning 2010, clinical studies demonstrated that the drug could prevent people from contracting the infection. Truvada could be a preventive measure for high-risk individuals such as those with HIV positive partners provided the users counsel sexual health counsellors and use condoms.

A three year study showed that the daily in-take of Truvada reduced the risk of infection in healthy gay and bisexual men by 42%, who belong to high risk group.
A recent study in 2011 found that Truvada reduced infection by 75% in heterosexual couples in which one partner was infected.

A recent Press-Release by FDA informs that they have since given their first ever nod for this anti-HIV drug to the pharmaceutical company Gilead Sciences. (Source: The Hindu-July 18, 2012)

6. CONCLUSION:

S brief and simple treatment of anti HIV drugs was given in the above paragraphs. Attending to the needs of HIV/Aids affected and infected people requires talents in various fields. A highly qualified doctor should have a bent of social service and also should be a psychologist. Likewise, a social worker should not only be a good psychologist, but also should have a fundamental knowledge of AIDS medication. Also a psychologist should have the knowledge of both social service and medicine.

That is with that idea that this article is submitted. Days are not far off when an ordinary person in India will talk of TRUVADA like a layman knows ELISA today.

Let all of us, who belong to various disciplines of knowledge join together to fight against this dreaded 20th century monster.