Why deaths at initiation of ARVs
Even with the initiative to reduce HIV related deaths world wide,we still have victims who have not come to terms with regimen initiation.
By Joy Wachiye
WHO stage 3 and 4.
HIV infects white blood cells in the body’s immune system called T-helper cells (or CD4 cells). The virus attaches itself to the T-helper cell; it then fuses with it, takes control of its DNA, replicates itself and releases more HIV into the blood
With these two stages ,3 and 4,there has been an increased viral load in the body.
The vast replication of the virus in the blood will fight the body’s defense mechanisms .Due to increased viremia and taking advantage of DNA ,the immune system is weakened and now opportunistic infections begin to manifest.
The many infections arising will now make the body’s functional systems to begin failing.
Antiretroviral treatment combines a range of drugs that target different stages in the HIV life cycle, making it very effective. If it’s taken correctly, it keeps the immune system healthy, prevents the symptoms and illnesses associated with AIDS from developing, and means that people can enjoy long and healthy lives.
Stages of the HIV life cycle
1. Binding and fusion
The virus attaches itself to a T-helper cell and releases HIV into the cell.
Fusion or entry inhibitor drugs stop this happening.
2. Conversion and integration
Once inside the T-helper cell, HIV changes its genetic material so it can enter the nucleus of the cell and take control of it.
NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors) and integrase inhibitor drugs stop this happening.
3. Replication
The infected T-helper cell then produces more HIV proteins that are used to produce more HIV particles inside the cell.
4. Assembly, budding and maturation
The new HIV particles are then released from the T-helper cell into the bloodstream which infect other cells; and so the process begins again.
Protease inhibitor drugs stop this happening.
HAART initiation
Knowing how HIV infects the body helps people understand prevention and treatment options, and why it’s important to start antiretroviral treatment as soon as possible after testing positive.
Initiation of antiretroviral drugs at advanced stage may not be effective as much for you will be treating multiple infections at the same time; fungal infections,bacterial infections,parasitic infections, and with all these the already failing immune response cannot give the body enough back up.
Special attention should therefore be given to patients with advanced stage disease,non-functional status, low baseline CD4 count,low baseline hemoglobin,low baseline weight,tuberculosis co-infection and old age.
As a government and health institutions we must rise up and go into the community to create awareness on the need of early HAART initiation to reduce HIV related deaths at initiation of regimen.
If we care,we arise to the task.
Reference
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