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There are several Drugs / Medicine which specifically target Aids / HIV at different points in its life cycle. Using them in combination has proved much more effective than prescribing them one at a time. In Europe and the US, combination therapy has resulted in a huge drop in Aids deaths and in some people the Drugs / Medicine have reduced the virus to undetectable levels. However, the Drugs / Medicine do have side effects, they do not work for all people and the effectiveness of individual Drugs / Medicine can wear off. And they are very expensive.
What were the first anti-HIV Drugs / Medicine?
The first Drugs / Medicine to be developed to combat HIV were AZT (also called zidovudine or Retrovir), ddI (didanosine or Videx) and ddC (zalcitabine or Hivid). These all belong to a group of Drugs / Medicine called nucleoside analogues or reverse transcriptase inhibitors.
They inhibit the action of an enzyme called reverse transcriptase which enables HIV to spread, leading to a breakdown of the patient's immune system.
AZT taken alone has been shown to reduce HIV transmission from woman to baby.
Women who avoid breastfeeding and take AZT are about 66% less likely to pass on the virus to their child.
Using combinations of Aids / HIV Drugs / Medicine
Scientists noticed that people using more than one of the Drugs / Medicine were less likely to develop Aids, the syndrome of diseases caused when HIV has destroyed the immune system. They were therefore more likely to live longer.
In the UK, five nucleoside analogues have been licensed. In addition to AZT, ddI and ddC, doctors can also prescribe 3TC (lamivudine or Epivir) and d4T (stavudine or Zerit).
Some patients are also taking part in trials for another nuceloside analogue drug called abacavir.
Another group of Drugs / Medicine which stops the reverse transcriptase enzyme from working is non-nucleoside reverse transcriptase inhibitors or NNRTIs for short.
One, nevirapine, has been licensed in the US and is available in the UK. Two others are being tested.
The Drugs / Medicine are particularly effective for people who have not had any other anti-HIV Drugs / Medicine before, but they have to be taken with at least two nucleoside analogues.
Other anti- Aids / HIV Drugs / Medicine
There are three licensed Drugs / Medicine in Europe which target another enzyme which helps HIV to spread.
They are usually used in combination with nucleoside analogues. They are: indinavir (sold as Crixivan), ritonavir (trade name Norvir) and saquinavir (sold as Invirase).
Using a protease inhibitor in combination with other anti-HIV Drugs / Medicine can reduce the progress of HIV and the risk of death by 50% in people whose immune systems have been severely compromised. The benefits for those whose immune systems have been so severely attacked by HIV is not as noticeable.
However, combinations that contain indinavir or ritonavir can reduce the virus to almost undetectable levels in many people with HIV.
Scientists are creating more protease inhibitors.
Aids / HIV Resistance
When Aids / HIV reproduces, it can produce different strains which may be resistant to some Drugs / Medicine.
In some cases, the new strains can be resistant not just to one drug, but to other related Drugs / Medicine.
The mutation of Aids / HIV is one of the main reasons that a particular combination of Drugs / Medicine can lose effectiveness over time.
People are advised to change their combination of Drugs / Medicine if it becomes less successful at fighting HIV.
Drug-resistant Aids / HIV can be transmitted from person to person through body fluids - the same way as ordinary HIV.
Taking combination therapy
Taking the wrong dose of anti-HIV Drugs / Medicine or the wrong combination can be more dangerous in the long run that not taking the Drugs / Medicine at all.
This is because wrongly treated HIV can reproduce at very high rates and produce resistant strains very quickly.
Taking combination therapy can be very disruptive to daily life.
The Drugs / Medicine have to be taken at the right time in the right doses. Some have to be taken on an empty stomach and others on a full stomach.
It is vital that patients do not forget to take their pills as, if the level of Drugs / Medicine in the bloodstream drops too low, HIV may develop resistance to them.
The side effects associated with the different anti-HIV Drugs / Medicine vary according to the drug and the individual taking them. They can include anaemia.
Because of the difficulties surrounding combination therapy, some HIV organisations have developed services for helping people take their medicine and for giving them more information about the different Drugs / Medicine.
Aids / HIV Expense
The Drugs / Medicine are very expensive, which means it is difficult for governments in developing countries to pay for them.
Combination therapy is estimated to cost around $950 per month.
At the end of last year, some firms involved in manufaturing Drugs / Medicine used in combination therapy reduced their prices for developing countries.
For example, in Uganda, the cost of combination therapy was reduced to around $500 per month.
However, this is still well out of the reach of most Ugandans. Even middle income Ugandans are only estimated to earn around $400 a month.
AIDS deaths, which increased ferociously in the United States throughout the 1980s and early '90s to a peak of 51,000 a year, suddenly abated in 1996 with the advent of antiretroviral combination therapy, a pricey and toxic brew that pulled people from their hospital beds like Lazarus. The relief was so intense that Andrew Sullivan announced "the end of AIDS," and researcher David Ho held out the hope of "eradication." It's often forgotten that AIDS deaths didn't fall to 9,000 a year by 2001 because of drug discovery alone. Those lives were also saved by a national commitment to provide access to the new medications. Throughout the late 1990s, Congressional support for the AIDS Drug Assistance Program was so strong on both sides of the aisle that appropriations exceeded presidential requests every year.
That has now changed. As the growing epidemic slams up against state austerity measures, ADAP has descended into crisis, and Republicans in Washington have refused to intervene. As of early October, more than 600 people with HIV have been denied access to medications through the program. Three states have tightened income eligibility requirements; five have restricted the list of drugs they cover, hampering competent treatment; thirteen have capped their programs, leaving the sick to languish on waiting lists. ADAP has served as the payer of last resort since 1987, providing HIV medicines for hundreds of thousands of people with HIV who lack insurance, or whose prescription benefits don't come close to matching the drugs' exorbitant price tag. Most ADAP users are the working poor, earning too much to qualify for Medicaid at jobs that don't provide health plans. Study after study has confirmed that the program saves public-health dollars by preventing expensive hospitalizations--and saves lives. But since February, two people have died while on the West Virginia waiting list, and five more just died on Kentucky's. There are no death tallies for those whose income puts them a few dollars above states' new restrictive income requirements.
Doctors, social workers and people with HIV describe a desperate scramble to gain access to lifesaving medications. In Alabama, the waiting list is 137, growing by nine or ten a week; to save additional dollars, the state just blocked coverage of the latest HIV drug, Fuzeon, a treatment used almost exclusively by those who have run dry of options. In Oregon, when the cash-strapped state temporarily eliminated some Medicaid prescription coverage, the ADAP waiting list ballooned; administrators responded by restricting covered drugs and instituting "cost sharing."
Margaret Nicholson, a Springfield, Oregon, homecare attendant who survives with her mother and husband on less than $20,000 a year, lost her ADAP coverage because she couldn't afford the new co-pays; she has now gone four months without seeing a doctor and is scraping by on pill samples. In North Carolina, HIV doctor Aimee Wilkin says some of her waiting-list patients, forced to seek medicines through drug company charity programs, have faced multiple treatment interruptions, the result of bureaucratic delays, exposing them to the risk of HIV drug resistance. In Kentucky, caseworkers are so desperate they're asking churches to pass the hat to sponsor someone's pills for a few weeks at a time.
Even after aggressively negotiating with drug companies to save ADAP $65 million with price breaks for next year, advocates with NASTAD, an association of state AIDS directors, calculate that it will take an ADAP increase of $214 million to cover the growing need next year--the amount requested by Senator Charles Schumer in a budget amendment rejected on a largely party-line vote (with one brave exception, Republican Mike DeWine). Other Republicans, even from states with bursting waiting lists, like Alabama, Colorado, Nebraska and North Carolina, voted no, apparently under intense pressure from George W. Bush and Bill Frist to stick to their domestic budget cap. The health and labor spending bill is currently in conference, where a minimal increase of $25 million to $38 million is under debate.
Such underfunding, combined with an aggressive new federal HIV testing initiative, could swell ADAP waiting lists into the tens of thousands in 2004, according to Bill Arnold of the ADAP Working Group. In his State of the Union address in January, Bush made AIDS a cornerstone of his "compassion" agenda, announcing a $15 billion emergency plan to confront the global epidemic. He spoke of a doctor in rural South Africa who said that hospital workers, lacking drugs, simply tell their AIDS patients to go home and die. "In an age of miraculous medicines," the President went on to say, "no person should have to hear those words."
Six hundred--and counting--have now heard those words here at home. "For the people on those wait lists," says Arnold, "it will be just like the 1980s, when there were no drugs, where you get pneumonia or a brain infection and within a couple of years you're gone."
77 Canada Pharmacy has Drugs / Medicine to supply Aids / HIV Patients. Ordering Aids / HIV Medicine / Drugs from 77 Canada Pharmacy is Private and Discreet.
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