Description: This is how advances in HIV drugs have helped change the pandemic process.

• There is no cure for HIV yet, but over the last 40 years, treatment options have improved significantly, improving the quality of life for people living with HIV.
• These expanding treatment options have also created new weapons for HIV prevention and approached the suppression of the AIDS epidemic.
• Even if medical services were interrupted during a Covid pandemic, the drugs available for HIV helped protect people from the onset of severe cases of Covid-19.

the 4th HIV research for prevention (HIVR4P) The conference ended on Thursday, but there is still much to learn and unpack about the progress of HIV research.

This is the first in a series of Bhekisisa resources that provide part of the pre-conference program. Announced to journalists around the world These HIVR 4P videos, and their coverage, will help explain some of the progress in preventive research and the best way to report on them.

First: From January 12th, a session to end the HIV epidemic while maintaining the progress of the Covid-19 pandemic.

The session was presented to the director with the President of the United States by a medical adviser National Institute of Allergy and Infectious Diseases, Anthony Fauci.

How advances in HIV treatment have changed people’s lives

It’s been 40 years since The first case of AIDS was reported.. At that time, what was once a death sentence became a manageable chronic condition. Scientists have been enthusiastic about pushing the boundaries of HIV research and improving the outcomes of the lives of people living with HIV.

The study has made significant strides and changes in life expectancy for newly diagnosed 20-year-olds.

In the 1980s, Fauci explained that 20-year-old HIV patients were expected to live only a year or two after being diagnosed with progressive disease or AIDS. But today, the newly diagnosed 20-year-old can live for another 53 years.

What are the factors influencing this change? A menu of treatment options currently available to combat HIV.

There was little that people diagnosed with HIV in the 1980s could do, but now there are several different types of drugs called antiretroviral drugs (ARVs) that can be used to treat HIV.

These medicines have helped save countless lives. There is no cure for HIV yet, but ARV helps control the virus, and when taken correctly, people can continue to live normally.

What are antiretroviral drugs?

First, Clarify some terms: Antiretroviral treatment (ART) refers to a combination of various antiretroviral drugs or drugs (ARVs) taken daily by people living with HIV.

We currently have 7 classes of ARV.. These drugs are grouped in terms of how they respond to HIV or how they fight HIV.

ARV makes HIV replication difficult. That is, it makes a copy of itself... This reduces the amount of virus in your body, called the viral load.

So why are these drugs important?

Without treatment, HIV attacks and weakens the body’s immune system. This is done by destroying part of the natural defense system called CD4 cells or T cells.

Think of CD4 cells as a firefighter in your body. CD4 cells help fight fires (infections) by alerting colleagues to threats and adjusting them safely.Similarly, CD4 cells Coordinates and stimulates other immune cells In the body to fight infections.

In our analogy, ARVs are various types of protective devices that help firefighters stay safe during firefighting activities.

In general, a well-functioning immune system is about 500-1500 CD4 cells in a drop of blood (cubimm).. This is called a CD4 count. When this number drops to less than 200 CD4 cells per drop of blood, HIV infection progresses to that number. State-of-the-art stage –AIDS.

At this stage, the body becomes more susceptible to opportunistic infections such as pneumonia and tuberculosis, increasing the risk of illness and death.

However, if someone can take ARV and reduce the amount of virus in the system, these fire marshal cells have a better chance of getting infected.

The way and when people take these medicines has changed over the years.

Initially, people were prescribed ARV only when the number of CD4s was low. This indicates that the immune system has weakened and its functioning has been impaired, explains infectious disease doctor Kevin Rebe in a 2016 article. please refer to..

This is a new survey in 2015 The best treatment plan for people living with HIV was to start a course of ARV as soon as possible after diagnosis., Regardless of the number of CD4s, Rebe writes.

These drugs (ARV) and their combination in a different treatment plan (ART) do not treat HIV. However, when taken as intended, it helps keep the HIV viral load low, count up the body’s CD4, reduce the risk of death, and reduce the risk of transmitting the virus.

What do you need to end the HIV epidemic?

ARV is not only used to treat people living with HIV, but also plays an important role in preventing the transmission of HIV from person to person.

Ultimately, ending this epidemic means offering more options and “optimization of HIV treatment and prevention toolkits” to people, Fauci explained.

This should include “continuous development of new and improved tools, because we have extraordinary tools, but we can always be better. And in fact, we I’m doing better. ”Read more about Search for HIV vaccine..

As research in this area progressed, we learned more about HIV and its treatment. Over time, scientists have come up with the best way to use drugs to have the greatest impact. One such breakthrough was evidence confirming the following idea. Undetectable equals untransmittable (Or U = U).

The basic idea behind U = U is: People who are infected with HIV have very low viral load, so if standard tests cannot detect (cannot detect) the virus in the blood, the virus cannot be transmitted to others (cannot be transmitted).

Most HIV patients who use ARV correctly cannot detect viral load. Therefore, getting as many people with HIV as possible with ARV will not only help people with HIV to live longer and healthier lives. It also helps control the spread of the virus. The following is an example of how ARV is used to prevent the spread of HIV.

To Prevent mother-to-child transmission Pregnant women living with HIV take ARV. After giving birth, the baby is also enrolled in an HIV drug course.

People infected with HIV can become infected with emergency ARV within 72 hours of exposure.is this Post-exposure prophylaxis (PEP).

Preemptive precautions are also available. People who are not infected with HIV but are at high risk of getting the virus can take HIV medications before they get infected.is this Pre-exposure prevention (PrEP).

There are also several options available within PrEP, and several options are imminent, including a new 8-week injection.

How does Covid-19 affect people living with HIV?

Some of the global goals outlined in the United Nations Development Program are: End the HIV epidemic by 2030.. The idea was to achieve this by reducing new HIV infections and AIDS-related deaths by 90% in 20 years.

The number of new infections They were the worst since 1988 And there was a historic reduction in deaths, There is still more work to be done..

Many countries that have already failed to reach their goals are facing further setbacks in the Covid-19 pandemic.

The impact of this new public health threat has direct and indirect impacts on global HIV treatment and prevention programs, Fauci outlines.

What are the indirect effects? -Service interruption.

As Fauci explained, the Covid-19 pandemic interrupted and disrupted the provision of essential medical services, including those that people depended on for the treatment and prevention of HIV.

A 2020 interim report By World Health Organization (WHO) I found it Thirty-two (32%) of the 101 countries with established ART programs experienced some form of confusion in the provision of these services. About 31 of these countries reported partial turmoil, and one said the turmoil was serious.

So what are the potential consequences of these interruptions in healthcare services?

Estimate of a study In low- and middle-income countries with high HIV burdens, such turmoil could increase HIV-related deaths by 10% over the next five years (compared to virtual scenarios without a COVID pandemic).

What about the direct effects — are people living with HIV at increased risk of developing severe COVID-19?

According to Fauci: Yes, no.

One of the concerns about Covid-19 is that underlying medical conditions, such as diabetes, can increase the risk of developing a serious illness, Fauci explained. There are also some risks associated with people who have endangered the immune system — where HIV comes in.

“If you get HIV, you might expect to be immunocompromised,” says Fauci. “However, many HIV patients are on antiretroviral therapy, have normal CD4 counts, and cannot detect viral load.”

Therefore, the initial expectation may have been that people living with HIV have a weaker immune system and are therefore more vulnerable to Covid-induced complications. But instead, we have seen that people living with HIV are not at high risk as a result of their diagnosis because of the successful implementation of ARV to control viral load.

Rather, what makes people The higher risk is having multiple medical conditions, Or comorbidities.

Therefore, the number of people infected with HIV in Covid-19 is increasing, but this is not a direct result of HIV status. Instead, this high mortality rate is due to the greater burden of comorbidities on people living with HIV.

Fauci explains: “A potential risk factor for severe Covid-19 is high prevalence, especially in the elderly. In other words, people who are infected with HIV have the same number of comorbidities as others who are not infected with HIV. Have [have].. But you have it in a more general way. “

But in the end When keeping all elements the samePeople who live with HIV and those who are HIV-negative have the same risk of being infected with SARS-CoV-2. In addition, Covid-19 infection progresses similarly in both individuals and both face the same consequences of COVID infection.

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