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A new ray of hope for people living with HIV

Sindy He

Vocab Bank

Subcutaneous administration: medication situated or applied under the skin.


Antiretroviral: a class of drugs that suppress the activity of retroviruses such as HIV.


Ryan White CARE Act: The most significant federal program about HIV. The RWHAP (Ryan White HIV/AIDS Program) provides funding for HIV care and treatment for low-income people diagnosed with HIV.

apsid inhibitors: A class of drugs that interfere with HIV capsid.

Intramuscular injection: an injection which puts medications to a specific area of muscle.


Summary

The Human Immunodeficiency Viruses (HIV) weaken your ability to fight daily infections and illnesses because of its ability to damage the cells in your immune system aggressively. The term AIDS (acquired immune deficiency syndrome) refers to a wide range of potentially life-threatening diseases caused by the HIV virus severely damaging your immune system. There is no way to transmit AIDS from one person to another, but the HIV virus can.

HIV is not currently curable, but drug treatments are very effective at keeping most people healthy and long-lived. The objective of HIV therapy is to have a viral load that is unnoticeable. This indicates that the amount of HIV virus in your body is too low to be identified by a test. One common treatment is Antiretroviral medicines which according to the World Health Organization is a class of drug that inhibits the development of retroviruses such as HIV. This drug works by preventing the virus from growing and duplicating in the human body, which enables the immune system to repair itself and consequently avoiding further harm. Sometimes HIV drugs do not work for some groups of infected people because they develop drug resistance, and loss of effectiveness of medication in treating disease or condition. This may be due to mutations in the HIV that cause the drug to fail to recognize and inhibit the virus from reproducing and spreading in the human body. These changes result in a new strain of virus that is resistant to the effect of the drug. Thus, many HIV patients develop resistance very quickly to HIV medicines. A recent study published by the San Francisco Aids Foundation states, "more than 70 - 80% of people with virological failure develop acquired HIV drug resistance. (Keep in mind that once a person becomes virally suppressed, these drug resistant mutations are no longer an issue) (Warren Tong, 2020)." Even more, the Federal Centers for Disease Control and Prevention, also known as CDC reports that approximately 44% of patients receiving HIV treatment have not been able to achieve viral suppression. It is clear; it is important to develop new drugs that are particularly resistant to resistance.

Earlier last year, the Food and Drug Administration (FDA) approved Cabenuva, the first longest-acting intramuscular injection given every month to two months by ViiV Healthcare company for the treatment of HIV/AIDS. In a study published in the New England Journal of Medicine, 92 .5% of participants switching to Cabenuva

maintained undetectable viral loads (fewer than 50 copies/mL) after 48 weeks (almost a year), compared to 95.5% who continued their oral regimen. However, the side effects and the inconvenience due to the frequency of injections make this treatment option non-ideal. Sunlence, approved by the FDA in December, 2022, is a milestone for the medical treatment of HIV, and it is used to suppress HIV in patients who have become resistant to other regimens. The injection frequency also decreases.

Sunlence or lenacapavir is developed by Gilead Sciences. It is the first of a new category of drugs approved by the FDA known as capsid inhibitors. These inhibitors operate by inhibiting the virus's protein coat, or capsid, interrupting numerous phases of the viral life cycle. According to an article published by the ClinicalTrial.gov, 83% of patients who took Sunlenca with another HIV treatment combination reached an undetectable viral load after nearly a year. The therapy begins with a schedule of oral pills and injections, followed by six-month maintenance injections. A physician and infectious disease specialist at Boston Medical Center, Sabrina Assoumou, explains that this treatment may be particularly beneficial for elderly patients who are diagnosed during outbreaks of the COVID-19 and who have difficulty adhering to previously more complex treatment regimens, leading to treatment resistance.

Additionally, Dr. Wendy Armstrong, a professor of medicine at Emory University School of Medicine, furthers that this new twice-yearly medication also makes it easier for people who face transportation difficulties. This treatment is effective and at the same time very expensive. According to USA Today, for the first year of therapy, the drug would cost $42,250 , and for the

following year, it would cost $39,000 a year. Fortunately, the Ryan White CARE Act and Medicaid allows many patients to receive medication assistance . At the same time the medical profession is joining forces with the government aiming to have the drug quickly added to the formulary of insurance plans.

From pills to intra venous injections, from monthly to half-annually, developments in medicine have undoubtedly greatly improved the quality of life for HIV patients Th ere is no cure for HIV, but huge strides have been made in treatment, and experts hope that expanded access to long-acting drugs will pave the way for easier treatment options.


While we support people with HIV, we must also learn to prevent the disease. If you keep the following in mind, you can greatly avoid exposing to the virus. First and foremost, it is important to use a condom during any form of sexual activity (oral , virginal, and anal). Secondly, never share needles or other injection utensils such as syringes, spoons and cotton buds. Thirdly, if you may have exposed to HIV, do not panic, seek advice from your local sexual health clinic or GP on how best to reduce your risk. People living with HIV should take effective HIV treatment, exercise regularly and eat a healthy diet.

Reference


1. Commissioner, Office of the. " FDA Approves New HIV Drug for Adults with Limited Treatment Options." U.S. Food and DrugAdniinistra tion, FDA,

www.fda. ov/news-events/ ress-announcements/fda-a roves-new-hiv-dru -adults- Ii mited-treatment-options.

2. Hassanein, Nada. "A New HIV Treatment Shot Is given Only Twice a Year. It Could Be a'Game Changer.'." USA Today, Gannett Satellite Information Network, 30 Dec. 2022,

3. "Antiretroviral Drug Optimization." World Health Organization, World Health Organization , www.who.int/groups/antiret roviral-drug-optimization

4. Ton g, Warren, and Warren Tong Warren Tong is a freelance health and science journalist. " Here's What You Need to Know about HIV Drug Resistance." San Francisco AIDSF oundation, 16 July 2020,

www.sfaf.org/collections/beta/heres-what-you-need-to-know-about-hiv-drug-resistanc


5. HIVPr evention in the United States:Mobilizing to End the Epiden·l!c. www.cdc.gov/hiv/pdf/polici es /cdc-hiv-prev e ntion-bluebook.pdf





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