Typical regimens consist of two nucleoside analogue reverse transcriptase
inhibitors (NARTIs or NRTIs) plus either a protease inhibitor
or a non-nucleoside reverse transcriptase inhibitor (NNRTI). Because
HIV disease progression in children is more rapid than in adults,
and laboratory parameters are less predictive of risk for disease
progression, particularly for young infants, treatment recommendations
are more aggressive for children than for adults. In developed
countries where HAART is available, doctors assess the viral load,
rapidity in CD4 decline, and patient readiness while deciding
when to recommend initiating treatment.
Anti-retroviral drugs are expensive, and the majority of the world's
infected individuals do not have access to medications and treatments
for HIV and AIDS. Research to improve current treatments includes
decreasing side effects of current drugs, further simplifying
drug regimens to improve adherence, and determining the best sequence
of regimens to manage drug resistance. However, only a vaccine
is postulated to be able to halt the pandemic. This is because
a vaccine would possibly cost less, thus being affordable for
developing countries, and would not require daily treatments.
However, after over 20 years of research, HIV-1 remains a difficult
target for a vaccine.
A number of studies have shown that measures to prevent opportunistic
infections can be beneficial when treating patients with HIV infection
or AIDS. Vaccination against hepatitis A and B is advised for
patients who are not infected with these viruses and are at risk
of becoming infected. Patients with substantial immunosuppression
are also advised to receive prophylactic therapy for Pneumocystis
jiroveci pneumonia (PCP), and many patients may benefit from prophylactic
therapy for toxoplasmosis and Cryptococcus meningitis as well.
Daily multivitamin and mineral supplements have been found to
reduce HIV disease progression among men and women. This could
become an important low-cost intervention provided during early
HIV disease to prolong the time before antiretroviral therapy
is required
The definition of "alternative therapies" in AIDS has
changed since that time. Then, the phrase often referred to community-driven
treatments, untested by government or pharmaceutical company research,
that some hoped would directly suppress the virus or stimulate
immunity against it. Examples of alternative medicine that people
hoped would improve their symptoms or their quality of life include
massage, stress management, herbal and flower remedies such as
boxwood, and acupuncture; when used with conventional treatment,
many now refer to these as "complementary" approaches.
Despite the widespread use of complementary and alternative medicine
by people living with HIV/AIDS, the effectiveness of these therapies
has not been established.
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