Questão 14 - USS (Univassouras) Medicina 2025

HIV/AIDS TREATMENT

DR. NICOLA WILLIAMS, PH.D

 

Human immunodeficiency virus (HIV), the causative viral agent of acquired immunodeficiency syndrome 
(AIDS), is a devasting and lethal disease that has caused widespread suffering worldwide for almost half a 
century and we still have no cure for this disease. But, while those infected can expect to continue treatment 
throughout their lifetime, in recent times there have been advancements in therapeutics.

 

[5] The introduction of daily combination antiretroviral therapy (cART) led to a significant drop in AIDS-
related morbidities and mortality. Even so, a mechanism of HIV persistence today is the proliferation of 
cells that were infected prior to the introduction of ART. In addition, cART therapy comes with a whole 
host of problems, including premature aging, drug fatigue, toxicity, and inflammatory effects. These side 
effects exacerbate the incidence of other diseases, such as cardiovascular disease and chronic obstructive 
[10] pulmonary disease (COPD). 

 

There are remaining knowledge gaps in the campaign against HIV. Challenges to long-acting antiviral 
therapy involve mutations which are resistant and understudied populations. The development of drug-
resistant mutations has been a barrier to achieving a cure for HIV. Meanwhile, problems with adherence to 
cART regimens involve adverse drug reactions and limited access to therapy.

 

[15] The targeting of integrase has been touted as one of the most promising approaches to combating HIV 
infection. This protein is highly unique. The inhibitors formulated to inhibit integrase are long-acting and 
have shown exceptional promise in their capacity to block HIV integration and replication. Meanwhile, 
another technique that holds promise is the in-vivo delivery of gene-editing tools to either target the virus 
or enhance the immune system or protect cells from becoming infected.

 

[20] There are opportunities for a collaborative effort and cross-fertilization of concepts from cancer research, 
for example, by utilizing studies done on immune resistance in the field. The same goes for research into 
coronavirus disease 2019 (COVID-19), whereby increased knowledge of the mechanisms involved in severe 
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection could aid further understanding of HIV.

 

At present, most of the research into a cure for the virus has been carried out by high-income countries.  
[25] In developed countries, the incidence of infection rates is much lower and tends to be mainly problematic 
within the remit of the male homosexual population. Bearing this in mind, we need to remain cognizant 
of the fact HIV strains are genetically and biologically diverse and vary according to sex, ethnicity, and 
geographical locale.

Available at: https://www.news-medical.net/health/Recent-Advancements-in-Treating-HIV.aspx. Accessed in: 22 aug. 2024. (Adapted). 

    “Even so, a mechanism of HIV persistence today is the proliferation of cells that were infected prior to the introduction of ART.” (l. 6-7)

 

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