Effects Of Human Immunodeficiency Virus

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Human Immunodeficiency Virus (HIV) is a virus spread by bodily fluids of infected individuals; it results in a depressed immune system as the virus destroys CD4+ cells. There are currently approximately 89,000 people living with HIV in the UK with 78,900 diagnosed cases. HIV cases are declining with 5,164 cases diagnosed in 2016 compared to 6,286 in 2015.

The discovery and implementation of antiretroviral therapy (ART) changed the prognosis for many with HIV from a fatal death sentence to a manageable chronic disease which enables sufferers to lead full lives. 96% of people living with HIV in the UK accessed ART treatment (Figure 2) in 2016.

Sustained treatment results in viral suppression which makes HIV untransmissible,
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Non-adherence also increases risk of developing drug-resistant viruses putting other members of the population at risk.

Depression is a common aliment for people suffering from HIV sometimes triggered by life stresses and stigma resulting from a HIV+ diagnosis. Stress itself is important as it can decrease adherence and also directly suppress immune function thereby decrease CD4+ levels exacerbating the effects of non-adherence. Patients who were diagnosed as depressed were 1.76 times more likely than those who were not depressed to not adhere to their ART regimen.
Prescription of antidepressants and psychotherapy sessions demonstrated an increase in ART adherence. Mindfulness training (MT) involves redirecting attention, avoiding emotional reactions and developing skills of self-regulation. In comparison to a control group the group with an MT intervention had a decreased viral load on follow up suggesting increased adherence. Studies have shown that MT decreases anxiety, depression whilst improving sleep quality and cognitive function.
As ARTs do not result in a cure throughout a person’s lifetime many different regiments may be prescribed targeting various stages of the virus’ replicative cycle. To decreases risk of resistance many countries prescribe a combination of drugs with multiple doses throughout the day, the NHS prescribes between one to four pills daily. As shown in the AACTG and the Danish
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