Patient T. R: A Case Study

Antivirals are the treatment for HIV and presently there is no known cure. Treatment most often involves combinations of different drugs to avoid creating strains of the virus that are immune to single drug treatments (Mayo Clinic, 2013). The number of CD4 or T cells monitors treatment response. The viral load should be undetectable while undergoing antiviral therapy. The count is checked when treatment starts and usually monitored every 3-6 months. Even if someone has an undetectable viral load, the spreading of HIV is still a possibility.

The Acquired Immune Deficiency Syndrome denotes a spectrum of conditions that are caused by the HIV virus. Infection with this disease does not result in the instant occurrence of the related signs and symptoms. However, an individual is likely to experience flu-like symptoms after he or she is infected with it. Eventually, the person experiences a prolonged period of apparent health with no visible signs. On progression, the infection adversely interferes with the immune system of the individual. The weakening of the body’s defense system increases the risk of recurrence of common infections and opportunistic illnesses that

K.D. is a 36-year-old gay professional man who has been human immunodeficiency virus (HIV) positive for 6 years. Until recently, he demonstrated no signs and symptoms (S/S) of acquired immunodeficiency syndrome (AIDS). The appearance of purplish spots on his neck and arms persuaded him to make an appointment with his physician. When he arrives at the physician’s office, the nurse performs a brief assessment. His vital signs (VS) are 138/86, 100, 30, 100.8° F. K.D. states that he has been feeling fatigued for several months and is experiencing occasional night sweats, but he also has been working long hours, has skipped meals, and has been particularly stressed over a project at work. K.D.’s physical examination is within normal limits (WNL) except for his rapid heart rate and respirations, low-grade fever, and skin lesions. The doctor orders a chest x-ray (CXR), CBC, lymphocyte studies, ultra viral load, Cytomegalovirus (CMV) assay, and a PPD (purified protein derivative) test. K.D. made an appointment

Mr. .J. is a 30 year old Caucasian male presented to the Emergency Department with symptoms of myalgia, fever, rash, swollen glands, leukopenia, and thrombocytopenia. Mr. J. reported fever and sore throat started about a week ago and the rash presented today. Mr. J. stated “I thought I had the flu but I am not feeling any better and now I have a rash, that’s why I decided to come to the E.D.”. (Health and Human Services panel, 2013)

As have been described above, HIV can have a potential effect on immunological cells, which are important to protect the body from additional infections such as Tuberculosis (TB), Cytomegalovirus (CMV) and other viral or bacterial infections. An effective treatment is needed to reconstruct what HIV has damaged. Antiretroviral therapy (ART) is a common treatment to stop the viral replication and decrease the disease progression, which may lead to a vast decline of the morbidity and mortality. The standard treatment involves a combination of at least three drugs; often known as a highly active antiretroviral therapy (HAART) where the most common types are Nucleoside reverse transcriptase

People with poor immune systems, such as Mr Wilde, are at risk of a severe infection by the cytomegalovirus (Torpy, 2010). Mr Wilde is immunocompromised due to his HIV, a virus that weakens the immune system and compromises its ability to fight infection (Gillespie, 2014). HIV affects CD4+ T lymphocytes, which normally fight infection, killing the cells until they can no longer fight infections that would not infect someone with a healthy immune system (Craft and Gordon, 2010). The virus replicates in the first few weeks, and is accompanied with flu-like symptoms (Craft and Gordon, 2010). Infected patients are then generally asymptomatic for years, until their CD4+ T lymphocytes are so low in number that they become debilitated by normally harmless infections; although treatment can slow the disease, it is ultimately fatal (Craft and Gordon, 2010). Human immunodeficiency virus

Treatment for HIV is just to control the disease. They use a combination of drug therapies known as cocktails. This way when the virus figures out how to get around one there is another drug to block it from duplicating itself.

Initial curative treatment in the early 1990’s used interferon and the antiviral ribavirin with a cure rate of 50% (Watson, n.d., p. 1). 2011 saw the invention of two antiviral medications, telaprivir and boceprevir, that increased cure rates to 70%. In 2013 newer drugs, simeprevir and sofosbuvir, were introduced with the later creating 90% cure rates in patients (Watson, n.d., p.gs. 1-2). Simeprevir (Sovaldi) was created for administration once per day over a minimum of a year (Gilead, 2014). Eradication of the disease in patients is effective in patients co-infected with HIV with low rates of side effects (Sulkowski, et al., 2014), highlighting its efficacy in complex patient populations. The cost of such treatment is $1,000 per day with an average cost for curative course exceeding $94,000 (Venteicher, 2014). The medication is FDA approved and prescribed readily, but patients are not receiving access to the medication through their insurers.

HIV RNA (viral load) and CD4 T lymphocyte (CD4) cell count are the two surrogate markers of antiretroviral treatment (ART) responses and HIV disease progression that are used to manage and monitor HIV infection. The key goal of ART is to achieve and maintain durable viral suppression. If a patient has virologic failure, it means that they are unable to achieve or maintain suppression of viral replication to an HIV RNA level <200 copies/mL. Therefore, they should be assessed for virologic failure which include an assessment of adherence, drug-drug or drug-food interactions, drug tolerability, HIV RNA and CD4 T lymphocyte (CD4) cell count trends over time, treatment history, and prior and current drug-resistance testing results. Moreso, drug-resistance testing should be performed while the patient is taking the failing antiretroviral (ARV) regimen or within 4 weeks of treatment discontinuation.

Acute (Primary) HIV infection. “Acute HIV occurs 1-4 weeks after transmission and is accompanied by a burst of viral replication with a decline in CD4 cell count. Most patients manifest a symptomatic mononucleosis-like syndrome which is often overlooked. Acute HIV infection is confirmed by demonstrating a high HIV RNA with either a negative HIV antibody test or a reactive ELISA with negative or indeterminate Western blot” (Sax, 2013, p.3).

The fact is that the medications stop new infections by killing the HIV virus before taking control in the body. This conclusion was obtained while investigating the way in which the virus develops

Treatment for HIV has improved drastically over the last 20 years. Antiretroviral drugs are medication that attack and destroy the retrovirus. In 1995, the FDA approved antiretroviral therapy (ART). This is where the patient takes two to three types of medication, as single therapy is not advised, this improves treatment as the different drugs work together to combat the virus. Haart is an antitrtrovirus therapy, which was introduced in 1996. It has shown to reduce death rate and hospital admission; it has also shown to decrease transmission of the disease. The use of haart in developing countries has shown a huge reduction in mortality and morbidity, associated with HIV, also seen to slow progression of AIDS. This is due to is lowering viral load in the patients’ blood and sexual fluids. In Antiretroviral dug used in these therapies are very important, the combination of drugs work by stopping the virus from replicating. Also the anti-retroviral medicine used, in many cases can increase their CD4 and their T cell counts. This will leading to patients quality of life improving and allowing longevity of life. This has shown to be a huge advance help improve patients’ lives and the life expectancy of people who live with HIV/AIDS.

Although the introduction of highly active antiretroviral therapies (HAART) marked a seminal development in HIV-1 treatment, the therapies have since been characterized by poor patient adherence, a high incidence of acquired antiretroviral resistance in HIV-1, as well as endocrine and metabolic imbalances resulting in irregular fat redistribution (lipodystrophy), insulin resistance, and abnormal blood glucose (dysglycemia), cholesterol and lipids (dyslipidemia), and bone resorption and deposition.8 Atazanavir has

Arildsen et al. (2012) performed a prospective, cross-sectional study investigating endothelial dysfunction, increased inflammatory markers and activated coagulation in HIV-positive individuals after initiation of highly active ART. Twenty treatment naïve, nonsmoking, HIV positive patients were followed for 6 months and examined at three different times: 1) before starting HAART, 2) after 3 months of treatment with a HAART regimen consisting of 1 protease inhibitor (either indinavir or lopinavir coupled with ritonavir) and two NRTI (zidovudine and lamivudine) [PI/NRTI] and 3) after 3 months of treatment with a HAART regimen consisting of 2 NRTIs (zidovudine and lamivudine) plus one NNRTI (efavirenz)[NRTI/NNRTI]. Controls were healthy and

The emergence of drug-resistant strains of human immunodeficiency virus( HIV) and treatment failure can result from non-adherence to antiretroviral therapy (ART). (Michel Morin;2000)