HIV prevention? The success of HIV treatment

I was in practice less than 10 years when AIDS starting killing people. Now life expectancies have improved greatly and transmission mother to baby appears to be preventable.

Here below look at the rate of diagnosis and death over time–very impressive success for the treatment.

The key is a drug group called protease inhibitors, because retroviruses are parasitic RNA viruses (they don’t have DNA) and replicate by a parasitic process.

Retrovirus: A virus that is composed not of DNA but of RNA. Retroviruses have an enzyme, called reverse transcriptase, that gives them the unique property of transcribing their RNA into DNA after entering a cell. The retroviral DNA can then integrate into the chromosomal DNA of the host cell, to be expressed there. HIV is a retrovirus.

Protease inhibitors (PIs) are a class of antiviral drugs that are widely used to treat HIV/AIDS and hepatitis caused by hepatitis C virus. Protease inhibitors prevent viral replication by selectively binding to viral proteases (e.g. HIV-1 protease) and blocking proteolytic cleavage of protein precursors that are necessary for the production of infectious viral particles.

Protease inhibitors have been developed or are presently undergoing testing for treating various viruses:

HIV/AIDS: antiretroviral protease inhibitors (saquinavir, ritonavir, indinavir, nelfinavir, amprenavir[1] etc.)
Hepatitis C: boceprevir, telaprevir
Given the specificity of the target of these drugs there is the risk, as in antibiotics, of the development of drug-resistant mutated viruses. To reduce this risk it is common to use several different drugs together that are each aimed at different targets.

In addition to general info on success of treatment, this link talks about success in reducing maternal transmission in utero of the viral infection HIV.


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