Management of HIV/AIDS in the context of Serodiscordant


Management of HIV/AIDS in the context of Serodiscordant

⭐ Core Definition: Management of HIV/AIDS

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the replication cycle of HIV. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.

Treatment has been so successful that in many parts of the world, HIV has become a chronic condition in which progression to AIDS is increasingly rare. Anthony Fauci, former head of the United States National Institute of Allergy and Infectious Diseases, has written, "With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach." In the same paper, he noted that an estimated 700,000 lives were saved in 2010 alone by antiretroviral therapy. As another commentary noted, "Rather than dealing with acute and potentially life-threatening complications, clinicians are now confronted with managing a chronic disease that in the absence of a cure will persist for many decades."

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Management of HIV/AIDS in the context of HIV/AIDS

The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a preventable disease. It can be managed with treatment and become a manageable chronic health condition. While there is no cure or vaccine for HIV, antiretroviral treatment can slow the course of the disease, and, if used before significant disease progression, can extend the life expectancy of someone living with HIV to a nearly standard level. An HIV-positive person on treatment can expect to live a normal life, and die with the virus, not of it. Effective treatment for HIV-positive people (people living with HIV) involves a life-long regimen of medicine to suppress the virus, making the viral load undetectable.

Treatment is recommended as soon as the diagnosis is made. An HIV-positive person who has an undetectable viral load as a result of long-term treatment has effectively no risk of transmitting HIV sexually. Campaigns by UNAIDS and organizations around the world have communicated this as Undetectable = Untransmittable.

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Management of HIV/AIDS in the context of HIV/AIDS in the United States

The AIDS epidemic, caused by the emergence and spread of the human immunodeficiency virus (HIV), developed in the United States between the 1970s and 1980s. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection. Initially, infected foreign nationals were turned back at the United States border to help prevent additional infections.

The number of United States deaths from AIDS has declined sharply since the early years of the disease's presentation domestically. According to 2023 data, there was a 12% decrease in the amount of new HIV infections than there was in 2018.

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