AIDS, in medicine: Tests and Treatment

Tests and Treatment

Various blood tests now are used to detect HIV. The most frequently used test for detecting antibodies to HIV-1 is enzyme immunoassay. If it indicates the presence of antibodies, the blood is more definitively tested with the Western blot method. A test that measures directly the viral genes in the blood is helpful in assessing the efficacy of treatments.

There is no cure for AIDS, but it may be treated with a number of different antiretroviral drugs, often in combination. Early treatment with retrovirals, as soon as a person tests positive for infection with HIV, has been shown in studies to reduce to the transmission of HIV. Drugs such as AZT, ddI, and 3TC, which are reverse transcriptase inhibitors, have proved effective in delaying the onset of symptoms in certain subsets of infected individuals. The addition of a protease inhibitor, such as saquinovir, amprenavir, or atazanavir, to AZT and 3TC has proved very effective, but the drug combination does not eliminate the virus from the body. Efavirenz (Sustiva), another type of reverse transcriptase inhibitor, must be taken with protease inhibitors or older AIDS medicines. Highly active antiretroviral therapy (HAART), a combination typically of three or more anti-AIDS drugs, is now the preferred treatment. Opportunistic infections are treated with various antibiotics and antivirals, and patients with malignancies may undergo chemotherapy. These measures may prolong life or improve the quality of life, but drugs for AIDS treatment may also produce painful or debilitating side effects.

Many experimental AIDS vaccines have been developed and tested, but none has yet proved more than modestly effective, including some that underwent full-scale testing. The development of a successful vaccine against AIDS has been slowed because HIV mutates rapidly, causing it to become unrecognizable to the immune system, and because, unlike most viruses, HIV attacks and destroys essential components of the very immune system a vaccine is designed to stimulate.

Governments and the pharmaceutical industry continue to be under pressure from AIDS activists and the public in general to find a cure for AIDS. Attempts at prevention through teaching “safe sex” (i.e., the relatively safer sex accomplished by the use of condoms), sexual abstinence in high-risk situations, and the dangers to drug users of sharing needles have been impeded by those who feel that such education gives license to promiscuity and immoral behaviors.

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