 In April 2010 the South African Government launched a major counselling and testing campaign (HCT) which marked a welcome change from South Africa's history of HIV.The HCT campaign is a widespread strategy implemented in all health authorities whereby all patients will be counselled on the importance of knowing their HIV status and will be offered a test. Through this proactive approach the government of South Africa aim to test 15 million people for HIV by June 2011.
South Africa has the largest antiretroviral therapy programme in the world, but given it also has the world’s largest epidemic, access to treatment is low. At the end of 2007, an estimated 28% of infected people were receiving treatment for HIV, below the average across lower- and middle-income countries.
The state of HIV treatment in South Africa is disappointing and can only be seen in the context of years of doubting the effectiveness of treatment at the highest levels of government, and the delay and slow pace of delivering a public ARV programme.
Articles below are all general information articles about vaccines. For news articles, please go to the news section, or use the search function.
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Antiretroviral - The basics |
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 Antiretroviral drugs are medications for the treatment of infection by retroviruses, primarily HIV. When several such drugs, typically three or four, are taken in combination, the approach is known as highly active antiretroviral therapy, or HAART. The American National Institutes of Health and other organizations recommend offering antiretroviral treatment to all patients with AIDS. Because of the complexity of selecting and following a regimen, the severity of the side-effects and the importance of compliance to prevent viral resistance, however, such organizations emphasize the importance of involving patients in therapy choices, and recommend analyzing the risks and the potential benefits to patients without symptoms.
There are different classes of antiretroviral drugs that act at different stages of the HIV life-cycle.
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 '’’AntiViral-HyperActivation Limiting Therapeutics’’’ (AV-HALTs) are an investigational class of antiretroviral drugs used to treat Human Immunodeficiency Virus (HIV) infection. Unlike other antiretroviral agents given to reduce viral replication, AV-HALTs are single or combination drugs designed to reduce the rate of viral replication while, at the same time, also directly reducing the state of immune system hyperactivation now believed to drive the loss of CD4 T helper cells leading to disease progression and Acquired Immunodeficiency Syndrome (AIDS).
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Entry inhibitors, also known as fusion inhibitors, are a class of antiretroviral drugs, used in combination therapy for the treatment of HIV infection. This class of drugs interferes with the binding, fusion and entry of an HIV virion to a human cell. By blocking this step in HIV's replication cycle, such agents slow the progression from HIV infection to AIDS
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Integrase inhibitors are a class of antiretroviral drug designed to block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. Since integration is a vital step in retroviral replication, blocking it can halt further spread of the virus. Integrase inhibitors were initially developed for the treatment of HIV infection, but they could be applied to other retroviruses.
The first integrase inhibitor approved by the U.S. Food and Drug Administration (FDA) was Raltegravir (brand name Isentress), approved on October 12, 2007. Research results published in the New England Journal of Medicine on July 24, 2008, concluded that "raltegravir plus optimized background therapy provided better viral suppression than optimized background therapy alone for at least 48 weeks."
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Protease inhibitor (pharmacology) |
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Protease inhibitors (PIs) are a class of drugs used to treat or prevent infection by viruses, including HIV and Hepatitis C. PIs prevent viral replication by inhibiting the activity of HIV-1 protease, an enzyme used by the viruses to cleave nascent proteins for final assembly of new virons.
Protease inhibitors have been developed or are presently undergoing testing for treating various viruses:
- HIV/AIDS: antiretroviral protease inhibitors (saquinavir, ritonavir, indinavir, nelfinavir, amprenavir etc.)
- Hepatitis C: experimental agents: BILN 2061 (All clinical trials of BILN 2061 have been suspended due to cardiac issues), VX 950 (trade name Telaprevir), or SCH 503034
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Raltegravir (MK-0518, brand name Isentress) is an antiretroviral drug produced by Merck & Co., used to treat HIV infection. It received approval by the U.S. Food and Drug Administration (FDA) in October 2007, the first of a new class of HIV drugs, the integrase inhibitors, to receive such approval.
Mechanism
Raltegravir targets integrase, an HIV enzyme that integrates the viral genetic material into human chromosomes, a critical step in the pathogenesis of HIV. The drug is metabolized away via glucuronidation.
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Reverse Transcriptase Inhibitor |
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Reverse transcriptase inhibitors (RTIs) are a class of antiretroviral drug used to treat HIV infection, tumors, and cancer. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase enzyme that retroviruses need to reproduce.
Types
RTIs come in three forms:
- Nucleoside analog reverse transcriptase inhibitors (NARTIs or NRTIs)
- Nucleotide analog reverse transcriptase inhibitors (NtARTIs or NtRTIs)
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
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Synergistic enhancers of antiretrovirals usually do not possess any antiretroviral properties alone, but when they are taken concurrently with antiretroviral drugs they enhance the effect of that drug.
One of these is an over-the-counter nutritional supplement and another two of these have been FDA approved (for other indications). The effects of these drugs, however, will require further evaluation before being clinically exploited.
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