HIV Disease Management in the Highly Active Antiretroviral Therapy (HAART) Era

Human Immunodeficiency Virus (HIV) infection, with the complexity of disease and its progression has become a challenge to human beings. A UNAIDS global estimate reveals that currently 33.2 million people are living with HIV infection world wide. HIV infection leads to variable disease course in different people, amongst them are long term non-progressors, who survive for more than 10 years after getting infected. The biological basis of this variability in the disease progression is still unknown. Due to the chronicity of the disease and the extent of morbidity it causes, management of such individuals has become a challenge for physicians treating HIV infected patients. To effectively monitor the disease progression and the response to Highly active Antiretroviral Therapy (HAART) in the poor, developing and economically weak third world countries that carry most of the burden of HIV seropositive patients, it becomes financially overburdened to acquire resources and infrastructure necessary for patient management. Monitoring the disease progression and the response to Highly Active Antiretroviral Therapy (HAART) is traditionally carried out using TCD4+ cell counts and HIV/RNA viral load.

Highly Active Antiretroviral Therapy

Many clinical and laboratory markers have been used to estimate disease progression in HIV1 infection. Markers of AIDS development include viral markers (plasma HIV RNA load, serum p24 Ag, serum anti p24 antibodies), Surrogate markers (antibodies against p17, gp 120, gp 41 and nef gene product) and nonspecific markers including CD4+ T-cell counts, CD8+ T-cell counts and Delayed Type Hypersensitivity test (DTH)


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