Antiviral Strategies

P R 0 JDate: 8/97
1/, 01' IllIIII111111III11111 11111 AntiviralStrategies
/ information, 5571095.0291.009
inspiration and
Advocacy for personsDiscussion Paper
living with HIV/AIDS.
HIV (Human Immunodeficiency Virus) is a virus that infects and takes over
certain cells of the immune system that are important in fighting disease. The
A ntiviral virus then uses these cells to make new copies of itself, which then go on to
- infect other cells. This causes the infected cells to function improperly and die
Stra teg les prematurely, weakening the immune system and permitting the development
of opportunistic infections (opportunistic infections are infections that "take
the opportunity" to flourish when the immune system is damaged by HIV).
The immune system is very complex and researchers do not yet know all the ways HIV, the immune system and
opportunistic infections interact. The overall goal of antiviral therapy is to slow or stop this process, and
thereby slow or stop the progression of HIV disease and the destruction of the immune system. While other
approaches to combating HIV infection have been proposed and tested, thus far only antiviral therapy has been
proven to slow disease progression and extend life. A balanced approach to understanding and making decisions about antiretroviral therapy must include knowledge of the benefits, risks and limitations of existing
therapies, as well as the prospects for improvements offered by combination therapies and newer drugs.

The Goal of Antiviral Therapy
Once HIV was identified as the cause of AIDS, stopping or slowing
the reproduction of the virus became a major scientific goal. Significant progress has been made, yet uncertainty remains about
when to start and when to switch or combine antiretroviral therapies. Also, the failure of existing drugs to remain effective for long
periods of time is sometimes misunderstood as meaning that the
drugs don't work at all. Making wise decisions about the use of
antiviral therapies requires understanding the benefits and risks
of therapies, good communication with a knowledgeable physician and proper use of various laboratory tests. In recent years,
the advent of better drugs and combination therapy has made it
possible for the first time to develop long-term strategies for antiviral management of HIV. The objectives of antiretroviral therapy
should be:
To prolong life and improve quality of life for the long-term;
To supresses virus to below the limit of detection of the currently available tests (HIV RNA), or as low as possible, for as
long as possible;
To optimize and extend the usefulness of currently available
therapies;
To minimize drug toxicity and manage side effects and drug
interactions.

Why Use Antiviral Therapies?
The reasons for using antiviral therapies are fairly clear despite
doubts and frustration raised by the inability of early single drug
therapies to produce long-term benefits.
When a person is first infected with HIV, high virus levels develop
that are often accompanied by. symptoms and a decline in the
number of CD4+ T cells. The immune system, without the use of
antiviral therapies, succeeds in producing a dramatic, but incomplete, suppression of the
virus. In most cases
CD4+ cell counts return T G lAn a p.
partially toward normalw Anie.
levels and a person usu- eSuIt T- n..
ally regains full clinical
health for many years. Reomendtinsasd o Sag
New studies demonstrate o ies Feea u- lie)-.that even during this WaTry,, 1s....
time of seemingly good
health, there is an aggressive battle waged on
a daily basis between HIV
and the immune system.
In addition to immune
dysfunction caused by Ty
HIV, over time, the im
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