HIV/AIDS Medications

Red started taking ARVs today. The ARVs that Red is taking are Zidovudine and Lamivudine. I wanted to just write about what those 2 meds do, but as I was researching I got more and more fascinated by the science behind HIV and its medications. Some of the stuff that HIV meds do is amazing. I'm like how the hell did they even discover this stuff? HIV meds are truly modern day miracles, and the people who came up with them are geniuses.

For the benefit of my non-pozzie friends, and for my pozzie friends who aren't sure about our meds work, let's start with the basics. Here are a few key terms that you need to first understand in order to see how HIV meds work:

1. HIV
• HIV is short for the Human Immunodeficiency Virus. It is named so because the virus attacks cells within our body that form part of our immune system, or the system in our body that helps us fight disease.
2. CD4
• CD4 T helper cells are a type of white blood cell (cells that fight disease) that HIV attacks. Increased HIV infection leads to lower CD4 counts. In the Philippines, HIV treatments start once your CD4 level drops to below 350. In most Western countries, HIV treatments can start at any time.
3. AIDS
• When your CD4 count falls below 200, you are officially considered to have AIDS, or Acquired Immunodeficiency Syndrome. This means you are considered to be more prone to opportunistic infections, or diseases that take advantage of your weakened immune system. With the help of HIV meds, your CD4 count can go back up. However, even if your CD4 count goes back above 200 you will still be considered as having AIDS.
4. Viral load
• This is a measure of how much of the virus you have in your system. It is expressed in parts per milliliter.

Medicines for HIV/AIDS are called Antiretrovirals or ARVs. They are called that because HIV is classified as a retrovirus. A retrovirus is a type of virus that replicates using the reverse transcriptase enzyme, or the enzyme that synthesizes DNA from RNA instead of the normal process of synthesizing RNA from DNA. I'm not entirely sure what that means, but this video explains in a simple enough manner how HIV replicates:

So in a nutshell, there are a whole lot of processes involved in the replication, of HIV. What ARVs try to do is prevent specific processes from happening, which is why a lot of the HIV meds are classified as inhibitors because they interfere with, block or suppress certain stages of the HIV replication process. We can't really call ARVs cures, because although they manage the presence of HIV in our bodies, they don't actually remove the virus -- they just prevent it from replicating.

ARVs are normally taken in combination with each other. This is called HAART, or Highly Active Antiretroviral Therapy -- the idea being that in order to effectively fight HIV you need to prevent as many of the virus replication stages from happening as you can. Also, HIV easily mutates, which is why it is especially important for people with HIV to make sure that they take their meds on time and exactly as prescribed by their doctors because if they don't, the HIV strain they have might become resistant to the ARVs they are taking. In order to check if the ARVs are working, you need to get CD4 counts and viral load tests done as recommended by your doctor.

Which brings me back to the ARVs that Red is taking. Zidovudine is better known as Azidothymidine or AZT. It was the first approved treatment for HIV and it works by inhibiting the replication of HIV via the reverse transcriptase enzyme. The most common side-effects include upset stomach and acid reflux or heartburn, headache, cosmetic reduction in abdominal body fat, light sleeping, and occasional loss of appetite. Lamivudine does pretty much the same thing, and aside from treating HIV it is also used to treat hepatitis B.

Red hasn't texted me yet so I'm hoping that means he isn't experiencing any side effects. I seriously hopes he takes his meds on time. I'm seriously worried that he'll fall asleep and not take them on time. I'm so gonna be pissed off if that happens.