AIDS

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Belinda Rowland

Many therapies that are directed at improving mental state can have a direct impact on disease severity and quality of life. The effectiveness of many have been proven in clinical studies. These include:

• massage
• laughter/humor
• stress management training
• visualization
• cognitive therapy
• aerobic exercise
• prayer

Other treatments for AIDS include homeopathy, naturopathy, acupuncture, and chiropractic.

Treatment for AIDS covers four categories:

In recent years researchers have developed drugs that suppress HIV replication. These drugs fall into three classes:

• Nucleoside analogues. These drugs work by interfering with the action of HIV reverse transcriptase, thus ending the virus' replication process. These drugs include zidovudine (sometimes called azidothymidine or AZT), didanosine (ddi), zalcitabine (ddC), stavudine (d4T), and lamivudine (3TC).
• Protease inhibitors. Protease inhibitors are effective against HIV strains that have developed resistance to nucleoside analogues, and are often used in combination with them. These compounds include saquinavir, ritonavir, indinavir, and nelfinavir.
• Non-nucleoside reverse transcriptase inhibitors. This is a new class of antiretroviral agents. Two are available, nevirapine and delavirdine.

Treatment guidelines for these agents are in constant change as new medications are developed and introduced. Two principles currently guide doctors in working out drug regimens for AIDS patients: using combinations of drugs rather than one medication alone; and basing treatment decisions on the results of the patient's viral load tests.

Most AIDS patients require complex long-term treatment with medications for infectious diseases. This treatment is often complicated by the development of resistance in the disease organisms. AIDS-related malignancies in the central nervous system are usually treated with radiation therapy. Cancers elsewhere in the body are treated with chemotherapy.

Prophylactic treatment is treatment that is given to prevent disease. AIDS patients with a history of Pneumocystis pneumonia; with CD4 counts below 200 cells/mm3 or 14% of lymphocytes; weight loss; or thrush should be given prophylactic medications. The three drugs given are trimethoprim-sulfamethoxazole, dapsone, or pentamidine in aerosol form.

Because many patients with AIDS suffer from abnormally low levels of both red and white blood cells, they may be given medications to stimulate blood cell production. Epoetin alfa (erythropoietin) may be given to anemic patients. Patients with low white blood cell counts may be given filgrastim or sargramostim.

Treatment of pregnant women with HIV is particularly important in that anti-retroviral therapy has been shown to reduce transmission to the infant by 65%.

At the present time, there is no cure for AIDS. Treatment stresses aggressive combination drug therapy when possible. The use of multi-drug therapies has significantly reduced the numbers of deaths, in this country, resulting from AIDS. The potential exists to possibly prolong life indefinitely using these and other drug therapies to boost the immune system, keep the virus from replicating, and ward off opportunistic infections and malignancies.