An update on HAART: part 1
Rosy Weston, MRPharmS, RegPharmNZ, is senior principal pharmacist (HIV and sexual health), Simon Portsmouth, MRCP, MBChB, is consultant physician (HIV and sexual health) and Andrew Benzie, MRCP, MRPharmS, is specialist registrar (HIV and sexual health), all at St Mary’s NHS Trust Hospital, London
Acquired immunodeficiency syndrome (AIDS) was first described in 1981. It is caused by the human immunodeficiency virus (HIV), which destroys and impairs the cells of the body’s immune system, notably CD4+ T-cells (“CD4”). Over time, the resulting immunosuppression permits the development of opportunistic infections. These are due to pathogens that cause asymptomatic infection or minor illness in the immunocompetent, but can cause potentially life threatening infection or malignancy in those who are immunosuppressed.
The US Centers for Disease Control and Prevention define AIDS as the presence of one of 26 conditions indicating severe immunosuppression associated with HIV infection, such as Pneumocystis jiroveci pneumonia (“PCP”). A diagnosis of AIDS in the US is also given to HIV-infected individuals when their CD4 count falls below 200cells/mm3. On average, an uninfected adult will have a CD4 count between 800 and 1,500cells/mm3.
In December 2005, the Health Protection Agency released the latest statistics for people living with HIV in the UK. Nearly 60,000 people are living with the virus but, of those, more than one third remain unaware of their infection. This news, combined with the report of increasing baseline resistance to antiretroviral therapy, is cause for concern.
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Citation: The Pharmaceutical Journal URI: 10018060
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