The History of Antiretroviral Therapy

We are still very much at the mercy of retroviruses. From the seemingly unconquerable HIV to cancer-inducing pathogens, millions continue to teeter on the brink of death from retroviruses. Yet despite continued challenges, there is a great deal to be encouraged about, especially when it comes to advances in antiretroviral therapy.

What is a Retrovirus?

• A retrovirus is classified as a virus that attaches itself to the host cell and transcribes its viral RNA genome into cellular DNA. The result is the host cell and the virus become one, making it difficult for the normal immune response to combat it. Further, instead of killing the cell almost immediately after injecting its genetic material, as is the case with many DNA viruses, the retrovirus is able to live as part of the host for an extended period of time. Thus the person infected with a retrovirus might live for some time without experiencing any strong symptoms and then suddenly find themselves completely overwhelmed. This is the case with the human immunodeficiency virus. Only after a long period of incubation do the symptoms of acquired immune deficiency syndrome manifest themselves.

Early History of HIV/AIDS

• Because HIV infection and the onset of AIDS is such an important issue, any discussion of antiretroviral therapy will necessarily center on specific treatments for the disease.
  While scientists have been able to identify HIV infections as far back as the 1950s, the actual epidemic of infections did not occur until the late 1970s and went largely unnoticed until the early 1980s. At first thought to be isolated within the homosexual male population, it was later discovered that the disease had originated in West Africa and that the entire population was at risk. HIV suppresses the immune system of those infected, eventually getting to the point where mild infections such as the flu can lead to pneumonia and other life-threatening conditions.
  Despite being caught relatively off-guard in the early 1980s, the medical and scientific community, along with research grants provided by governments and organizations all over the world, were able to isolate the specific virus causing AIDS and thus start producing effective treatments.

Historical Advances of Antiretroviral Therapy

• Some specific achievements in the history of antiretroviral therapy as it relates to AIDS:
  -In 1983, the Institut Pasteur in France discovers the HIV virus and links it to AIDS. This is followed by a similar claim made by U.S. doctor Robert Gallo in 1984.
  -In 1985, the FDA approved the first HIV antibody test, allowing blood supplies and individuals to be screened for infection.
  -In 1987, the first FDA-approved antiretroviral drug AZT debuts. It also marked the year in which latex condoms where found to be effective in preventing the transmission of the virus through sexual intercourse, an important step in lowering infection rates.
  -1991-93 saw the introduction of transcriptase inhibitors, drugs that helped suppress the transcribing of viral RNA into healthy cells.
  -By 1995-96, a new class of drugs termed protese inhibitors were approved. These lowered the amount of viral load within the blood stream, helping to minimize the onset of AIDS.

Current Treatment and Effects

• The advent of further protease inhibitors in the late 1990s, led to the "triple cocktail" method of antiviral treatment that combines up to three antiretroviral drugs according to the particular stage of infection in order to suppress HIV. Unfortunately, the combination of drugs and the potency of the drugs themselves can cause moderate to severe side effects such as diarrhea, loss of sensation in digits and muscle soreness.
  Still, with the proper access to drugs, many people infected with HIV are now able to live for extended periods of time without every developing AIDS and the life threatening complications that go with it. Even for those already experiencing AIDS, antiretroviral therapy can extend life expectancy beyond the average of one year.

Other Applications of Antiretroviral Therapy

• In addition to being effective in suppressing HIV, antiretroviral drugs developed to fight AIDS are increasingly being used to treat other diseases that affect the immune system or are caused by retroviruses.

Current Polcies to Treat HIV/AIDS

• In addition to continued research on better antiretroviral drugs, the public health focus on HIV/AIDS also lies in prevention and the search for a vaccine. Despite promises and hopes going back to the 1980s, there remains no effective known vaccine against HIV. Much of the activism surrounding HIV/AIDS is directed towards making antiretroviral drugs available to developing countries at prices that the average infected person can afford.