Treatment of HIV infection

Currently there is no cure for the eradication of HIV infection.
The treatment of HIV infection consists in controlling the virus through a combination of drugs that block the replication of the virus, reducing viral load and consequently the destruction of the immune system.

In Western countries, much of the success achieved in reducing the spread of HIV is due to the results of scientific research that has allowed the identification of drugs with potent antiviral activity.

In 1987 the first antiretroviral drug, zidovudine (Azt), was introduced, and in the following years other drugs with different mechanisms of action were added.
In 1997 was introduced a new category of antiretroviral drugs, protease inhibitors, capable of hindering the viral enzyme necessary for the production of the outer coating of the virus.

In recent years, other new classes of antiretroviral drugs have been introduced, including:

Fusion inhibitors
which block the entry of HIV into the host cell by preventing the penetration of the viral genome into the host cell

Integrase inhibitors
which inhibit the integration of the HIV genome into the host cell DNA, thus limiting viral replication

Ccr5 inhibitors
which inhibit the Ccr5 receptor of the host cell, blocking virus entry.

Due to the strong tendency of HIV to mutate, it is necessary not only to find new drugs, but also to administer several antiretroviral drugs simultaneously (combination therapy). The aim is to minimize or at least delay the emergence of viral strains that are resistant to antiretroviral drugs.

Currently, HIV-positive people are offered a highly effective therapy, called Haart (Higly Active Anti-Retroviral Therapy), which consists of a combination of several antiretroviral drugs. However, it must be kept in mind that the current therapeutic strategies, although very effective, do not allow the cure of the infection, but allow to keep it under control. Through the use of antiretroviral treatment, today an HIV positive subject has a life expectancy similar to that of an uninfected subject, with a good quality of life.

Currently, new classes of drugs aimed at stimulating and supporting the immune system, rather than direct antiviral action, are being tested. In addition to drugs, many studies have been underway for several years to develop a vaccine that can prevent infection among HIV-negative people, or can improve the course of the disease in those already infected.