The Fear of the Disease and Effects of the Medications

Go back

Is there a definitive and effective medication to eliminate the most dangerous most challenging virus in the world, the Human Immunodeficiency Virus (HIV)? And when does this nightmare end, the nightmare that has weighed heavily for long on all of humanity and specifically the LGBTQIA+ community?

Ever since its discovery and recording the first cases with the virus in 1981, the LGBTQIA+ communities have been taking the larger blame for its spread, to the extent that media and journalists, when it first appeared, named it the “Gay-Related Immune Deficiency”; and with the change of the official name of the virus and the stigma that stuck to it, and the discovery of medications that limit its spread, there are still many challenges that face those living with the virus, most importantly surpassing the medications’ side effects, those necessary to take to live with the virus and preserve the capabilities of the immune system.

The Beginnings of Looking for a Treatment

In the eighties, there were no medications to treat the infection with the Human Immunodeficiency Virus, getting infected practically meant suffering from AIDS, and getting the HIV diagnosis equaled death penalty, and at the time the fear of a real plague spread. In the year 1987, the first medications arrived to the market, which were able to at least slow down the disease progression, despite their dangerous side effects.

The “Zidovudine” drug, discovered years prior to the emergence of the virus, was used as the first drug to attempt controlling the spread of the virus, but shortly after, it was discovered that the virus has a high ability to evolve and resist its effect.

With the dawn of the nineties, a new drug was added to the medicinal protocol, “Dideoxycytidine”, which was named the “two-drug therapy”, in an effort to reduce the virus’s ability to multiply itself, limiting its spread. But other than having to take the dosage twice or thrice daily all lifelong, there were many side effects which were reported to the doctors, most commonly: nausea, vomiting, headaches, in addition to the psychological effects of fear of forgetting to take the dosage, also the failure of the medication in some cases to limit the spread of the virus, and those living with the virus feeling the medication is useless.

In the nineties the protocol was modified again, and it was called at the time “Highly active antiretroviral therapy”, in its beginnings it was normally a therapy of three or more antiretroviral medications (Triple-drug therapy), but despite its effectiveness, one of its flaws was the obligation to take several medications twice a day at least, also binding some of the medications together without the others, and the obligation to take some with food and some without; it was a complicated therapy, and this reduced the person’s ability to commit, along with the emergence of multiple side effects, some of which was considered extremely dangerous, like: Peripheral Neuropathy, Bone Marrow Suppression, Anemia, and Hepatomegaly.

The Current Therapy

Currently, there are more than 30 antiretroviral medications, including many combinations with a stable dosage, within which one pill contains two medications or more from one medication category or more. And today, many of those living with HIV have a grip over the virus via taking one or two pills, only once a day according to the current medicinal protocol.

Despite the huge development in medications it is still not possible to be cured from the infection with HIV, but it can be treated with the antiretroviral medications which work on stopping and reducing the multiplication of the virus. The antiretroviral medication can also lead to the decline of the viral load in the body so the immune system can operate normally and the person living with the virus can enjoy good health, committing to the therapy; also the potentials of transmitting the virus from those living with it to others drop when the medication is successful.

The Medication and Its Side Effects

The challenges start with the person’s acknowledgement of his\her pathological situation and the necessity to accept change in his\her life, where in the first stage of taking the medication all precautions must be taken in practicing safe sex, and making sure to take the medications in a steady daily time with committing to the doctor’s instructions, and most importantly, getting the suitable psychological support whether from close friends or from psychological support service providers. Those living with HIV also suffer from the constant feelings of stigmatization and fear of transmitting the infection to others, in addition to fear from the unknown future considering the large amount of inaccurate information surrounding living with the virus.

The current therapy -mostly- consists of two drugs, most famously, which are used in Egypt, are:

● Truvada: A medication of two combined drugs (Emtricitabine\Tenofovir) and it belongs to the “Nucleotide analogue reverse transcriptase inhibitors” medication family, which works on paralyzing the virus from rebuilding and multiplying itself, and is also used to prevent being infected with the virus, as the World Health Organization has recommended using it in prevention in 2019.

Truvada is distinguished by the small pill size and the singular daily dosage, also by how quickly the side effects disappear in comparison to the previous generations of this disease’s medications. When starting to take Truvada the person may suffer from some sleep issues, nausea and vomiting, stomach gases and abdominal pain, loss of appetite, and general exhaustion and weakness in the body… yet most of these side effects disappear within two weeks from the start of taking the medication, and some studies have found that getting psychological support has a major effect in hindering the severity of the side effects. It is also completely prohibited to quit taking the medication without consulting the doctor.

Yet, the long term effect of Truvada may include high cholesterol levels in blood, high blood sugar, muscle weakness, some defects in the kidney functions, and dyspnea. This is why doctors usually advise following a healthy lifestyle while taking the medication with practicing sports, a healthy diet, and avoiding smoking. Truvada also affects the sperms, which leads to embryos deformations, and doctors do not recommend taking it while breastfeeding, hence why it should be discussed with the doctor when there are attempts for fertility and embryos’ procurement for those living with the virus.

● Efavirenz: Belongs to the medications family known as “Non-nucleoside reverse transcriptase inhibitors”, and by collaboration with Truvada they form a mixture, suitable for resisting the virus’s ability to mutate and evolve. The Daily dosage is only one pill that is usually taken with Truvada or the other medication prescribed for the case, and is preferably taken in the evening.

Doctors recommend taking it at least two hours following the last meal, since the fat-saturated meals increase the absorption of the medication which increases the severity of its side effects. In case the dosage is forgotten, it must be taken the minute it is remembered, making sure there are at least 12 hours remaining for the following dosage (The daily steady time). It is completely prohibited to quit taking the medication without consulting the doctor.

The side effects of Efavirenz are considered more severe than Truvada, and they include: Depression, nervousness and anxiety, as well as sleep disorders like insomnia and nightmares; those living with the virus also suffer in the beginnings of taking the drug from exhaustion, general fatigue, dizziness, and that might be accompanied with gastronomical system disorders like vomiting, nausea, diarrhea or constipation with abdominal pains, as well as a skin rash.

The long term effect of Efavirenz consists of high cholesterol levels in blood, and high liver enzyme levels.

Doctors advise those who take Efavirenz to consult them in case they desire to have a baby, where it might cause embryos deformation.

Therapy in the Future

The medical society and World Health Organization hope to control the virus by the year 2030 along the vision “2030 A World Without AIDS”... and in the last years new treatment methods came to light which are a cause for optimism that this vision will be achieved; treatments like the surgical one by implanting bone marrow with a genetic mutation that prevents the virus from reproduction in the first place and paralyzes it from entering the CD4 targeted cells, which enables the immune system to isolate and kill it. Researchers also are working on a new treatment, those living with the virus may take once monthly instead of the daily medication.

The medical society hopes and works on reaching a definitive treatment soon that fully cures from the virus, since all of the currently existing medications only reduce the viral load and do not completely annihilate the existence of the virus.

Featured