Featured VideoYour Heart and HAART Therapy
Do HAART therapies increase your risk for cardiovascular disease? As you partner with your doctor, these are important questions to consider as part of choosing the right treatment method. Listen to Dr. Salim Virani, clinical cardiologist, explain the pros and cons of HAART therapy and what can be done if you experience cardiovascular issues.
Treatments improve life expectancy
One of the exciting developments in HIV medicine is that we now have effective treatments! Those who are HIV-positive can actually plan to have a fairly normal life expectancy if they adhere to the treatments. Learn about your options for heart-healthy living with healthy food choices, adequate physical activity and medication considerations to help you live a long, heart-healthy life with HIV.
Highly Active Antiretroviral Agent Therapies (HAART)
The current treatments for HIV are Highly Active Antiretroviral Agent Therapies (or HAART). It is important to note that there is currently no cure for HIV, but the HAART therapies can reduce the amount of HIV found in the blood. When the viral load (the amount of virus in each cubic millimeter of blood) is lowered, your body can make new healthy T-cells.
Before the widespread use of antiretroviral therapies, people who were HIV-positive would eventually die from opportunistic infections. The HIV would weaken the immune system over time. Eventually, AIDS (Acquired Immune Deficiency Syndrome) would develop. People with AIDS cannot fight off opportunistic infections, and eventually these infections cause death.
How do HAART therapies work?
There are several ways HAART therapies work. It helps to first understand how the virus attacks the body.
- The virus enters the bloodstream. First, the virus enters the bloodstream when the blood or bodily fluids from an HIV-positive person enter the body of another person via sexual contact, needle sharing, breast feeding or transfusion.
- The virus attaches to T-cells. As shown in the picture, the virus has small antennae-like protrusions that can attach to the the white blood cells (T-cells or CD4s) in the blood stream.
- The virus puts viral genetic material into the T-cell and alters T-cell DNA. Once the virus connects with the T-cell, the virus attempts to bind with the T-cell and deposit virus-reproducing material into the T-cell, targeting the nucleus and damaging the cell DNA stored there.
- The virus multiplies and re-enters the bloodstream. When the HIV virus has penetrated the T-cell, the virus uses the T-cell as a host, not only to "reprogram" the T-cell itself, but to reproduce more cell-damaging viruses and dump them into the bloodstream.
When the HIV genetic material is inside the T-cell, it needs two chemicals in order to reproduce itself. They are protease and reverse transcriptase. HIV medications can limit the viruses' ability to duplicate itself by inhibiting the protease and the reverse transcriptase.
It is also important to know that HIV viruses can adapt to medications, reducing the drugs' effectiveness, so sometimes medications must be changed.
HAART therapies can help keep your HIV in control by suppressing the virus at each stage.
HAART therapies are designed to:
- Suppress the viruses' ability to attach to the T-cells
- Inhibit the viruses' ability to alter the T-cell DNA
- Interfere with the reproduction of viruses inside the cell
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)
- Nucleoside Reverse Transcriptase Inhibitors (NRTI)
- Protease Inhibitors (PI)
You and your doctor can work together and make a plan to help you live a long and healthy life. Your HIV medications can reduce your viral load and increase your T–cells (or CD4s), which is one of the most important things you can do to keep yourself healthy. These treatments can mean the difference between life and death, so if you're having trouble staying on your medications, tell your doctor the truth. Do everything you can to take them as directed even if you experience side effects. However, do keep track of your side effects and report them to your health care provider. Together you can find the best medications with the least amount of side effects. The better you feel, the more likely you are to stay faithful to your regimen.
Do HAART therapies cause heart disease?
Over the last several years there have been many studies on the antiretroviral therapies and their effectiveness. Antiretrovirals clearly improve your chances for staying healthy with your HIV. Even though these medications can cause side-effects, large studies like the SMART study have shown that dropping off your antiretroviral therapies makes the disease worse. In fact, dropping off HAART therapy can even worsen problems like cardiovascular disease and blood sugar, which some have thought were HAART therapy side-effects. So if you have an increase in cholesterol or blood sugar while on your HIV therapies the medical evidence shows us that it is better to keep the HIV therapies going and add additional therapies to help with the cardiovascular issues.
In other words, we treat whatever problems you may encounter, but we don't give up. Your best chances for living well are to take your antiretrovirals, improve your overall health as much as you can, and work with your health care provider to decide the best course for any gaps that remain.