How Antiretroviral Therapy Reduces the Risk of Opportunistic Infections

Introduction: Human Immunodeficiency Virus (HIV) attacks the body’s immune system, specifically the CD4 cells (T cells), which are vital in fighting infections. Without effective treatment, HIV can weaken the immune system to the point where it progresses to Acquired Immunodeficiency Syndrome (AIDS). This progression increases vulnerability to opportunistic infections (OIs) and other illnesses. With advancements in treatment, especially with the Undetectable = Untransmittable (U=U) concept, individuals with HIV can maintain healthy lives and avoid transmitting the virus.

The Role of Antiretroviral Therapy (ART):

ART has transformed HIV from a fatal disease to a manageable chronic condition, in fact, it’s become more manageable than most non-communicable chronic diseases. By suppressing the virus, ART helps maintain immune function, which can prevent many of these infections and cancers from developing. Below are the many benefits of ART.

Improved Quality of Life

ART helps people living with HIV (PLWH) maintain a strong immune system by reducing the viral load in their bodies

Understanding U=U (Undetectable = Untransmittable):

U=U is a groundbreaking concept that underscores the impact of ART. If a person with HIV achieves and maintains an undetectable viral load (fewer than 200 copies of the virus per mL of blood), they cannot transmit the virus to sexual partners. This concept has profound implications for public health, relationships, and stigma reduction.

1. How ART Achieves an Undetectable Viral Load

• Consistent use of ART can reduce the amount of HIV in the blood to undetectable levels.
• While it may not completely eliminate the virus from the body, it keeps it at such low levels that transmission is no longer a risk.

2. Health Benefits Beyond Transmission Prevention:

• ART not only prevents transmission but also supports overall immune health.
• By achieving and maintaining an undetectable viral load, individuals lower their risk of opportunistic infections and other complications associated with untreated HIV.

3. Impact on Stigma and Public Perception:

• U=U helps reduce stigma around HIV by emphasizing that people living with HIV on effective treatment are non-infectious.
• This knowledge fosters more acceptance, and it also encourages testing and treatment.

Further Benefits of ART are:

Prevention of AIDS

• Without treatment, HIV can progress to AIDS, a life-threatening condition where the immune system becomes severely compromised. ART prevents this progression.

Reduction in Mortality Rates

• ART dramatically decreases the risk of HIV-related complications and deaths, making it a life-saving intervention.

Prevention of Mother-to-Child Transmission

• Pregnant women on ART significantly reduce the risk of transmitting HIV to their unborn babies or during breastfeeding.

Psychosocial Benefits

• Consistent treatment and good health outcomes can improve mental well-being and reduce the stigma associated with HIV.

Conclusion:

While untreated HIV can lead to AIDS and increase susceptibility to various illnesses, effective use of ART can prevent progression and allow people to live long, healthy lives. U=U represents a major milestone in the fight against HIV, ensuring that those on successful ART can enjoy relationships and lives free from fear of transmission.

Sources

• https://www.who.int/health-topics/hiv-aids#tab=tab_1
• https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524
• https://hivinfo.nih.gov/understanding-hiv/fact-sheets/what-opportunistic-infection
• https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-treatment-basics
• https://www.aidsmap.com/about-hiv/faq/what-does-undetectable-untransmittable-uu-mean