Miami Dade College
Human Immunodeficiency Virus The fight between the virus and the immune system for supremacy is continuous. Our body responds to this onslaught through production of more T-cells, some of which mature to become helper T-cells. The virus eventually infects these targets and eliminates them, too. More T-cells are produced; these too become infected, and are killed by the virus. This fight may continue for up to ten years before the body eventually succumbs, apparently because of the inability to any-longer produce T-cells. This loss of helper T-cells finally results in the complete inability of our body to ward-off even the weakest of organisms (all kinds of bacteria and viruses other than HIV) which are normally not ever a problem to us. This acquired condition of immunodeficiency is called, AIDS. (Brown, 1995). Symptoms are perceived indicators of change in normal functioning as experienced by the person. Persons infected with HIV report myriad symptoms that indicate disease progression. For example, in a study of 134 persons with HIV/AIDS in Taiwan, Tsai, Hsiung and Holzemer reported that the following symptoms were frequently described: nausea (40.3%), pain (24.6%), anxiety (21.6%), vomiting (16.4%), diarrhoea (14.9%), fear (14.2%), and lack of appetite (10.4%). Fantoni et al. found that the most frequent symptoms of the 1,128 HIV-infected persons they surveyed in Italy were fatigue (65%), anorexia (34%), cough (32%), pain (29%), and fever (29%). Mathews et al. reported on the symptoms of a national sample of more than 4,000 HIV/AIDS outpatients in the United States: fever/night sweats (51.3%), diarrhoea (51%), nausea/anorexia (49.8%), dysesthesias (48.9%), and severe headache (39.3%). Karus et al found in their study of ill HIV patients (≥ 95% AIDS) in Alabama (n = 47), Baltimore (n = 91), and New York City (n = 117) that on average, patients reported 10.9 (SD = 7.6) to 12.7 (SD = 6.2) symptoms. (Peltzer, 2008).
Highly active antiretroviral therapy (HAART) for the treatment of HIV infection was introduced a decade ago. The median CD4 cell count when starting HAART increased from 170 cells per muL in 1995-96 to 269 cells per muL in 1998 but then decreased to around 200 cells per muL. In 1995-96, 58% achieved HIV-1 RNA of 500 copies per mL or less by 6 months compared with 83% in 2002-03. (Lancet, 2006). Anti-HIV drugs are highly toxic and can cause serious side effects, including heart damage, kidney failure, and osteoporosis. Many (perhaps even most) patients cannot tolerate long-term treatment with HAART. Because treatment regimens are unpleasant and complex, many patients miss doses of their medication. Failure to take anti-HIV drugs on schedule and in the prescribed dosage…