Let's understand how antiretrovirals work.
Yesterday I shared the first part of a series of publications that I plan to make in relation to HIV and its action on CD4 T Lymphocytes, a topic that I particularly find extremely interesting, because even though there is a lot of information, explained in different ways, people do not quite understand, and basically what works best is prevention, at least in the light of current knowledge.
Yesterday I mentioned the action of the CD4 and CD8 T lymphocytes, bearing in mind that it is the former that are mainly affected by HIV, producing consequences that consist in making the human body more sensitive not only to infections but also to some types of cancer that are not usual.
Today I would like to explain how the virus affects CD4 T lymphocytes and how the drugs that exist today work to counteract this disease and try to control it, even when it cannot be cured. If you want to know more about it, I invite you to read on, I know you will be interested in what I am about to tell you.
HIV, like most viruses, has no ability on its own to reproduce, so it must enter the cellular interior of its cognate cells via receptors in order to use the metabolic machinery, as well as nutrients, to replicate within, in this case, CD4 T lymphocytes.
In this way it weakens the body's immune system. As HIV destroys CD4 T cells, the body loses its ability to fight infection and other diseases. This makes the body more prone to opportunistic infections, which are diseases that do not normally affect people with healthy immune systems.
To summarize.
- HIV enters the body.
- It gets into the bloodstream.
- It begins to bind to CD4 T-lymphocytes through specific receptors, which allows it to enter the cell.
- A specific enzyme is generated that is encoded in the DNA of the virus. The virus replicates.
- The cell dies and the viruses created are released, which will repeat this process as many times as possible in other cells.
We can see that there is a sequence in the infection process, in which the cells are affected. The knowledge of this particularity has allowed the creation of drugs that are used to control the disease. These drugs are called antiretrovirals. There are several types of these, which are classified according to their mechanism of action and their ability to block HIV replication in the body. The general classification is as follows:
Reverse transcription inhibitors: block HIV reverse transcription, which prevents the virus from replicating in immune system cells.
Protease inhibitors: block HIV protease, an enzyme that is necessary for virus replication.
Integrase inhibitors: block HIV integrase, an enzyme that is necessary for insertion of the HIV genome into the DNA of immune system cells.
Fusion inhibitors: block the fusion of HIV with immune system cells, which prevents the virus from replicating.
In general what has been achieved is the limitation of viral replication, even allowing that in some cases HIV is not detected in the immune system, which is an advance, even if it is not a definitive solution. I would also like to point out that these drugs are usually used at least two at a time in order to have a better control of the disease.
As I mentioned above, each type of drug will act at a specific point in the infectious process, limiting replication in some way, thereby preventing the virus from increasing in proportion to attacking more and more cells.
Reverse transcription is a process by which HIV uses the genetic material of a cell to produce copies of the virus. In the case of reverse transcription inhibitors they block this process by binding to the enzyme called reverse transcriptase, which is necessary for HIV replication.
HIV spreads in the body by fusing its capsid to the surface of CD4 T lymphocytes. Once the virus has fused with the cell, its genome is inserted into the cell's DNA and begins to replicate. Fusion inhibitors block this process by binding to proteins called gp41 and gp120, which are necessary for HIV to fuse with immune system cells.
When HIV fuses with an immune system cell, its genome is inserted into the cell's DNA through the action of integrase. This enzyme cuts the cell's DNA and inserts the HIV genome at the appropriate site. Integrase inhibitors block this action by binding to integrase and preventing it from cutting the cell's DNA. In this way, integrase inhibitors prevent HIV from replicating in the cells of the immune system.
Protease is an enzyme that cuts large proteins into smaller fragments. In the case of HIV, protease cuts large proteins called polyproteins, which are produced during virus replication, into smaller fragments that are then assembled to form new viruses. Protease inhibitors block this action by binding to the protease and preventing it from cleaving the polyproteins. In this way, protease inhibitors prevent HIV from replicating in the cells of the immune system.
This is the "pharmacological arsenal" available to control the disease, because as I have already said, there is no definitive cure.
Generally, at least two of these types of drugs will be used, in order to be more effective and also to avoid the development of any type of resistance to antiretroviral drugs. It should also be noted that the treatment does not only consist of taking drugs, since when the person acquires the virus, he/she must maintain a life as healthy as possible in all aspects.
Good nutrition, exercising, not drinking alcohol, not staying up late at night, in short, doing everything possible to lead as healthy a life as possible to avoid weakening the body in different ways.
I hope this post has been of interest to you and that some knowledge has remained in you. Thank you very much for reading it, and if you have any doubt or suggestion you can leave it in the comments.
I knew that you could do it! It is so awesome that these drugs can lead to the status of virus undetectable in blood exams!
!1UP
Thank you @gwajnberg
Yes, they can make it undetectable.
I know a person who is infected with HIV and he has a wife, is on strict treatment, has had virtually undetectable virus for years.
The wife also has no detectable virus, they have a son, and he is not infected.
They have done a great job. And it shows that the treatment works well.
You have received a 1UP from @gwajnberg!
@stem-curator, @vyb-curator, @pob-curator, @neoxag-curator, @pal-curator
And they will bring !PIZZA 🍕.
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It very important topic I think we can gain more knowledge if we read it
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