Can Medication Now Treat HIV-AIDS?

We usually see the immune system as an isolated system waiting undisturbed for an intruder organism to attack the body. But the reality is that a lot of these potential diseases are eliminated by our immunity and so you never see their symptoms. The immune system constantly produces new cells that patrol your body and monitor the presence of substances that can possibly cause harm to it. These substances are what evoke an immune response.  

All healthcare measures that we take are to maintain an efficient and constantly active immunity. We usually look up to our immune system to protect us from the attacks of pathogens or threats posed by other etiologies. But what happens when the immune system itself is taken over?

Viruses are microscopic creatures that are the tiniest but the most notorious disease causing agents. These organisms are not capable of multiplying on their own. When they cause an infection, they take over the human cell machinery for their spread. This bars the usual functioning of the cells. The Human Immunodeficiency Virus (HIV), a retrovirus, infects key cells of the immune system known as the T-cells. It thus effectively shades itself from other components of the system. A pronounced depletion of immune cells weakens the system. The regular infections that aren’t lethal also burden the patient’s body greatly. The condition is hence referred to as an Acquired Immunodeficiency Syndrome (AIDS).

Clinical management of HIV-AIDS is faced with unprecedented challenges owing to the ability of the virus to evade immune responses. The HIV drug market thus received no boost until recently.

What is all the hype about?

The marketing clearance of Biktarvy, a drug for HIV-AIDS by the US FDA shook the world. It was introduced by Gilead Sciences Inc a bio-pharmaceutical company. Market research reports forecast sales of about one billion dollars for the establishment in the coming year. They also suggest a rise to five times this amount by 2024. 

The company got a much needed boost from this approval after a failed quarter. HCV medication, the company’s flagship product saw a great plummet in its sales. A lost competition with one drug was covered up by a win in another. The company that had forecasted a further slow-down in the sales now expects to grow at a faster pace. It has an upper hand in the HIV drug market because this medication is approved for people who have never taken anti-retroviral drugs and also for people who have been on a similar medication for only 3 months with no failure in treatment. Its contemporaries are approved only for people who’ve been taking similar drugs for at least 6 months and have no adverse effects. Even the subjects of clinical trials showed no treatment-emergent resistance.

How does Biktarvy work?

Biktarvy is also referred to as the ‘triple-drug’ for HIV. Until now, people were using multiple pills to keep the viral count low. But Biktarvy is based on a once-daily single tablet regimen. It is a combination of an integrase inhibitor, bictegravir, and nucleoside reverse transcriptase inhibitors emtricitabine and tenofovir alafenamide. For the HIV to enter the T-cells of the immune system and take charge, integrase and reverse transcriptase are crucial enzymes. They allow it to replicate in the human host. The inhibitors prevent the integration of viral genetic material with the host genome. The infection hence remains under control.

The body’s response to the drug can be measured in terms of viral load or T-cell counts. A decrease in the former and a stability or increase of the latter is indicative of a positive result. Biktarvy works with no food intake regulations and no minimum required counts of the virus.

Is it safe?

Contraindications:

·         The use of Biktarvy during pregnancy has not been studied sufficiently

·         The drug cannot be used along with medications containing dofetilide or rifampin.

Adverse reactions:

Diarrhea, nausea, and headaches were commonly observed side effects during the clinical trials. However, there can be more severe reactions in the body post intake of Biktarvy. Medical conditions of buildup of lactate and abnormal functioning of enzymes and transporters in the body have been reported due to the administration of this drug. These can lead to fatal medical situations.

Worsening existing impairments:

People with renal or hepatic implairments have been advised against the usage of this drug. It is known to exacerbate these issues. Instead of treating AIDS, Biktarvy in very rare cases, also caused fatal autoimmune disorders.

The future of the drug:

Biktarvy, in its trial phases has shown to be highly efficient with minimum challenges and threats. It has also helped raise Gilead back in the field of bio-pharmaceuticals. The FDA approval has paved way for the long term sustainability of the company. It will continue to compete in the field of its core franchise.