Effect of Highly Active Antiretroviral Therapy (HAART) on Human Immunodeficiency Virus Disease Pathogenesis and Progression

Abstract

Human immunodeficiency virus (HIV), the causative agent of Acquired Immunodeficiency Syndrome (AIDS) was discovered way back in 1983. More than three decades since its discovery, HIV infection diagnosis, treatment and management has been a big challenge to the medical field. HIV infection is attributed to cause compromised T-cell and B-cell immunity, promote different malignancies and the infected individuals are at risk of acquiring other viral, bacterial, fungal and parasitic infections. HIV disease progression was found different in infected population, where few HIV infected patients develop AIDS in less than 5 years and are called as early progressors, HIV infected population in whom development of AIDS is slow and may remain normal up to 10 years are termed as late progressors and patients in whom the symptoms of AIDS are not seen even after 10-15 years are labeled as long term non-progressors. The variability in disease progression is not completely understood. After the discovery of HAART, the mortality of the HIV infected population has significantly reduced but the morbidity attributed to HAART has remained as a serious concern. From being a life threatening infection HIV has now become a chronic infection, where patients live their natural life years with the HAART therapy. Among the most significant changes in HIV infection and pathogenesis is the development of non-infectious complications attributed to the HIV infection, HAART therapy, other demographic factors and co-morbidities. Other factors that influence the disease pathogenesis and progression include chronic immune activation, drug resistance and toxic side effects of HAART therapy. Among this Immune activation plays a key role in the pathogenesis and progression of HIV infection.