CLINICAL MANAGEMENT OF HIV/AIDS INFECTION USING ANTIRETROVIRAL DRUGS IN A NIGERIAN ENDEMIC SETTING

Current HIV/AIDS treatment strategies aim at maximal suppression of virus load levels (the number of free virus particles in the blood plasma) over long periods. Aside from inducing strong side effects, the long term effectiveness of HAART is also limited by the evolution of drug-resistant variants. Even in patients with viral load levels suppressed below detectable limits (50 copies/ml), ongoing viral replication can be found in a variety of tissues and cell types. Persistent virus production is facilitated by sub-inhibitory drug levels in infected cells or by host immune failure. Therefore, pre-existing or newly produced drug resistant mutants can emerge that have a selective advantage under drug pressure. These mutants become dominant in the virus population and lead to viral rebound and therapy failure. The protease inhibitors are potent antiviral drugs because the protease activity is absolutely essential for production of infectious viruses. The newest class of drugs is the fusion inhibitors that block virus entry into cells.