Taking Charge of Your Health

– You may have heard the term HAART referring to HIV treatment. But what exactly does that mean? Well, HAART, which stands for highly active antiretroviral treatment refers to the sort of modern day, present treatment regimen for
treating HIV infections. And it’s called highly active because compared to the
previous treatment regimen, HAART is just a lot more effective and so the name just kind of stuck. So before we give just one type of drug to help control an HIV infection, we usually give an NRTI which stops the reverse transcriptive step and infection of a CD4 cell. But, you know, HIV likes to mutate a lot and it turned out that
when only one type of drug was given for an infection, the HIV would eventually become resistant to that type of drug. So, of course, the drug
didn’t work anymore and the person’s infection
would almost sort of pick up where it left off it would start to worsten again. Except this time, almost
more aggressively in a way because now it would be resistant to that original type of treatment. But in comes HAART, highly active treatment. And you know, it’s not that we’re using totally different drugs, I mean, sure we’ve got a few more
types at our disposal now, but the key thing is that nowadays we know that if we give
two or three drugs, which is what we usually do in HAART. So if we give two or three drugs, instead of just one, the HIV infection can be
really well controlled. And what do I mean by that? Well, each of the drugs in
a particular HAART regimen works in a slightly different way, stopping HIV at different points during its replication. So these drugs used together are really effective at preventing HIV from making copies of itself. It’s life cycle just
won’t be able to continue, so new varions just
don’t end up being made. And you know, if we do
encounter, by chance, an HIV particle that’s resistant to one of the antiretroviral drugs, chances are it wouldn’t be resistant to the other two drugs that make up that particular HAART cocktail. And you know it would be really hard for HIV to become resistant to all of the drugs in a
particular HAART regimen. I mean, here, let’s do some math. Not super hard math, I’ll leave that to Sal, but in your body HIV
multiplies essentially, and it creates a few billion
new viral particles per day. And during replication, it’s reverse transcriptive enzymes makes a lot of mistakes, in fact, for every
about 10,000 nucleotides it adds on to a new strand of DNA it makes a mistake, and it inserts the wrong base. One in every 10,000 bases is wrong. And it doesn’t have a
very good repair mechanism like we do for our DNA, so this mistake sticks around. So let’s say, for arguments sake, that one of these mistakes
affects one of our drugs target proteins within the HIV. Let’s say this stretch of DNA here was supposed to code for intergrace. So this virus’s intergrace enzyme will still work, but our intergrace inhibitors might not be able to stop it anymore because it’s mutated. Well, our HAART cocktail would still be able to
stop this mutant HIV because we have other places
in the replication cycle that we can inhibit it. So essentially, a virus
would have to mutate, either randomly, or sort of evolve by selective pressure to become resistant to all of the HAART drugs that we’re throwing at it in a given cocktail. And, in fact, the chance that
it could become resistant to all three of the types of drugs would be at the very least one in ten to the twelfth power, that’s one in a trillion chance. I’m just multiplying one in 10,000 here by one in 10,000 here, by one in 10,000 here. And, you know, I’m being
really generous here, because this is assuming that the one in 10,000 base mutations are even occuring at the target enzymes coding sequence of DNA. So, bottom line here is that it will be extremely unlikely for an HIV particle to mutate during replication in
a way that would let it escape from all three of the HAART drugs. And you know, of course, it would be extremely unlikely to
thus find an HIV particle just floating around in the bloodstream that’s resistant to multiple drugs. Because remember, replication
is actually suppressed by taking the ARV, so once you’re on HAART, potential mutants aren’t
even being created anymore. Or, at least a lot less so. So now you have an idea of what HAART is, a drug cocktail, two to three different types of drugs all taken together that A. Makes drug resistance
by HIV really unlikely, and, B. That’s still able to fight off resistance strains that
we might encounter. But you know, there’s a few
other things to consider with HAART. I mean, for example, who gets HAART? And when is it prescribed during the course of the infection? And, how do you sort of take it? I mean, is it a bunch of pills? Is it an injection? Well, let’s start here with who and when. Because you might reasonably think that, you know, everyone
who’s diagnosed with HIV gets started on HAART right away and you know there’s good evidence that that is a good idea. But it gets a little complex because there are some drawbacks to starting therapy early and by early, I just mean
before the onset of any symptoms or AIDS defining illnesses, and, you know, these drawbacks
need to be considered. For example, there are some side effects of the ARV drugs, such as an increased risk
of cardiovascular disesases like heart attacks, or strokes. There’s potential problems
with bone health too, long term exposure to these ARVs are associated with a greater
loss of bone density as a person gets older. More than the normal loss
that happens as you age. There can be psychiatric
side effects, too, like feeling a bit sort of
sluggish in your thinking. And there can be gastroinestinal
side effects, too, like chronic diarrhea. So you can imagine that if someone has HIV but they’re in the latent phase, in other words they’re
not having any symptoms, starting them on antiretrovirals might actually cause a decrease in their quality of life at that given time period. The other thing that needs consideration is that, you know, if you do start a HAART treatment regimen then
you need to stick to it for the rest of your life, taking your medication every single day without fail. Because studies have repeatedly shown that stopping your ARVs, or not taking them every single day as prescribed, is associated with the HIV in your body becoming drug resistant. So that means that in the future if you decide to start
your treatment again, your drugs just may not
work as well anymore. They may not work at all, anymore. So when you talk to your doctor about the right time
to start your treatment you’ll probably go over some strategies to make sure you can take your medication every single day to minimize drug resistance from happening in your infection. And one thing that’s
helped out in a huge way for people taking their
medication every day, is the fact that these
combinations of these drugs, remember, you’re taking
cocktails of usually three of these types, combinations are available
in a single daily pill, nowadays, and that makes it a lot easier to stick to your
treatment schedule. I mean, a few years ago, and actually still in some countries, you’d have to take a handful of pills every single day, sometimes multiple times a day. And now you can get your whole combo in one single pill, taken once a day, so that’s really, really useful. So now we know there’s potential problems with starting HAART too early. But you know, when is the
right time to start, then? Well, it is a little
different for each person, so you’ll have to have
a chat with your doctor about the right time to start, but there’s a few general principles that’ll help guide the decision that you guys come to. So for one, we know that
if your CD4 T cell count is less than about 350 to 500 cells per cubic millimeter of blood then it’s time to start HAART. Remember, CD4 count is
sort of used as a marker for how far along the illness is, right? The lower the CD4 count the more damaged the immune system is. Viral load is important too. If the amount of HIV in your bloodstream is higher than 100,000 copies
per millimeter of blood, it’s time to start HAART. And, I know, the last thing
I’ll say about this is is if a person is pregnant, if they’re a young child, if they progress to AIDS, of, it there’s an opportunistic infection or an AIDS defining illnesss present, then regardless of CD4 count, even if you’re higher than
that 350 to 500 cutoff, HAART needs to be started right away to hep your immune system recover as much as possible.

22 thoughts on “HAART treatment for HIV – Who, what, why, when, and how | NCLEX-RN | Khan Academy

  1. Could somebody help me?

    What is the meaning of pre-HAART and HAART era?
    What is the era? When we start to use ART and when we start to use ART?

  2. How sad is this that the pharmaceutical business has done to the world. We all know that HIV is predominantly an African epidemic. Even so my heart goes out to all who have been infected and affected. Receive the knowledge i will share below. HIV biology is built on ARV not on HIV itself. All things are made to be = seen through the lens of ARV.

    How is CD8 looked at in HIV treated patients. It is said that when it increases it is a sign that the TREATMENT is failing. Of course when it fails more viral loads will infect the cells and CD8 will go off to shut the factories.

    In untreated patients CD8 does very well past the so called "latent" cells. He depletes CD4 cells as a result of them being infected. What exactly crumbles when CD4 is absent? The activation of B cell because when CD8 kills the cells before they activate the cells and alarms, B cell waits and nothing happens then we don't have enough B plasma cells therefore antibodies. It is the control of the virus itself that is the problem. Once this is not under control then the cells get infected and get killed. Where does our car break down? We need to go back to basics and not conclude on antiretroviral failures and pursuit to create a chronic illness.

    Mutation, latent cells, drug resistance etc, all these things that have caused fear and it became as though we are struggling to move this nightmare called HIV is as a result of business and the systems which were laid to sustain the chronic illness. What is drug resistance? HIV is resistant to ARV ONLY meaning if something else were used this would not be the case. Then with drug resistance then mutation was born, with latent cells the shock and kill theory was born and depletion self programmed death. Hmmmm. These are excuses of a particular product not that HIV is so wise. I mean the Missisipi story is the most stupid thing i have ever heard. How did it even make the tabloids. Since when is antiretroviral a cure? It does nothing to the infected cells rather it suppresses CD8. There are numerous studies that have indicated that CD8 is suppressed in treatment and HAART in particular .

    So if these cells are suppressed because they have been made the watchdogs of antiretroviral, the goals are that they should be suppressed because their increase is a sign of what TREATMENT FAILURE. Their original identity and contribution in the fight against HIV has been removed out of the sight of patience. I am talking about what is on the mainstream with patients who know nothing about immunity. If these cells are suppressed how then will they shut factories that persist. The infected cells that is. If they are suppressed then it will take many years to clear the virus infected cells.

    This who drama of seven steps of the HIV life cycle are with too much complexity and this is what HIV biology is made to be. Of all the steps the most important to prevent is the first, which is the attachment to the cells CD4 coreceptors the rest are just pointless because treatment is also time factor. It is about circulating the inhibitor at all times to prevent replication of the virus from the persisting cells. If the patient misses the time, i mean not that they are irresponsible, they are human beings. It is a burden to take drugs of such nature, we all know that they do miss their time and within that short period if the virus has passed binding it can quickly go to the integration. This the major part because it now determines that the cell is infected even if the virus can be prevented from being infectious. In all that cycle which exists on account of the antiretroviral treatment, meaning it was broken down like that for the creation of the antiretroviral business, only one step is only two steps are important. CCR5 Antagonist, cause how will you always catch the virus at the other stages with life issues such the burden of treatment. It is the blockage of infection and interrogation that hold the key to either a chronic illness or potential cure. Once the cell is infected then its chronic illness, persisting HIV replication. The rest are just business.

    The chronic illness is created by the type of treatment. All things are looked at through this lens and the world has perished from this business. As we speak if there were true intentions to rid this virus. Do we have something to tell infected cell apart from uninfected cells? All are counted as CD4%. You should expect that some of these cells are infected because they are the ones that are targeted by the virus. In untreated patients both the CD4 and CD4% depletes. That is CD8 very capable when not suppressed.

    How shall you know if CD8 is capable of killing infected cells or not when you use something that suppresses him. It is when you use the right medicine that the body will tell you where the problem is. All the problems of HIV are the problem of ARV. You are suffering the type of medication you are using and what it requires to perform. From it is HIV biology established as scientist race to form an infected cell killer to sell you the very thing you have.

    In pomegranate, there is no drug resistance. Locate a US PATENT DOCUMENT BY NEW YORK BLOOD CENTER POMEGRANATE HIV. Cut and paste these on your google search. Notice that the pomegranate juice inhibits the virus from binding to the CD4 coreceptors. This is one aspect of it. Then research "US PUNICIC ACID IMMUNE RESPONSE US PATENT DOCUMENT" Now chew the seeds or source concentrated seed oil and activate your immune response under an inhibitor. This proliferates your lymphocytes, your CD4+ and CD8+. These were not my source, it took me 5months to find anything about the seed as my source strictly said when i research i should look for the seed. It was hard to find it cause the fruit itself is a seed. The punicic acid has a three double bond, a poly unsaturated fatty acid. Research on it. research on the biomedical compounds of pomegranate. Now in this case the immune system is supported to do what it does best.

    I am about to finish the project. So far we reduced viral loads from 102 to 16 680 and this is without consistency as i did more of studying than run therapies. These therapies were on monthly bases which is 15 a day for 3 days or more. Then i left it for the next month, then another. 46 pomegranate reduced 63 600 within 17days after three days consumption. The CD4 increased, the CD8 too and CD4% came down. Now these are the goals of a cure. So now all that we need to know is how long will it take to clear infected cell. The CD4% tells you thoroughly that infected CD4 Helper T cell is dying.

    I am not yet sure how long the therapy should be but i am sure that you must take 15pomegranate a day. i believe sourcing concentrated seed oil for a quicker response. Push a month or two. Be disciplined.

    Khan Academy thank you for your video. I believe you can expand the study of this fruit and help the people if your heart is with us. I am definitely concluding in a speedily.

    God Bless
    Thato Lerato Mohlathe
    Matthew 12:42

  3. Dear Mr. Whoever you are speaking during this important video , you have to speak louder , way louder and clearer , my earphones are deeply penetrated in my ears and volume is on higgest still you talk like someone was actually asleep in the room where you were recording . I appreciate your information though .

  4. Start HAART when it turns into AIDS regardless of CD4 count?!! It is considered AIDS when count is less then 200. So it's questionable there. Otherwise all parts are very good

  5. Yes, rules have changed to starting treatment as soon as diagnosed. Khan has an incredible teaching gift and brilliant. Have you seen the number of videos that HE HIMSELF does?! This guy knows everything!

  6. I know have said this is incredible before, I have been waiting for this for the past five years thank you for introducing me to doctor kanayo 14 days natural cure. I saw some lady’s give out testimony of how they got cured here on YouTube videos• to cut the long story short i am finally free from type 2 diabetes after using doctor kanayo 14 days natural cure, everyone if you’re suffering for diabetes you should seriously consider consulting doctor kanayo for his 14 days natural cure here is cell number#- +1909””375””5642 to reach him• Lad’s his whatsApp is enable and his from America. It feels so great having my life back xoxo my dreams finally came through

  7. HAART is the same as using your army; air force and navy at the same time. Duh? We learned that a long time ago. We got an enemy [not just opponent] which is hell bent on killing us. We need to hit it with all we got. Then by GOD someone figured out the obvious: hit it with all we got at the same time. No cease fire; no discussion. Just hit it until it is dead. Well we can't yet quite kill the last one but we can put a massive dent in it. Good! Do it and save the lives of our race. Meanwhile come up with more weapons to attack the miserable virus.

  8. For the definitive treatment of HIV AIDS, contact us on: 0022998002980 available on WhatsApp, IMO and Viber. All our products are 100% natural causes natural plants and natural leaves without any side effects. All your questions will be welcome.

  9. HAART = AIDS by prescription; kills all fast growing cells indiscriminately; blocks DNA replication by ending Reverse Transcriptase and kills off nucleii

  10. I am here to testify how great man called Dr olufo herlped me out with herbs and roots which he prepared for me in use of curing herpes. I takes his product (cure) for (14) days before I am to known I was totally cure out of it, and i promised him that i will testify my healing to the whole world about how he cured me which I am very happy I am doing now , Dr olufo also cure all kinds of diseases , HIV  HEPATITIS, A,B,C , HERPES. CANCER, DIABETICS , FRIBLOD,ALL KINDS OF SPELL CAST ,and so much more , please you can get him contacted on his whatsapp or call on +79601141794 or email [email protected]

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