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The Latest Advancements In HIV Treatment

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The HIV infection development into a lingering illness has ramifications across every clinical care setting. Every nurse is supposed to be well-informed regarding the testing, prevention, chronicity, and treatment of the ailment to give high-quality care for persons with or at risk for HIV. As such, it is imperative to fathom the changing epidemiology of HIV and the most recent testing recommendations (Lee et al. , 2018). Additionally, it is critical to comprehend the corollaries of the aging population struggling with HIV infection, the developments in screening technology, and the nursing implications of the ongoing epidemic. This discourse provides an insight into the latest in HIV treatment Currently, there are new testing techniques which have been invented for screening the HIV infection. This has made screening the virus faster, less invasive and more accessible (Lee et al. , 2018). A clinician can presently screen urine or blood of the patient via fingerstick – every nurse is an HIV nurse.

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Nonetheless, there are other tests a nurse can perform to pinpoint the HIV antibodies within the oral fluid specimen, thus disregarding the need for venipuncture (Lee et al. , 2018). After he or she has collected the blood or urine specimen, the collection device is put in a vial which has preserved and is then sent to a central laboratory where immunoassay of the enzyme is carried out (Lee et al. , 2018) If the specimen is found to be reactive – antibodies are present – a confirmation sent has to be carried out. Substantial discoveries in the antiretroviral therapy have been made from the time zidovudine was designed. The initiation of the Highly Active Retroviral Therapy (HAART) has facilitated the manageability of the HIV-1 infection as a chronic malady in patients who achieve a durable virologic suppression and have access to medication (Saag et al, 2018). The HAART provides nurses with an effective treatment option when treating the naïve as well as the experienced patients – in matters of treatment. Nurses can prescribe various pharmacologic classes of drugs such as Integrase inhibitors (INSTIs) Fusion inhibitors (FIs), Entry inhibitors (CD4-directed post-attachment inhibitors), Nucleoside reverse transcriptase inhibitors (NRTIs), Chemokine receptor antagonists (CCR5 antagonists), Integrase inhibitors (INSTIs), Non-nucleoside reverse transcriptase inhibitors (NNRTIs), and Protease inhibitors (PIs) (Saag et al, 2018). Every class discussed above targets a distinct phase in the life cycle of the virus – the HIV virus has a tendency of infecting the CD4 T lymphocyte. However, it also targets other cells. Clinicians utilize these agents in practice depending on the side-effect profile, complexity or ease of their use, practical guidelines, efficacy grounded on the clinical evidence and clinician’s preference (Saag et al, 2018).

Although nurses have been able to manage the HIV infection easily using the Highly Active Retroviral Therapy (HAART), the adverse effects, resistance, pregnancy as well as connecting with the hepatitis C or Hepatitis B virus present are presenting a significant challenge to clinicians during therapy selection and maintenance (Saag et al, 2018). Thus, the invention of HAART has presented the nurses with a principal methodology for counteracting immune deterioration. A tenacious challenge in the prevention and treatment of HIV/AIDs is adherence to medication – clinicians getting patients to precisely take their medication to achieve the best outcomes (The Lancet, 2017). Presently, the infection can be prevented by taking a once-daily pill prescribed by a clinician. Nonetheless, the adherence to the once-daily treatment can be difficult for some individuals (The Lancet, 2017). To eradicate this issue, medical researchers have designed injectable, removable and ultra-long-acting formulation of the antiretroviral prescription known as dolutegravir. The effectiveness of the formulation has been tested in animal models – it constitutes an anti-HIV drug, a solvent and a polymer (The Lancet, 2017). The three- component liquid tend to solidify as soon as it is injected under the skin – the polymer then degrades gradually and releases the drug. Recent study after administration by a clinician, the formulation delivers the medication effectively.

Additionally, the medication presents a high level of tolerance without toxicity signs for a period of 5 months (The Lancet, 2017). A clinician can remove the implant safely and quickly by making a small incision in the skin – at the implant site. Therefore, the discovery of the implant has been projected to be the perfect formulation for preventing and treating HIV/AIDs. The HIV course of therapy does not only promote the health of the patients struggling with HIV, but also act as an effective strategy to prevent the transmission of HIV. The contemporary HIV regimen has been proven to reduce the viral load in body fluids such as rectal, vaginal and seminal fluids as well as blood to undetectable levels (Stirratt et al. , 2018). Nevertheless, the prescription has to be adhered to for the patients to become and maintain undetectability. Additionally, it is imperative for the patient to regularly visit the hospital so the viral load can be monitored even though they are taking drugs as prescribed – this will allow him or her to receive other medical support and remain undetectable levels (Stirratt et al. , 2018). The current evidence has revealed that HIV-positive persons who are engaged in care, are on treatment and have a constant undetectable viral load do not infect their sexual counterparts or their kid via breastfeeding, or through the sharing of contaminated syringes (Stirratt et al. , 2018). The home-grounded care for the HIV-positive patients encompasses the delivery of the antiretroviral regimens, medical care as well as psychological support. A comprehensive study of the home-based care that was offered by professional nurses compared with health- facilities and hospital-based treatment (Wood, Zani, Esterhuizen, & Young, 2018).

The research methodology was grounded on a thorough search on various electronic databases such as CINAHL, AID Search, MEDLINE, Cochrane Register of Controlled Trials, PsycINFO/LIT, and EMBASE, with an updates search conducted in late 2016. From the study, it has been concluded that there is a significant improvement in adherence to the antiretroviral drugs with the nurse-based care – however, the viral load was not affected whatsoever (Wood, Zani, Esterhuizen, & Young, 2018). Therefore, psychiatric nursing support has been encouraged coupled with home-based care since it has proven to improve the depressive symptoms and mental health. To sum it up, nurses led home-grounded intervention is encouraged today because it improves the mental health of the patient and adherence to antiretroviral therapy. It is also apparent from the above discussion that clinicians are supposed to focus on the prevention and treatment of the HIV complications as well as opportunistic maladies. Lastly, promoting the inclusion of nurses in direct clinical care responsibilities and psychosocial roles will improve the patients’ results and capitalize on an invaluable resource. Furthermore, it will ensure that most of the physicians as freed so that they can concentrate on medical care.

15 July 2020

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