Human Immunodeficiency Virus (HIV) Disease

Shape the Narrative of Human Immunodeficiency Virus – HIV with DiseaseLandscape Insights

As of the close of 2021, approximately 1.2 million individuals in the United States were reported to be living with HIV (Human Immunodeficiency Virus), with approximately 87% being aware of their HIV status, according to the Centres for Disease Control and Prevention (CDC). HIV is a virus that targets the immune system, and if left untreated, it progresses to AIDS (acquired immunodeficiency syndrome). The origin of HIV can be traced back to a particular species of chimpanzee in Central Africa. Studies suggest that HIV first emerged in humans in the late 1800s, having jumped from chimpanzees, where it is known as simian immunodeficiency virus.

The transmission to humans likely occurred when individuals hunted these chimpanzees for food and encountered their contaminated blood. Over the course of many years, HIV gradually spread throughout Africa before extending to other regions. The virus has been present in the United States since at least the central to the end of the 1970s. According to the World Health Organization (WHO), the estimated global HIV-positive population reached 39.0 million by the conclusion of 2022, with two-thirds of these individuals (25.6 million) residing in the WHO African Region.

Two copies of the single-stranded RNA genome make up the enveloped retrovirus known as the human immunodeficiency virus (HIV). The final stage of HIV disease, acquired immunodeficiency syndrome (AIDS), is brought on by it. After HIV enters the body, the patient experiences initial infection symptoms two to four weeks later. Following that, an extended chronic HIV infection sets established, perhaps lasting for several decades. Opportunistic infections and tumors which are typically lethal in the absence of treatment and are the primary characteristics of AIDS. HIV infect certain monkeys or great apes. HIV-1 and HIV-2 are the two forms of the virus. Several related viruses can also infect these animals. While HIV-1 is widespread worldwide, HIV-2 is nearly solely found in West Africa. Compared to HIV-2, HIV-1 is more easily spread, and HIV-1 infection leads to AIDS more quickly.

HIV only spread through interactions. The most popular methods in the US is: Taking medications to prevent or treat HIV and having vaginal or anal intercourse with an HIV-positive person without always using a condom. In terms of HIV transmission, anal sex is riskier than vaginal sex. Find out more about the risks of HIV connected with different types of sexual activity. Sharing injectable supplies with an HIV-positive person includes sharing needles, syringes, and other injectable supplies since blood harbor HIV. Sharing needles, syringes, or other injection supplies is another way that people who inject silicone, steroids, hormones, or silicone might contract HIV. The HIV symptoms vary depending on the stage of infection.

In the initial months following infection, the disease spreads more readily, but many people do not become aware of condition until much later. After infection, people do not show any symptoms for a few weeks. Some people are suffering from a flu-like disease, such as fever, headache, HIV rash, and sore throat. The infection progressively deteriorates the immune system. This causes other signs and symptoms of HIV like swollen lymph nodes, weight loss, fever, diarrhoea, and cough. Without treatment, people with HIV infection also develop severe illnesses like tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, cancers such as lymphomas and Kaposi's sarcoma. HIV causes other infections to get worse, such as hepatitis C, hepatitis B and m pox.

HIV infection is considered a pandemic. According to NCBI, estimates are that 40 million people have died from HIV infection and that there are currently more than 38 million people living with HIV infection. Since treatment has advanced and patients can now live longer with HIV, the prevalence of HIV has increased.  To stop the virus's spread and treat it, there have been AIDS-defining initiatives in the fields of research, education, and prevention.  Since the 1990s, there has been a decline in the annual number of new infections. Globally, the incidence of HIV and AIDS varies greatly, despite efforts in developed nations leading to improvements in mortality, quality of life, and aids transmission rates.  For instance, it is estimated that 25 million people of all ages in sub-Sarahan Africa are HIV positive. There is currently no HIV vaccine available.

DiseaseLandscape Insights helps the stakeholders by offering information about the HIV market, as well as informed decisions about medical equipment, treatments, and diagnostic methods. Many new technologies and innovations are also having an impact on the disease market and propelling its growth.

HIV is spreading throughout the world creating a drastic shift in an individual’s standard of life. The present condition of HIV disease would propel the industries in the appropriate direction and provide emerging opportunities for a variety of market leaders in the domain of landscape insights.

HIV Diagnostic Analysis:

After the exposure, many patients only experience an asymptomatic infection. Usually, it takes two to four weeks after exposure for symptoms to appear, but occasionally, it takes up to ten months. Acute retroviral syndrome is a group of symptoms that manifest suddenly. Even though none of these symptoms are unique to HIV, their increasing severity and length is a sign of a bad prognosis.

HIV is diagnosed through blood or saliva testing. Available tests include:

• Antigen/Antibody Tests - These tests usually involve withdrawing blood from a vein. Antigens are substances on the HIV virus itself and are generally detectable, a positive test in the blood within a few weeks after contact to HIV. Fourth-generation assay: Detect exact antibodies and P24 HIV antigens. Antibodies are produced by immune system when it's exposed to HIV. It takes weeks to months for antibodies to become measureable. The combination antigen/antibody tests take 2 to 6 weeks after exposure to become positive.
• Rapid Test- These tests look for antibodies to HIV in blood or saliva. Most rapid HIV testing, including self-tests done at home, are antibody tests. Antibody tests take 3 to 12 weeks after exposed to become positive.
• Nucleic Acid Tests (NATs) - These tests look for the actual virus in blood (viral load). It also involves blood drawn from a vein. If a person might have been exposed to HIV within the past few weeks, health care provider recommend NAT. NAT is the first test to become positive after exposure to HIV.
• Polymerase-chain-reaction: It is diagnostic or a confirmative test for HIV infection and provide information about the viral load.

Discuss the best HIV test for a particular person with healthcare practitioner. Person still requires a follow-up test week or months later to confirm the results if any of these tests come out negative.

When there is a likelihood of acute or primary HIV infection, the most delicate screening immunoassay available (ideally, a combination antigen/antibody immunoassay) in addition to an HIV virologic (viral load) test is performed. RT-PCR based viral load test is favored. A positive HIV virologic test normally specifies HIV infection.

Noticeable viremia does not develop till approximately 10 to 15 days after infection, and even the most delicate immunoassays do not give a positive result till five days after that. Therefore, initial negative immunoassay and virologic tests is misleading, and if the clinical suspicion for recent HIV exposure is high, repeat testing is done one to two weeks later.

HIV Diagnostic Market Players:

HIV Treatment Analysis:

To treat HIV infections and AIDS, antiretrovirals are prescribed in different combinations, this treatment is known as highly active retroviral therapy, or HAART. The antiretrovirals comprise protease inhibitors, CCR5 inhibitors, integrase inhibitors, non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), and NRTI fixed-dose combinations. HAART is a lifelong treatment for HIV that should be initiated for all patients, irrespective of their cd4 count in HIV level. If the patient has a low or undetectable HIV viral load, this therapy has been demonstrated to reduce morbidity and mortality as well as the risk of spreading the infection to others.

Single Tablet Regimens

A tablet containing 600 mg of Efavirenz, 200 mg of Emtricitabine, and 245 mg of Tenofovir Disoproxil is called Efavirenz/Emtricitabine/Tenofovir Disoproxil. It needs to be taken once daily as a single pill. Sleep disturbances, fatigue, vertigo, rash, nausea, vomiting, diarrhea, aberrant dreams, headaches, anxiety, depression, skin darkening, low blood phosphate levels, weakness, stomach pains, bloating, and flatulence are just a few of the acute HIV symptoms that it causes of HIV and aids.

• A tablet containing 25 mg of Rilpivirine, 200 mg of Emtricitabine, and 245 mg of Tenofovir Disoproxil is called Rilpivirine/Emtricitabine/Tenofovir Disoproxil. It needs to be taken once daily as a single pill. Nausea, vomiting, diarrhea, headaches, dizziness, insomnia, fatigue, weakness, rash, stomach pains, flatulence, elevated creatine kinase levels, low blood phosphate levels, skin darkening, mood swings, and depression are some of the side effects.
• A tablet containing 25 mg of rilpivirine, 25 mg of Tenofovir Alafenamide, and 200 mg of Emtricitabine is called Rilpivirine/Tenofovir Alafenamide/Emtricitabine. It needs to be taken once daily as a single pill. It results in decreased levels of white blood cells, red blood cells, and platelets; elevated lipids; fatigue; headache; light-headedness; insomnia; depression; nausea; abdominal pain; vomiting; flatulence; liver enzymes; dry mouth; elevated levels of amylase; and bilirubin.
• A tablet containing 150 mg of Elvitegravir, 150 mg of Cobicistat, 200 mg of Emtricitabine, and 10 mg of Tenofovir Tlafenamide is called Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide. It is recommended to take one tablet once daily. This regimen's side effects include headaches, dizziness, rash, nausea, vomiting, diarrhea, vomiting, and fatigue.
• Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil is a medication that contains 245 mg of Tenofovir Disoproxil, 150 mg of Emtricitabine, 150 mg of Cobicistat, and 200 mg of Emtricitavir. It is recommended to take one tablet once daily. It may result in rash, flatulence, headache, nausea, fatigue, diarrhea, dreams, dizziness, insomnia, and tiredness.
• An antiretroviral combination called Dolutegravir/Abacavir/lamivudine contains 300 mg of lamivudine, 600 mg of Abacavir, and 50 mg of Dolutegravir. It is recommended to take one tablet once daily. The list of adverse effects includes depression, flatulence, muscle soreness and discomfort, headache, diarrhea, stomach pain, drowsiness, dizziness, hair loss, nausea, fatigue, rash, itching, and vomiting.

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

• The recommended dosage for Abacavir tablets is 600 mg once daily or 300 mg twice a day. Nausea, fever, headache, vomiting, diarrhea, abdominal pain, exhaustion, and appetite loss are some of its adverse effects.
• Emtricitabine is recommended to be taken once daily as a capsule (200 mg). It may result in headaches, diarrhea, elevated creatine kinase levels, nausea, and skin darkening.
• Two 150 mg or three 300 mg tablets of lamivudine should be taken daily, depending on the dosage. The regimen may result in rash, fatigue, joint pain, hair loss, nausea, vomiting, diarrhea, and abdominal pain in addition to fever and insomnia.
• There are capsules with 100 and 250 mg of Zidovudine. You should take one 250 mg capsule twice a day. Nausea, exhaustion, headaches, weakness, muscle soreness, and vomiting are typical side effects.

NRTI Fixed-Dose Combinations

• Abacavir/lamivudine: A tablet containing 300 mg of lamivudine and 600 mg of Abacavir. One tablet should be taken each day. The most frequent adverse effects include nausea, vomiting, diarrhea, appetite loss, hair loss, fever, headache, stomach pains, exhaustion, runny nose, insomnia (inability to fall asleep), joint pain, muscle soreness, rash, and hypersensitivity reaction.
• This tablet contains 300 mg of Abacavir, 150 mg of lamivudine, and 300 mg of zidovudine. Two tablets should be taken daily. It can result in stomach pains, headaches, runny noses, exhaustion, nausea, vomiting, diarrhea, fever, appetite loss, hair loss, joint pain, rash, dizziness, muscle soreness, and hypersensitivity reaction.
• Tablet containing 200 mg of Emtricitabine and 245 mg of Tenofovir Disoproxil. Emtricitabine/Tenofovir Disoproxil. It is recommended to take one tablet once daily. It can result in low blood phosphate levels, rashes, nausea, vomiting, diarrhea, flatulence, headaches, dizziness, elevated creatine kinase levels, weakness, rash, skin darkening, stomach pains, and trouble sleeping.
• Zidovudine/lamivudine: Tablet containing 300 mg of zidovudine and 150 mg of lamivudine. One tablet should be taken twice a day. Nausea, vomiting, diarrhea, headaches, insomnia (inability to fall asleep), runny nose, cough, stomach pains, rash, fever, tiredness, joint pain, dizziness, muscle soreness, and appetite loss are some of its serious side effects.

Integrase Inhibitors

• Dolutegravir 50 mg tablet: 50 mg once daily; if taken with Tipranavir, Nevirapine, or Efavirenz, take 50 mg twice daily. In addition to an increase in liver and muscle enzymes, it can result in fatigue, flatulence, stomach pain or discomfort, headaches, rash, itching, vomiting, dizziness, and abnormal dreams.
• The recommended dosage for Raltegravir is 400 mg twice a day. Headache, sleeplessness, a hypersensitivity reaction, an infrequently severe rash, and intense thirst are some of its side effects.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

• Tablets containing 100 and 200 mg of Etravirine: Take one 200 mg tablet twice a day. Peripheral neuropathy and rash are the adverse effects. For two weeks, a 200 mg tablet of Nevirapine is taken once daily; after that, it is taken twice daily. In addition to fatigue, stomach pain, diarrhea, rash, nausea, headaches, and liver toxicity, it can also cause an allergic reaction.
• One 25 mg tablet of Rilpivirine is taken daily. Sleeplessness, headaches, rashes, stomach-aches, elevated liver enzymes, depression, dizziness, and vomiting are some of its serious side effects.

CCR5 Inhibitor

• Tablets containing 150 and 300 mg of Maraviroc: Take this medication at a dose of 300 mg twice daily. It may result in headaches, exhaustion, diarrhea, and in rare cases, liver disease.

Protease Inhibitors

• Atazanavir 150-, 200-, and 300-mg capsules: The 300-mg formulation, which should be taken once daily, also includes 100-mg ritonavir. It can result in hyperbilirubinemia, lipodystrophy, vomiting, liver toxicity, nausea, diarrhoea, rash, stomach-ache, headache, insomnia, and diabetes.
• Darunavir 600- and 800-mg tablets: Take one 800-mg tablet once a day along with 100-mg of ritonavir. Diarrhea, nausea, rash, headaches, stomach pain, lipodystrophy, diabetes, and liver toxicity are among its frequent side effects.
• The 20 mg Lopinavir and 50 mg ritonavir tablet, which is taken as two tablets twice a day or four pills once a day, is what makes up Lopinavir/Ritonavir. Increased lipids, liver toxicity, diabetes, nausea, vomiting, weakness, heartburn, headaches, diarrhea, and elevated liver enzymes are some of the possible side effects.
• Each tablet of Atazanavir/Cobicistat contains 150 mg of Cobicistat and 300 mg of Atazanavir. It needs to be taken just once daily. Hyperbilirubinemia, rash, exhaustion, lipodystrophy, jaundice, dry mouth, headache, dizziness, and vomiting, diarrhea, and sleep issues can all be brought on by it.

HIV Treatment Market Players:

Recent Development

• TGA has approved Cobas MPX (cobas 5800/6800/8800) - HIV1/Hepatitis C virus/Hepatitis B virus nucleic acid IVD, kit, nucleic acid technique (NAT), manufactured by Roche Diagnostics Australia Pty Limited on 25^th October 2023.
• On 7^th September 2022, TGA approved access HIV Combo V2 - HIV1/HIV2 antigen/antibody IVD, kit, chemiluminescent immunoassay Sponsored by Bio-Rad Laboratories Pty Ltd.
• Abbott Rapid Diagnostics Pty Ltd T/A Alere - Determine HIV-1/2 - HIV1/HIV2 antibody IVD, kit, immunochromatographic test (ICT), rapid is approved by TGA on 18 March 2021.

Clinical Trial Assessment

The DiseaseLandscape Insights consultancy firm provides valuable support in future market trends on the development of new pharmaceutical products. This support helps to streamline the planning and execution of clinical trials of novel medications and treatments, implement effective patient recruitment strategies, ensure regulatory compliance, and increase the likelihood of successful trial outcomes.

The below table gives information about some currently ongoing clinical trials, including their study titles and respective stages:

Conclusion -

The data of Disease Landscape Insights (DLI), especially in the battle against HIV, is of utmost importance. The comprehensive services of Disease Landscape Insights are designed to support the healthcare sector, its professionals, researchers, and industry participants in enhancing patient outcomes and fostering business growth and expansion.

Through harnessing the power of comprehensive market research, DLI services offer invaluable insights into the latest advancements, treatment techniques, and emerging trends in HIV management. These insights empower healthcare professionals to make well-informed decisions, develop targeted strategies, and provide personalized care to patients. Furthermore, our services act as a catalyst for collaboration and innovation, fostering partnerships among industry stakeholders and researchers to drive advancements in HIV treatment and prevention.

Overall, information from DLI allows all the manufacturers to perform extensive research and developments. Understand the market dynamics, analysis of the supply chain, and collaborations. All in all, with the utilization of our expertise, healthcare organizations attain a competitive edge, optimize patient outcomes, and actively contribute to the advancement of global healthcare standards.