World AIDS Day | The Imperative of Early Antiviral Treatment

To raise global awareness of AIDS, the World Health Organization (WHO) designated Dec. 1 of each year as World AIDS Day in 1988, calling on countries/regions and international organizations to engage in activities that promote and disseminate knowledge on AIDS prevention on this day.

The 36th "World AIDS Day" was celebrated on Dec. 1, 2023 under the theme "Let Communities Lead".

What is AIDS?

AIDS stands for Acquired ImmunoDeficiency Syndrome. It is caused by the Human Immunodeficiency Virus, commonly known as HIV.

HIV attacks T4 lymphocytes, central cells of the human immune system, causing the human body to lose its ability to resist and fight against life-threatening pathogens, thus leading to extremely rare, incurable infections and tumors, and ultimately death.

HIV itself does not cause any disease; instead, the compromised immune system following the impairment by HIV makes the body vulnerable to other infections, which ultimately leads to death.

How is AIDS Transmitted?

AIDS is transmitted through three different ways:

Sexual transmission

Blood transmission

Mother-to-child transmission

Clinical Manifestations of AIDS

From HIV infection to AIDS onset, there is a complete natural progression through four clinical stages, including acute HIV infection, clinical latency, pre-AIDS, and typical AIDS. Clinical manifestations at each stage represent a gradual and continuous progression of the disease.

At the acute infection stage, patients may experience fever, rash, or swollen lymph nodes, as well as mild symptoms of fatigue, sweating, nausea, vomiting, diarrhea, pharyngitis, headache, neurological symptoms, or meningeal irritation, etc.

HIV infection typically remains latent for 2 to 10 years, during which the infected individual may not exhibit any clinical symptoms. But this is neither a stillness nor a safe stage, as the virus continues to replicate with a devastating effect.

At the pre-AIDS stage, patients may suffer from swollen lymph nodes, generalized discomfort from viral disease, muscle pains, and various specific or recurrent non-fatal infections.

The typical AIDS stage, which some scholars refer to as fatal AIDS, is the final stage of HIV infection with three basic characteristics: severe cellular immunodeficiency, fatal opportunistic infections, and different types of malignant tumors. Patients with end-stage AIDS will undergo a complete immune system collapse, experience all sorts of severe syndromes and eventually results in death.

An AIDS diagnosis relies on definitive blood test results, not just clinical manifestations. Therefore, patients should seek medical attention early and adhere to treatment regimens.

How Can AIDS Be Prevented?

1. Limit the number of sexual partners and avoid high-risk sexual behavior.

2. Do not inject drugs and share injection needles with others.

3. Blood transfusions and the use of blood products must be supervised by a healthcare professional.

4. Do not share personal items such as toothbrushes, razors, and face scrapers.

5. Using a condom during sexual activities is one of the most effective ways to prevent sexually transmitted diseases (STDs) and AIDS.

6. Avoid direct contact with the blood, semen, and breast milk of AIDS patients to cut off routes of transmission.

Post-exposure prophylaxis: High-risk people who are likely to be infected with HIV can use drugs to block infection as early as possible and start antiretroviral therapy immediately within 72 hours after exposure to HIV.

How Can AIDS Be Treated?

Treatment goals:

Maximize inhibition of viral replication to the extent that viral load becomes undetectable, and reduce the viral mutation;

Reconstruct immune function;

Reduce abnormal immune activation;

Reduce the transmission of virus and prevent mother-to-child transmission;

Lower the incidence and mortality of HIV infection and non-AIDS-related diseases to make patients achieve the same life expectancy as uninfected people and improve their quality of life.

Antiviral therapy holds the key to AIDS treatment:

Highly active antiretroviral therapy (HAART) has significantly improved the anti-HIV efficacy, contributing to a marked enhancement of patients' quality of life and prognosis.

Azvudine (Shuangxinaike)

• First double-target nucleoside oral drug in the world to simultaneously target reverse transcriptase (RT) and viral infectivity factor (Vif) for the treatment of HIV infection

• With a dual-target mechanism of action to integrate two therapeutic mechanisms, minimizing the likelihood of drug-resistance

• Potential to become part of an oral long-term treatment for HIV infection due to its long-acting feature

• Won "China Patent Gold Award"

• Incorporated into the Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS (2021 edition)

• Approved with conditions by the National Medical Products Administration (NMPA) in Jul. 2021 for the treatment of HIV-1 infected adults with high viral load

• Officially included into the National Reimbursement Drug List in Jan. 2023, offering more advanced treatment options for patients with HIV