Protease inhibitors are FDA-approved to treat specific viral infections caused by retroviruses. There are two types of protease inhibitors.
Inhibition of the enzyme pathway used to replicate the particular virus results in a decrease in viral load. HIV protease inhibitors can also be classified as first-generation or second-generation protease inhibitors.
The first-generation protease inhibitors were previously effective for treating HIV but have been met with growing viral resistance due to mutations in the active site of the HIV protease enzyme. First-generation protease inhibitors include saquinavir, ritonavir, nelfinavir, indinavir, and amprenavir.
Second-generation protease inhibitors have greater potency against HIV infection and include lopinavir, fosamprenavir, and atazanavir. Adults with HIV may be treated with a drug regimen that includes protease inhibitors. Combination therapy is required because HIV can become resistant to a single drug.
Adults with HIV should tell their healthcare provider about any past history of medical conditions or medications before starting treatment with a protease inhibitor. Several protease inhibitors are FDA-approved for use in children. As with adults, protease inhibitors will be part of a multi-drug regimen. Many protease inhibitor drugs are available in liquid form for ease of administering to children.
The dosing of protease inhibitors for children is typically calculated based on weight. The following protease inhibitors are FDA approved for children :.
Seniors may take protease inhibitors; however, treatment will be based on current medical conditions the individual may have or other medications the individual may be taking. Seniors often have other health conditions, such as kidney or liver problems, cardiovascular problems, and low bone mineral density, that may be affected by the use of antiretroviral agents like protease inhibitors. For instance, protease inhibitors have been linked to an increased risk of bone loss, or osteoporosis , in older patients.
Patients with a history of osteoporosis may need to be put on an alternative treatment regimen. Decreased liver and kidney function in older people can also affect the clearance of protease inhibitors.
Therefore, seniors may need close monitoring to avoid complications of drug accumulation or build-up. Some protease inhibitors can be taken while pregnant. The following protease inhibitors are not recommended during pregnancy:. If a woman already taking antiretroviral drugs becomes pregnant, it is recommended to continue the current therapy and not change medications.
Antiretroviral treatment may significantly reduce the risk of HIV transmission while breastfeeding. However, among the many types of protease inhibitors available, the irreversible serine protease inhibitors PMSF phenylmethylsulfonyl fluoride , and AEBSF 4- 2-Aminoethyl -benzenesulfonylfluoride hydrochloride are commonly used protease inhibitors in the preparation of most homogenization buffers.
The reason for this is simple. Most proteases that are found in most cells and tissues belong to the serine protease group Chymotrypsin, Kallikrein, Plasmin, Proteinase K, Thrombin and Trypsin and they need to be rendered ineffective to ensure satisfactory protein purification yields.
PMSF works by deactivating the serine hydroxyl group and any other enzyme that contains serine in its active site through an esterification process. However, if the biological activity of such an enzyme needs to be maintained, one should consider using other types of serine protease inhibitor such as AEBSF, Aprotinin or Benzamidine. Metalloproteases, on the other hand, are best deactivated by using EDTA that chelates the metal ions required for metalloproteases activity. Protease inhibitors can have dangerous interactions with other medications, supplements, vitamins , and herbs.
It is essential to tell a healthcare provider about any other medications or supplements before taking protease inhibitors or other HIV medications.
This can help a person avoid serious interactions. In some cases, HIV can become resistant to protease inhibitors. This means that the virus does not respond to the medicine any longer. Viruses do this to try and survive. When it mutates, it may become resistant to the medicines a person is taking. In some cases, a person may contract a drug-resistant strain of HIV. This means the type of HIV they have does not respond to certain medications.
The best way to avoid HIV drug resistance is to take HIV medicines every day, precisely as a healthcare provider prescribes them. Do not skip doses, change doses, or stop taking a medication without talking to a healthcare provider. Using a 7-day pill box, a medication reminder app, or another reminder system can remind people to take their medicines each day. If they have adverse side effects, they can talk with their healthcare provider. When a person is taking protease inhibitors and other antiretroviral medications, their healthcare provider will conduct specific tests to be sure their medicines are working, including:.
A CD4 cell count measures the number of CD4 cells in a blood sample. A person may have a CD4 test before starting treatment and then periodically during treatment. A lower viral load number means there are fewer HIV copies in the blood. HIV treatment aims to lower the viral load to undetectable levels. This means that the HIV count is so low that the test cannot pick it up.
This is an indication that the person with HIV is in good health, and that they cannot spread the disease to sexual partners. However, even after a person reaches an undetectable viral load, they must keep taking their medicines as prescribed.
It is essential to go to all checkups and appointments during treatment to measure treatment success and talk about side effects or HIV treatment questions. Protease inhibitors are a class of antiretroviral medication that people use alongside other HIV drugs to manage HIV effectively. Today, medications are available to help extend the lives of those living with HIV. However, all treatments come with a cost, and finding out what to….
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