Some medical terms common to HIV therapy:
1. Protease inhibitor. "Protease inhibitors" have changed the face of the HIV epidemic and are the drugs responsible for the dramatic drop in the death rate from AIDS. These drugs stop an enzyme (HIV-protease) from functioning correctly so the new viruses that are produced are unorganized and not infectious. They don't do diddly-squat alone, but in combination can stop the virus from duplicating itself and subsequently destroying the immune system - if taken properly.
These drugs are to be taken with or without food, as directed, and they have LOTS OF SIDE EFFECTS, including your favorite - kidney stones.
2. Resistance. "Resistance" occurs when the virus learns how to get around the drug and reproduce itself. This usually happens when a person doesn't have enough of the drug in the body to completely stop the virus (i.e. when a few doses are skipped). The virus then reproduces, in the presence of inadequate drug concentrations. A mutation occurs in the virus, and it suddenly ignores the drug and continues its life cycle, even when the drug gets back to previous adequate concentrations.
3. Viral load test. "Viral load" is a measurement of viruses in a drop of blood (yep, we can actually measure that now - it's very cool). People can start out with more than a million viruses per mL of blood. With effective therapy, this can be reduced to "undetectable." "Undetectable" is the goal of therapy, but it doesn't mean the virus is gone for good. The viruses still are hiding in the lymph nodes and brain, and if you're Magic Johnson and go on national TV saying "I'm cured, I'm cured - I'm undetectable," you make my job a little more interesting.
4. Antivirals. "Antiviral" is an umbrella word. Antivirals are drugs that stop viruses. "Antiretrovirals" is a little more accurate because the drugs stop retroviruses like HIV, but the group also includes two other types of drugs: reverse transcriptase inhibitors (like AZT, ddI, ddC, d4T, 3TC nevirapine, efavirenz and 1592) and the aforementioned protease inhibitors, including indinavir, ritonavir, nelfinavir and saquinavir.
5. Adherence. "Adherence" is the nice way of saying that you take your meds correctly - or in adherence to the regimen the doctor intended. "Compliance" is another word for adherence, but it sometimes has a negative connotation.
We have a protocol at our clinic to make sure people are really ready to take these drugs before they begin, because once resistance to one set of drugs develops, it often translates to resistance to many other drugs. We approach HIV treatment from the standpoint that people really only have one good shot at stopping the virus. We have to make that shot count. The battle against the disease has become very interesting, especially since the dynamics of HIV infections are changing - there's a swing toward infection among IV drug abusers and away from gay men. (Let me tell you, it's been increasingly tougher.)