Monday, February 6, 2012

The AIDS Alphabet: N is for "NUKES" (NRTIs) and "non-NUKES" (NNRTIs)

The AIDS Alphabet: N is for "NUKES" and "non-NUKES"

An excerpt from life with NUKES, non-NUKES and other medications that fight HIV/AIDS from Journeys Through Darkness: A Biography of AIDS.

NNRTIs: Non-Nucleoside Reverse Transcriptase Inhibitors (a.k.a. Non-NUKES) are medications that inhibit the reverse transcriptase enzyme by binding directly to the enzyme. NNRTIs include: nevirapine (Viramune) and efavirenz (Sustiva).
NRTIs: Nucleoside analogue Reverse Transcriptase Inhibitors (a.k.a. NUKES) represent the earliest antiretroviral drugs. They act by incorporating themselves into the DNA of the virus and blocking an enzyme called reverse transcriptase, which HIV needs in order to replicate. NRTIs include: zidovudine (Novo-AZT, Retrovir), lamivudine (Epivir, 3TC), and stavudine (d4T, Zerit).


Journeys Through Darkness: A Biography of AIDS by Alina Oswald with Photographs by Kurt Weston

Excerpt from Chapter Eight: Modern Crucifixion"

The modern-day face of AIDS is not a face of death anymore, but rather is defined by new terms like “Crixi bellies,” “PI pouches,” “buffalo humps” or “sunken cheeks [syndromes].” It is partly a face of HAART regimens, the very medications vital for patients to sustain a normal life and lifespan. Therefore, especially in North America and Western Europe, the contemporary face of AIDS is associated with physical deformations that sometimes can transform a patient’s appearance beyond recognition.
Due to the new protease inhibitors he was on, called d4T, Kurt Weston was also starting to grow a buffalo hump and a stomach pouch (also known as a P.I. pouch). When he asked his doctor to switch him to a drug that wouldn’t distort his body, his doctor told him about a new medication at the time, an entry inhibitor that was coming up the pipeline and becoming available.
In 2003, FDA approved a medication called Fuzeon (or T20) supposed to fight HIV by not allowing the virus to enter the T cell. Because it is difficult to manufacture, the drug is extremely expensive and available only as an injection. Studies have shown that AIDS patients who are on Fuzeon may get skin rashes where they self-administer the shots, or some may become more prone to developing pneumonia.
Doctors put the photographer on Fuzeon and a combination of other medications. While on Fuzeon, Kurt has experienced very few side effects and he liked that very much. Also, to make best use of the medication and his time, he had no choice but to quickly learn how to integrate his shots into his daily schedule.
Ever since his diagnosis, AIDS has been a constant variable in the equation that describes Kurt Weston’s existence. In time and with the appearance of new treatments, the threat of his disease has turned from immediate to manageable. These days, AIDS has become more of a constant companion in his life rather than a threat, but it continues to influence, at least partly, all decisions, minor and major alike, that he has to make—be they related to his studies, to traveling or eating his meals.