The Acquired Immune Deficiency Syndrome (AIDS) is caused by a virus know as Human Immunodeficiency Virus (HIV). This virus attacks the immune system (CD4 cells) and exposes an individual to host opportunistic infections. The infections acquired by an individual when his immune defenses are low are termed as opportunistic infections. These infections generally do not affect healthy persons while the immunocompromised patients are the softest targets for such infections. The attack of these infections was more frequent and more severe in the past before beginning of the widespread use of potent combination of antiretroviral therapy (ART). However, with the advent of ARTs there has been noteworthy reduction in mortality rate of HIV patients and reduction in risk of AIDS-related opportunistic infections.
The most common opportunistic infections in HIV positive people are Candidiasis, Cytomegalovirus (CMV), Cryptococcosis, Cryptosporidiosis, Mycobacterium avium complex (MAC), Mycobacterium tuberculosis (TB), Pneumocystis pneumonia (PCP), Progressive multifocal leukoencephalopathy (PML) and Toxoplasmosis (Toxo). A person’s T cell or CD4 count determines his/her risk for certain opportunistic infections. It is therefore necessary that medications are used to boost the CD4 cells. The use adoption of standard antiretroviral therapy (ART) consisting of combination of at least three antiretroviral (ARV) drugs have been proven beneficial in suppressing the HIV virus and halting the progressing of HIV disease.
The very first class of drugs used as antiretroviral therapy was nucleoside reverse transcriptase inhibitors (also called NRTIs). The major drugs in this class include zidovudine, didanosine, stavudine, lamivudine, abacavir, tenofovir, emtricitabine. Non-nucleoside reverse transcriptase inhibitors and integrase inhibitors constitute other classes of ART drugs. If the patient population is not engaged in ART therapy or other preventive measures such as vaccination programs and prophylaxis, AID-related opportunistic infections are bound to occur. Some of the major AIDS-related opportunistic infections and their recommended treatment drugs include Pneumocystis Jiroveci Pneumonia (Trimethoprim-sulfamethoxazole), Toxoplasma gondii Encephalitis (pyrimethamine, sulfadiazine and leucovorin), Cryptosporidiosis (Paromomycin), Mycobacterium tuberculosis Disease (Isoniazid, rifampin, ethambutol, pyrazinamide and DOTS therapy), Mycobacterium avium Complex Disease (Clarithromyci and azithromycin),and bacterial pneumonia (levofloxacin, moxifloxacin, or gatifloxacin).
On the basis of geography, the global AIDS-related opportunistic infections market is segmented into six major regions, namely, North America, Europe, Asia Pacific, Middle East, Africa and Latin America. The highly priced branded drugs are sold in markets such as North America and Europe which formulates them into global leader in the overall AIDs-related market. Despite the availability of antiretroviral therapy in the developed nations such as United States, the AIDS-related opportunistic infections are causing significant morbidity and mortality. The disease is more serious in other regions, particularly in Africa. Of the estimated 34.2 million HIV-infected individuals worldwide, more than 22.9 million people are from Sub-Saharan Africa and represent continuous demand for HIV/AIDS treatment drugs. The patients in these low- and middle-income countries of other regions were earlier deprived of the antiretroviral therapy or HIV treatment due to high costs of therapy. However, with the increasing production of generic drugs in countries like India, the treatment cost has reduced drastically and have helped in improved uptake of antiretroviral therapy in these countries. In 2011, more than 8 million received ARV therapy which represents significant growth in supply of this therapy drugs. The WHO recommendation for ARV usage for prevention of HIV infection, particularly for pregnant women, young children and other population with HIV risk is expected to further drive the drugs market for AID-related opportunistic infections.
Some of major companies in the global AIDS-related opportunistic infections market include ViiV Healthcare, Gilead Sciences, Inc., Bristol-Myers Squibb Co., Merck & Co., Johnson & Johnson, Pfizer, Inc., GlaxoSmithKline plc, and Janssen Therapeutics.
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