Starting Art During Pregnancy Or Breastfeeding
If you’re pregnant or breastfeeding it’s particularly important that you start treatment straight away. This is because ART prevents HIV from being passed on to your baby.
ART is safe to take during pregnancy and breastfeeding, and will keep you and your baby healthy. Talk to your healthcare worker about which combination of antiretroviral drugs is best for you and feel free to ask them any other questions or concerns that you have. They are there to help.
Hiv And Aids Medication
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There is no cure for HIV and AIDS, but medicines can help. Many people with HIV live long and relatively healthy lives.
HIV damages your immune system by attacking blood cells that help fight infection.
Acquired Immune Deficiency Syndrome is the condition that develops if HIV is not treated.
The medications used to fight HIV are called antiretrovirals. They work to stop the virus multiplying. This helps to protect your immune system from damage caused by HIV.
The medications used to treat HIV and AIDS may be similar.
If your immune system has already been damaged, treatment can help stop further damage and even allow the immune system to partly repair itself.
Registering With An Hiv Specialist
There are increasing numbers of options available to you for treating HIV. Registering with an HIV specialist is essential in order to find out what options are best for you. This is free through public hospitals and Sexual Health Services. In the meantime, our counsellors are available for guidance and support.
You can access a number of services and specially trained health professionals for People Living with HIV from organisations throughout Aotearoa.
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Getting Support With Starting Treatment
Its important that you feel ready to start ART and understand how to take it properly. Current HIV treatment has to be taken every day for the rest of your life. You might feel good about starting HIV treatment, because it is something you can do to stay healthy and strong. But it is also normal to feel worried about it, or to have questions.
In addition to talking to your doctor, you may find it helpful to talk to someone who has experience of taking HIV treatment. Many clinics have peer mentors, who can offer support and information, or can put you in touch with community organisations and peer support groups.
What About Reports Of Cured People
Only two people, Timothy Brown and Adam Castillejo, have been completely cured of HIV.
During treatment for acute myeloid leukemia, Brown received a bone marrow transplant from a donor who had a genetic mutation that leads to HIV resistance.
After the transplant, doctors could no longer detect HIV in Browns body. The exact reason why is still unknown.
Castillejo also received a bone marrow transplant, but to treat lymphoma. Like in Browns case, the donor had a genetic mutation that leads to HIV resistance.
Reports of other cured people may actually refer to long-term nonprogressors . While progression to AIDS is still possible without antiretroviral drugs, LTNPs are able to maintain stable viral loads and CD4 cell counts for long periods of time.
About 5 to 15 percent of people living with HIV are LTNPs. LTNPs can also be broken down further based off their viral load:
- Viremic controllers are people who maintain a viral load at very low, but still detectable, levels.
- Elite controllers are people who maintain viral load at undetectable levels. Elite controllers are very rare. Its estimated that they make up less than 1 percent of people living with HIV.
There have also been reports of HIV-1 control in people who have previously taken antiretroviral drugs. These people are called post-treatment controllers and are also rare.
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Questions To Ask About Each Drug
One of the most important things you can do to make sure you take your medicine correctly is to talk with your medical provider about your lifestyle, such as your sleeping and eating schedule. If your provider prescribes a drug, be sure and ask the following questions :
- What dose of the drug should be taken? How many pills does this mean?
- How often should the drug be taken?
- Does it matter if it is taken with food, or on an empty stomach?
- Does the drug have to be kept in a refrigerator?
- What are the possible side effects of the drug?
- What should be done to deal with the side effects?
- How severe do side effects have to be before a provider is called?
During every medical visit you should talk about whether you are having trouble staying on your treatment plan. Studies show that people who take their medicine in the right way get the best results: their viral loads stay down, their CD4 counts stay up, and they feel healthier.
Understanding Hiv And Aids
Survival with HIV requires that you maintain regular and consistent treatment. Only around 65% of the 1.2 million Americans who have HIV are on treatment, according to the U.S. Department of Health and Human Services. Of these, an estimated one in four will drop out of HIV-specific care, and only 56% will achieve the complete viral suppression that is needed to avoid disease progression.
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How Does Antiretroviral Treatment Work
Without treatment HIV attacks the immune system – the part of your body that protects you from other infections. If people living with HIV dont take treatment they become more vulnerable to other illnesses.
ART stops HIV from making copies of itself. This keeps the amount of virus in your body low, protecting your immune system so youre less likely to get sick.
With good healthcare and treatment, people with HIV can expect to live as long as people who dont have HIV. You can continue to have relationships, to work or study, to make plans, to have a family whatever you would have done before your HIV diagnosis.
By keeping the amount of HIV in your body low, ART also reduces the risk of HIV being passed on. People living with HIV who take their treatment properly can achieve something called an undetectable viral load. This is when the amount of HIV in their body has been reduced to such low levels that it cant be passed on through sex. To know if you have an undetectable viral load, its important to attend regular appointments with your healthcare team to have your viral load measured this can tell you how effective your treatment is and how much HIV there is in your body.
Means And Requirements For Hiv Transmission
People may become infected with HIV if they engage in specific risk behaviors or if they are exposed through needlestick injuries . Other blood contact with mucous membranes or non-intact skin provides a possible, but not probable, chance of transmission.
HIV is transmitted through:
- Unprotected anal, vaginal, and oral intercourse
- Sharing needles or other injection equipment
- A mother passing the virus to her baby either before or during birth
- An infected woman breastfeeding her infant
- Accidental needlestick injuries, or infected body fluid coming into contact with the broken skin or mucous membranes of another person
- A transfusion prior to 1986 of HIV-infected blood or blood products
In extremely rare cases, HIV can be transmitted by sharing razors or toothbrushes, if infected blood from one person was deposited on the toothbrush or razor and the blood entered the bloodstream of another person.
The transmission of HIV depends upon:
- The availability of the infectious agent in sufficient quantity
- The viability of the infectious agent
- Thevirulence of the infectious agent
- The ability of the infectious agent to reach the bloodstream, mucous membranes, or broken skin of a potential host
One of the predictors of the infectious level of an HIV-positive person is viral load, which is how much HIV is present in the bloodstream. Studies show a clear connection between higher viral load in the blood and increased transmissibility of HIV.
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Common Side Effects Of Hiv Drugs
The following chart lists some HIV medication side effects that are more common and a few special precautions. To prevent interactions with other medicines, it is important to tell your doctor about all drugs you take. Also tell your doctor right away if you have new, unusual, or long-lasting symptoms.
| Nucleoside Reverse Transcriptase Inhibitors | Common Side Effects |
- Stopping protease inhibitors, but only under the guidance of your doctor
- Hypoglycemic drugs taken by mouth
- Insulin injected under the skin
Hyperlipidemia is an increase of fat in the blood. These fats include cholesterol and triglycerides. This condition can lead to heart disease and pancreatitis, an inflammation of the pancreas. Some protease inhibitors can increase this side effect.
Symptoms of hyperlipidemia do not exist. The only way to know if you have this condition is to have lab tests at least once a year.
Treatment of hyperlipidemia includes taking cholesterol-lowering drugs, such as statins or fibrates.
Lipodystrophy is also called fat redistribution. If you have it, your body produces, uses, and stores fat differently. This side effect is associated with the use of both NRTIs and PIs as well as the HIV virus itself. It is less common with the newer medications.
Symptoms of lipodystrophy include:
- A buildup of fat in the neck or upper shoulders, belly, or breasts
- A loss of fat in the face, arms, legs, or buttocks
Treatment of lipodystrophy may include:
Symptoms of liver damage include:
How Is Hiv Treated
Basics
There are many treatments that can help people with HIV, and current treatments are very effective and safe. As a result, most people with HIV are living long and healthy lives. Treatment is recommended for everyone with HIV infection, and generally should be started as early as possible.
Medicines slow the growth of the virus or stop it from making copies of itself. Although these drugs don’t eliminate the virus from the body, they keep the amount of virus in the blood low. This protects the health of the person with HIV and also can prevent HIV from passing to sex partners.
The amount of virus in the blood is called the viral load, and it can be measured by a test.
There are several types of anti-HIV drugs. Each type attacks the virus in a specific way.
Pop question: True or false. HIV medicines eliminate virus from the body.
TrueFalse
Pop question: True or false. HIV medicines eliminate virus from the body.
Answer: FALSE. HIV drugs cannot eliminate HIV virus from the body, but they can reduce it to very, very low levels. The main goal of HIV drugs is to reduce viral load as much as possible for as long as possible.
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Hiv Medicines Prevent Mother
It is important pregnant women with HIV continue to take their HIV medication as prescribed by their doctor.
Most HIV medicines are safe to use during pregnancy. HIV medicines slow down the growth and multiplication of the HIV virus in the body and have reduced the rate of mother-to-child transmission of the virus in the U.S and Europe to less than 1%.
Babies born to women with HIV also receive HIV medicine for 4 to 6 weeks after birth. HIV medicine reduces the risk of infection from any HIV that may have entered a babys body during childbirth.
Why Is Hiv Not Spread By Mosquitos
Have you ever wondered why mosquito-transmitted infections were responsible for shutting down the first attempt to build the Panama Canal or are able to kill hundreds of thousands of children each year in Africa, yet no one has ever been infected with HIV from a mosquito bite?
The answer lies in the nature of the mosquito, but even more so in the nature of HIV.
If you were around during the early days of AIDS, especially in the early 1980s, before the means of transmission was firmly established, AIDS was pure terror. People were worried about eating in restaurants in Greenwich Village, swimming in pools, and even having an infected kid in the same classroom with their children. Looking back it seems almost impossible that Ryan White, a 13-year old boy who contracted HIV from a blood transfusion in 1984, would not be allowed to return to his school in Indiana because of parentsâ fear. Even as late as the 1990s the fear remained.
In 1991 Lakersâ star Magic Johnson revealed he had contracted HIV and immediately retired. But in 1992 Johnson came out of retirement to play in the NBA All-Star Game. During a mid-court tribute to Johnson, all the players walked onto the floor to hug him â one at a time. The expressions on many of their faces were unmistakable: âI donât want to hug this guy.â Other players told reporters off the record that they didnât want to guard him during the game.
Table 1. Some pathogens that are transmitted by mosquitos
NOTES:
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When To Start Hiv Treatment
Its now recommended that everyone diagnosed with HIV starts treatment straight away after being diagnosed.
In the UK, national guidelines set out standards for HIV treatment. They currently recommend that anyone with HIV who is ready to commit to treatment should start it regardless of their CD4 count .
Tips For Staying On Your Treatment Plan
Before you start a treatment plan, you should:
- Get your health care provider to write everything down for you: names of the drugs, what they look like, how to take them , and how often to take them. This way, you’ll have something to look at in case you forget what you’re supposed to do.
- With your provider’s help, develop a plan that works for you.
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How Hiv Medications Work
HIV medications primarily work by stopping the virus from replicating.
The virus targets the immune system by invading and destroying white blood cells called CD4 cells. These play an important role in fighting infections and keeping the body healthy.
After invading a white blood cell, the virus uses the cell to replicate itself. This allows HIV to multiply within the body. Over time, the immune system loses strength and is less able to fight off infections and disease.
Antiretroviral drugs stop the virus from replicating. This helps protect the immune system and prevent disease. When a person takes antiretroviral therapy effectively, the virus usually reaches undetectable levels in 36 months.
Due to modern advances in antiretroviral therapy, HIV-related complications, such as opportunistic infections , are less common. Increasing numbers of people never develop stage 3 HIV infection, also known as AIDS.
Modern antiretroviral therapy has made it possible for people with HIV to have life spans similar to those of people without the infection.
recommend that all people with HIV take antiretroviral therapy, regardless of how long they have had the virus and their current health.
Healthcare providers work with people to find an HIV regimen that best meets their needs.
As part of this process, a doctor may recommend drug-resistance testing. This identifies medications that may not be effective in treating a persons HIV.
Is It Safe To Take Prep For Hiv
Truvada and Descovy are generally safe, but some people may experience side effects. Some of these side effects may be serious.
Before starting Descovy or Truvada for PrEP, talk with a healthcare professional about any health conditions you have and the side effects and benefits of PrEP. For example, if you have serious kidney conditions, these medications may not be safe for you to take.
Also, if youve contracted hepatitis B in the past, let your doctor know. Stopping Truvada or Descovy may worsen a hepatitis B case.
A healthcare professional will monitor your liver function and can treat the hepatitis B case if it flares up.
Its important not to take PrEP medications if you live with HIV. This is because the drug may become resistant to the virus if you take it while you live with HIV.
You will have a blood test done before starting the medication and will retest at least every 3 months while youre taking it.
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Integrase Strand Transfer Inhibitors
Integrase inhibitors stop the action of integrase. Integrase is a viral enzyme that HIV uses to infect T cells by putting HIV DNA into the human DNA.
Integrase inhibitors are usually among the first HIV drugs used in people who have recently contracted HIV. This is because they work well and have minimal side effects.
The following drugs are integrase inhibitors:
- bictegravir
- dolutegravir
- tenofovir disoproxil fumarate
- zidovudine
As a stand-alone drug, tenofovir alafenamide fumarate has received full FDA approval to treat chronic hepatitis B but only tentative FDA approval to treat HIV. A person with HIV who takes tenofovir alafenamide fumarate will likely receive it as part of a combination HIV drug, not as a stand-alone drug.
Tenofovir disoproxil fumarate, emtricitabine, and lamivudine can treat hepatitis B as well.
Zidovudine was the first FDA-approved HIV drug. Its also known as azidothymidine or AZT. Zidovudine is rarely used in adults now. Its mainly given to babies born to HIV-positive mothers as a form of post-exposure prophylaxis .
How Do I Talk To My Partner About Their Risk Of Acquiring Hiv
People living with HIV can involve their partners in their treatment plans. Research shows that adhering to treatment often can improve with support from loving relationships and from the community.
Pre-exposure prophylaxis , in which an HIV-negative person takes antiretroviral medication to prevent infection, can be part of the conversation. Learn more about PrEP.
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