How Do Hiv/aids Medicines Work
HIV/AIDS medicines reduce the amount of HIV in your body, which helps by
- Giving your immune system a chance to recover. Even though there is still some HIV in your body, your immune system should be strong enough to fight off infections and certain HIV-related cancers.
- Reducing the risk that you will spread HIV to others
What Are The Types Of Hiv/aids Medicines
There are several different types of HIV/AIDS medicines. Some work by blocking or changing enzymes that HIV needs to make copies of itself. This prevents HIV from copying itself, which reduces the amount of HIV in the body. Several medicines do this:
- Nucleoside reverse transcriptase inhibitors block an enzyme called reverse transcriptase
- Non-nucleoside reverse transcriptase inhibitors bind to and later change reverse transcriptase
- Integrase inhibitors block an enzyme called integrase
- Protease inhibitors block an enzyme called protease
Some HIV/AIDS medicines interfere with HIV’s ability to infect CD4 immune system cells:
- Fusion inhibitors block HIV from entering the cells
- CCR5 antagonists and post-attachment inhibitors block different molecules on the CD4 cells. To infect a cell, HIV has to bind to two types of molecules on the cell’s surface. Blocking either of these molecules prevents HIV from entering the cells.
- Attachment inhibitors bind to a specific protein on the outer surface of HIV. This prevents HIV from entering the cell.
In some cases, people take more than one medicine:
- Pharmacokinetic enhancers boost the effectiveness of certain HIV/AIDS medicines. A pharmacokinetic enhancer slows the breakdown of the other medicine. This allows that medicine to stay in the body longer at a higher concentration.
- Multidrug combinations include a combination of two or more different HIV/AIDS medicines
Patients Cured Of Hiv Infection
The so-called “Berlin patient” has been potentially cured of HIV infection and has been off of treatment since 2006 with no detectable virus. This was achieved through two bone marrow transplants that replaced his immune system with a donor’s that did not have the CCR5 cell surface receptor, which is needed for some variants of HIV to enter a cell. Bone marrow transplants carry their own significant risks including potential death and was only attempted because it was necessary to treat a blood cancer he had. Attempts to replicate this have not been successful and given the risks, expense and rarity of CCR5 negative donors, bone marrow transplant is not seen as a mainstream option. It has inspired research into other methods to try to block CCR5 expression through gene therapy. A procedure zinc-finger nuclease-based gene knockout has been used in a Phase I trial of 12 humans and led to an increase in CD4 count and decrease in their viral load while off antiretroviral treatment. Attempt to reproduce this failed in 2016. Analysis of the failure showed that gene therapy only successfully treats 11-28% of cells, leaving the majority of CD4+ cells capable of being infected. The analysis found that only patients where less than 40% of cells were infected had reduced viral load. The Gene therapy was not effective if the native CD4+ cells remained. This is the main limitation which must be overcome for this treatment to become effective.
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Where To Find Other Types Of Hiv Support
Those with HIV might be looking for support that goes beyond paying for care. Financial support is vital, but its not the only care available.
Support groups, mental health resources, health management apps, and dating apps, can also make a huge impact. They can help remind those with HIV that theyre not in this alone and provide the emotional and social support needed when managing HIV.
Funding For The Hiv Response In The Usa
Funding for the HIV response has increased significantly over the course of the epidemic. Primarily, this growth has been driven by increased spending on mandatory domestic care and treatment programmes, as more people are living with HIV in the USA, as well as by greater investments to combat HIV in low and middle-income countries.135
The USAs domestic HIV budget includes funding for HIV care, housing support, HIV prevention and research.136 In May 2017, President Trump released his first federal budget request for the 2018 financial year, which included an estimated US $32 billion for combined domestic and global HIV efforts. The proposal signalled a decrease in funding for HIV of US $834 million, or 2.5%. Most of the cuts were made to the USAs global spending for the HIV response . Domestic discretionary programmes faced a US $789 million or 10% reduction, although mandatory funding was set to increase.137 The budget was rejected by Congress and spending remained at levels similar to the 2017 financial year.138
President Trumps proposed budget for the 2019 financial year, submitted in February 2018, again suggested spending cuts. This includes cutting US $40 million from CDCs HIV prevention programme, and US $26 million from a federal housing programme for people living with AIDS. It also includes cutting global HIV programmes by US $1 billion.139 However, this was rejected by Congress.140
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Medications For Hiv Infection
Other names: Acquired Immune Deficiency Syndrome Acquired Immunodeficiency Syndrome Acute HIV Infection Acute Retroviral Syndrome AIDS AIDS-Related Complex ARC Chronic Symptomatic HIV Infection HIV HIV Infection, Acute HIV Seroconversion Syndrome HIV/AIDS Human Immunodeficiency Virus Infection Primary HIV Infection
HIV stands for human immunodeficiency virus. It is a virus that attacks the immune system, specifically CD4 cells , which eventually reduces a persons ability to fight infection. HIV can progress to AIDS if left untreated.
Important Questions To Ask Your Doctor
Ask your doctor to tell you what you should know about your HIV medicines.
- What medicines am I taking to treat HIV?
- When should I take each medicine?
- Should I take my medicines with food?
- Which prescription medicines, herbs , over-the-counter medicines , or vitamins can affect my HIV medicines? Can my HIV medicines affect any of the other medicines I take?
- How should I store my HIV medicines? What about when I am away from home or go out of town?
- What are the side effects of the medicines I am taking?
- What should I do if I start having bad side effects?
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Nucleoside Reverse Transcriptase Inhibitors
| Brand Name |
|---|
| abacavir sulfate |
* Cimduo, Combivir, Descovy, Epzicom, Temixys, Trizivir, and Truvada are combination medicines.
For more information about the risks and side effects for each medicine, check
This information does not give the specific side effects or warnings for each medicine. Check the medicine label and talk to your healthcare provider about the side effects and warnings for the combination HIV medicines you are taking.
IMPORTANT TIPS
- Talk with your healthcare provider about being tested for HLA-B*5701 prior to taking abacavir or medicines containing abacavir.
- These medicines may cause lactic acidosis .
- These medicines may cause serious liver, pancreas, or kidney problems.
- If you have kidney problems or liver problems, such as hepatitis, talk to your healthcare provider before taking these medicines.
- These medications are taken by mouth. Retrovir can also be given as an intravenous infusion.
WARNING SIGNS
- Stomach pain with nausea and vomiting
- Feeling very weak or tired
- Problems breathing
| nevirapine |
For more information about the risks and side effects for each medicine, check
This information does not give the specific side effects or warnings for each medicine. Check the medicine label and talk to your healthcare provider about the side effects and warnings for the combination HIV medicines you are taking.
IMPORTANT TIPS
WARNING SIGNS
- Flu-like symptoms
| nelfinavir mesylate |
* Evotaz, Kaletra, and Prezcobix are combination medicines.
IMPORTANT TIPS
Start By Identifying Your Eligibility For Assistance
A popular misconception is that HIV assistance programs are meant to help only the lowest-income Americans. And while its true that many federal- and state-run programs limit access to those living at or below the federally prescribed poverty line, its not always the case.
Given the high cost of HIV treatment and care, a surprising number of benefits are available to individuals whose annual income is around $64,400 or families that have an annual income of around $87,100. This is because benefits are typically provided to those whose modified adjusted gross income is lower than 200% to 500% of the federal poverty level .
To clarify, modified annual gross income is not the total amount of money you and your spouse make over the course of a year. Rather it is the adjusted gross income found on your annual tax return plus the following add-backs:
- Non-taxable Social Security benefits
- Tax-exempt interest
- Exclude
With these figures in hand, you can calculate your MAGI and determine whether it falls beneath the FPL threshold prescribed by a particular federal, state, or privately funded program. Simply multiply your MAGI by the prescribed threshold to see if you qualify.
The federal poverty level , meanwhile, is a measure issued by the U.S. Department of Health and Human Services to determine whether an individual or family is eligible for federal assistance programs like Medicaid. In 2020, the DHHS set the following FPL guidelines for individuals and families:
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Get Hiv Care And Treatment
The Ryan White HIV/AIDS Program works with cities, states, and local community-based organizations. The Program provides primary medical care and essential support services to more than half a million people each year. Through the Program, people living with HIV who have no insurance or are underinsured can get the HIV medical care and other support services they need.
Changing Attitudes About Hiv
When someone is diagnosed with HIV, other people may have negative attitudes and beliefs about that person’s behaviour, lifestyle or circumstances in life. These negative associations form what’s called stigma, an experience that can decrease quality of life because it includes:
- judging
Efforts to end stigma will help to:
- prevent new infections
- ensure that people living with HIV receive the care, treatment and support they need
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The Cost Of Hiv Treatment
HIV treatment
Forty years ago, HIV and AIDS were unheard of in the United States. The first cases of what was then a mysterious illness were diagnosed in the 1980s, but effective treatments took several more decades to develop.
A cure for HIV doesnt yet exist, but treatments are available to extend the lives of those with HIV and help stop transmission of the virus. Many of the highly active antiretroviral therapies available today work effectively to slow the progression of disease caused by HIV.
But all treatments come with a cost some more than others. Lets take a look at the average costs of HIV treatment and potential ways to save money.
Generic Antiretrovirals And Multi
In 2017, savings to the U.S. health care system generated by the use of generic drugs and biosimilar products totaled $265 billion, including $40.6 billion and $82.7 billion in savings to Medicaid and Medicare, respectively.27
With substantial improvements in the long-term safety and effectiveness of contemporary ART, a number of regimens and regimen components in Table 6 remain listed beyond their patent protection date and are or will be available as lower-cost generic options. In one study, the savings associated with a transition to a hypothetical lower-cost generic ART could potentially help cover the 20-year, $480 billion projected costs to reach national treatment targets.5
Some research informs the cost impact of using specific generic ARV regimens or regimen components. In a cost-effectiveness analysis conducted before the availability of integrase strand transfer inhibitors , the use of generic efavirenz had an estimated saving of nearly $1 billion, and a regimen with generic EFV was very cost-effective.2 A more recent study describes a 25% reduction in both the wholesale acquisition cost and federal supply schedule cost associated with switching from branded coformulated dolutegravir/abacavir/lamivudine to branded DTG plus generic ABC and generic 3TC.2, 28
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Hiv And Tuberculosis In Brazil
Brazil is one of the 20 worst affected countries for both TB and TB/HIV co-infection, according to the World Health Organization .74 It was the first high-burden country to offer ART to all HIV-positive people with TB.75
In 2016, 87,000 people were diagnosed with TB in Brazil, 13% of whom were living with HIV, although new infections of TB and TB/HIV are declining. In 2015, less than 50% of TB patients living with HIV had access to ART. As a result, 1,900 of the AIDS-related deaths in 2016 were the result of TB.76
Whats The Treatment For Hiv
Theres no cure for HIV, but there are treatments that help people with HIV live long, healthy lives. Antiretroviral therapy is a combination of medicines that slows down the effects of HIV in your body and can help you stay healthy for many years. It can also lower or even stop your chances of giving HIV to anyone else.
ART lowers the amount of HIV in your body sometimes to the point where HIV wont show up on standard blood tests. If your HIV viral load is so low that certain tests cant see it, its called undetectable. When someone has an undetectable viral load, they cant spread HIV to others during sex.
Its important to remember that even with an undetectable viral load, HIV is still present in your body. If you stop treatment your viral load can go up, making it possible to pass HIV to others you have sex with. Your doctor or nurse can help you find the treatment thats best for you to help keep your viral load low, so you can stay healthy.
Paying attention to your lifestyle can help you stay healthy too. This means eating well, getting enough sleep, exercising, learning how to deal with stress, and avoiding alcohol, smoking, and drugs.
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Aids Drug Assistance Program
The Ryan White HIV/AIDS Program includes the AIDS Drug Assistance Program , which is funded by the federal government to help pay for HIV drugs for people who might not be able to afford them otherwise. This fund may even be used to pay for health insurance premiums for eligible clients in some cases.
Each US state provides its own coverage, and your local ADAP office can let you know which drugs it pays for and what the income limits are for your state. If you become part of the ADAP program, you will need to recertify every six months. Your local ADAP office can support you in this process as well.
In the past, some states have had a waiting list for ADAP. In other states, the ADAP program is big enough to cover not only HIV drugs, but also laboratory work, some medical care, and non-HIV medications, like those used to manage side effects and other chronic diseases.
The Ryan White program can also pay for doctor visits and support services for people living with HIV. In some instances, family members who are not living with HIV can receive support through a Ryan White program for women and/or children living with HIV. To find out more about the Ryan White program in your state, call your state’s HIV/AIDS hotline.
Who Is At Risk For Hiv
HIV can infect any person, no matter their age or gender or sexual preference. It is spread sexually, and by contact with infected blood, from mother to child during pregnancy, during childbirth, or through breast-feeding.
People have a higher risk of contracting HIV if they:
- Have sex. Even condoms dont provide 100% protection against HIV and the virus can enter your body through mouth sores following oral sex.
- Have a blood transfusion, especially in certain countries overseas. The risk in America is very small as hospitals and blood banks now screen the blood supply for HIV antibodies.
- Are pregnant and are HIV positive. Treatment for HIV during pregnancy significantly lowers the risk of passing on the infection to their babies
- Have a sexually transmitted infection . STIs act as a gateway to HIV infection because they compromise tissues or break the skin barrier in your genital area
- Are an uncircumcised man. Research has shown this increases the transmission of HIV.
HIV cannot be spread through hugging, kissing, dancing or shaking hands with someone who has the infection. It is also not spread through insect bites, air, or water.
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Assistance For Individuals Living With Hiv
Approximately half of all individuals taking Gilead HIV medicines in the United States receive them through federal and state programs at substantially discounted prices. We have a long history of working with state AIDS Drug Assistance Programs to provide lower pricing for our HIV medicines.
The Gilead Truvada for PrEP Medication Assistance Program helps eligible HIV-negative adults in the United States who do not have insurance to obtain access to Truvada for PrEP. Gilead also offers a copay assistance program to help eligible patients with insurance offset out-of-pocket costs. Gilead recently enhanced these programs to ensure the assistance provided for Truvada is consistent, regardless of whether an individual needs access for prevention or treatment. The number of people prescribed Truvada for PrEP has increased to more than 153,000 in the United States.
Hiv And Sex Education
The status of sexual health education varies substantially throughout the USA and is insufficient in many areas. In most states, fewer than half of high schools teach all 16 topics CDC recommends for effective sex education. Many also argue that sex education is not starting early enough.71
The percentage of schools in which students are required to receive instruction on HIV prevention is decreasing, from 64% in 2000 to 41% in 2014.72
Conservative support for abstinence-only sex education has also been a major barrier to progress, and has been shown to be associated with increased HIV rates among adolescents.73
President Obama eliminated three-quarters of the budget for abstinence-only sex education in 2009, which had previously received the majority of funding.7475 However, funding for abstinence-only sex education began to rise again in the following years and stood at US $85 million in 2016.76
In February 2018, this was renewed for two more years at US $75 million annually under the new name of sexual risk avoidance education.77 As of 2019, 37 states require that information on abstinence be provided, 27 of which require for abstinence to be emphasised, with the 10 remaining states requiring that abstinence is covered. In contrast, only 12 states require discussion of sexual orientation. Of these, nine states require that discussion be inclusive.78
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