Understanding Hiv Drug Resistance
A change in medications to avoid certain side effects isnt always the best solution, Dr. Grinspoon says. In HIV, you can develop resistance to therapeutics if you keep switching therapies, he explains.
Per HIVinfo.NIH.org, drug resistance in HIV typically occurs when the virus has the opportunity to mutate and multiply, and a medicine that was previously working no longer does what it should. The risk of drug resistance increases when you dont take an HIV medication exactly as directed, or you skip doses, start and stop using ART, or switch medications often.
If an HIV treatment plan that was once effective no longer seems to be, tell your doctor. Blood tests can identify drug resistance and help determine other effective HIV treatment options for you.
What Should I Tell My Healthcare Provider Before Taking Truvada For Prep
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney, bone, or liver problems, including hepatitis.
- If you are pregnant or plan to become pregnant. It is not known if TRUVADA can harm your unborn baby. If you become pregnant while taking TRUVADA for PrEP, tell your healthcare provider.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed if you think you may have recently become infected with HIV. HIV can be passed to the baby in breast milk. Talk to your healthcare provider about the risks and benefits of breastfeeding while taking TRUVADA for PrEP.
- All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TRUVADA may interact with other medicines. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
- If you take certain other medicines with TRUVADA, your healthcare provider may need to check you more often or change your dose. These medicines include certain medicines to treat hepatitis B or C infection.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call .1-800-FDA-1088.
Tips For Managing Side Effects At Home
In most cases, minor side effects can be managed with these tips:
- For a headache, make sure to drink enough fluids. Rest in a darkened room and take an over-the-counter pain reliever.
- For fatigue, try to get some low-impact exercise on most days. This will give you more energy and help you sleep better.
- If you have trouble sleeping, limit all fluids 2 hours before bed. Avoid caffeinated beverages in the afternoon and evening. Avoid heavy meals in the evening. Keep your bedroom quiet, dark and comfortable.
- For nausea, eat smaller and more frequent meals. Avoid heavy, greasy, spicy and acidic foods. Try adding some ginger to your diet, such as ginger ale or ginger tea. If you have poor appetite, supplement your diet with a protein shake.
- For diarrhea, add fiber to your diet from bananas, white rice, applesauce and white bread or toast. Avoid milk and dairy products. Avoid high-fiber foods like whole grains and brown rice and foods that are high in sugar and fat.
- For skin rashes, drink plenty of fluids. Avoid dry skin from long hot showers, strong soaps and skin products with alcohol. Use a moisturizing skin lotion. Protect your skin from the sun with sunscreen.
- For dry mouth, swish some warm salted water throughout the day. You can also try some crushed ice. Use a sugarless candy or lozenge to keep your mouth moist. Try licorice tea or an OTC mouth moisturizing product.
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What Is The Most Important Information I Should Know About Truvada For Prep
Before and while taking TRUVADA for PrEP:
- You must be HIV negative before you start and while taking TRUVADA for PrEP. Do not take TRUVADA to reduce the risk of getting HIV-1 unless you are confirmed to be HIV negative.
- Get tested for HIV-1 immediately before and at least every 3 months while taking TRUVADA.
- If you think you were exposed to HIV-1, tell your healthcare provider right away. They may do more tests to confirm that you are still HIV negative.
TRUVADA can cause serious side effects:
Changing Treatment Due To Side
Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working.
Your doctor can usually do something about side-effects, so it makes good sense to mention any that youre experiencing. If side-effects do persist, changing treatment may be an option. All anti-HIV drugs can cause side-effects, so it is possible that the drug you switch to might involve a risk of side-effects as well.
If your viral load is undetectable and you have no resistance to anti-HIV drugs then you should be able to switch to a different treatment. But dont stop taking your anti-HIV drugs without talking to your doctor.
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Managing The Side Effects
A healthcare provider can give advice and other forms of support to people experiencing side effects from HIV treatment. If the symptoms are severe or ongoing, they may recommend alternative medications.
It helps for people to discuss their lifestyle, needs, preferences, and current health status with their healthcare provider, who can take these into account when prescribing a treatment plan.
Antiretroviral drugs can interact with other substances, including:
- other medications
- supplements
- herbal products
To avoid interactions, people should discuss all current medications and supplements with their healthcare provider, as these can influence how HIV medications work. In some cases, they can cause adverse reactions.
Some HIV drugs may also make hormonal birth control less effective. Therefore, people who use hormonal birth control may need to use a different method to prevent pregnancy.
There is
recommend that all people with HIV take antiretroviral therapy, regardless of how long they have had the virus or their current health status.
This includes the following groups:
- people in the early stages of HIV
- people who are pregnant or breastfeeding
- people with stage 3 HIV
- people with HIV-related infections or cancers
Ideally, a person should begin antiretroviral therapy on the day they receive a diagnosis of HIV, or as soon as possible after this. This gives people the best chance of reducing their viral load and risk of complications.
Highly Active Antiretroviral Therapy
In 1996, highly active antiretroviral therapy was introduced for people with HIV and AIDS. HAART â often referred to as the anti-HIV “cocktail” â is a combination of three or more drugs, such as protease inhibitors and other anti-retroviral medications. The treatment is highly effective in slowing the rate at which the HIV virus replicates itself, which may slow the spread of HIV in the body. The goal of HAART is to reduce the amount of virus in your body, or the viral load, to a level that can no longer be detected with blood tests.
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The Effects Of Hiv On The Body
Most people are likely familiar with HIV, but they may not know how it can affect the body.
HIV destroys CD4 cells , which are critical to the immune system. CD4 cells are responsible for keeping people healthy and protecting them from common diseases and infections.
As HIV gradually weakens the bodys natural defenses, signs and symptoms will occur.
Find out what happens when the virus enters the body and interrupts its systems.
Once HIV enters the body, it launches a direct attack on the immune system.
How quickly the virus progresses will vary by:
- a persons age
- how quickly theyre diagnosed
The timing of their treatment can make a huge difference as well.
HIV targets the types of cells that would normally fight off an invader such as HIV. As the virus replicates, it damages or destroys the infected CD4 cell and produces more virus to infect more CD4 cells.
Without treatment, this cycle can continue until the immune system is badly compromised, leaving a person at risk for serious illnesses and infections.
Acquired immunodeficiency syndrome is the final stage of HIV. At this stage, the immune system is severely weakened, and the risk of contracting opportunistic infections is much greater.
However, not everyone with HIV will go on to develop AIDS. The earlier a person receives treatment, the better their outcome will be.
Early on, HIV symptoms may be mild enough to be dismissed.
What Is U=u And What Does It Mean For Me
U=U stands for Undetectable = Untransmittable.
U=U is a public health campaign to spread the message that if your blood tests show you have no detectable HIV then you cant infect anyone else with HIV .
The best way to keep your HIV viral load at an undetectable level is by taking your antiretroviral medicines exactly as prescribed.
If your HIV viral load is undetectable, then you can have sexual intercourse with no risk of spreading HIV to your partner. Its still important to remember that unprotected intercourse still puts you at risk of catching or passing on other sexually transmitted infections .
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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.
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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What Is Truvada For Prep
TRUVADA for PrEP is a once-daily prescription medicine for adults and adolescents at risk of HIV who weigh at least 77 pounds. It helps lower the chance of getting HIV through sex. You must be HIV negative before and while taking TRUVADA for PrEP.
To help determine if TRUVADA for PrEP may be an option for you, talk openly with your healthcare provider about your risk for HIV-1.
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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The 10 Most Common Side Effects Of Hiv Medication
Turns out, most aren’t as common as you think.
There are actually side effects to almost all new medications, so its not uncommon to feel aches and pains, headaches, stomachaches, or fatigue for a few days . Anything beyond that and you should tell your doctor. One 2008 study showed that 60 percent of people on antiretrovirals had diarrhea, but that was before the Food and Drug Administration approved Fulyzaq, the first antidiarrheal drug for people with HIV.
Side effects to HIV meds used to be brutal if you lived through the last few decades, you probably remember but with newer medications on the market, the majority of people will not experience any serious side effects. If you do, your doctor should help you find a treatment that works for you without them.
AIDS.gov has a list of the most common long-term effects of HIV meds on some users, which include lipodystrophy insulin resistance increases in cholesterol or triglycerides decreases in bone density , and lactic acidosis .
Bottom line: They are rarely severe, but if you have any side effect longer than a few weeks, dont just assume you have to just put up with it ask your doctor about it.
Effects On The Immune System
HIV primarily affects the body by targeting and damaging cells in the immune system. The immune system protects the body against viruses, bacteria, and fungi.
After attaching itself to a type of white blood cell called a CD4 T cell, the virus merges with it. These T cells are an important part of the immune system.
Once inside the CD4 T cell, the virus multiplies. It damages or destroys the cell, then moves on and targets other cells.
A persons CD4 T-cell count is an indication of the health of their immune system.
A healthy CD4 T-cell count is 5001,600 cells/mm3 of blood. If a person does not receive treatment for HIV, their CD4 T-cell count drops over time.
When it drops below 200 cells/mm3, the persons immune system is significantly impaired, making them more susceptible to opportunistic infections.
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What Should I Tell My Healthcare Provider Before Taking Biktarvy
- All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney or liver problems, including hepatitis virus infection.
- All the medicines you take, including prescription and over-the-counter medicines, antacids, laxatives, vitamins, and herbal supplements. BIKTARVY and other medicines may affect each other. Keep a list of all your medicines and show it to your healthcare provider and pharmacist, and ask if it is safe to take BIKTARVY with all of your other medicines.
- If you are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking BIKTARVY.
- If you are breastfeeding or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1800FDA1088.
What Are Antiretrovirals And Why Do I Need Them
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 medicines used to fight HIV are called antiretrovirals. They work to stop the virus multiplying. This helps protect your immune system from damage caused by HIV.
The medications used to treat HIV and AIDS may be similar.
If there is damage to your immune system, medicines can help stop further damage and even allow your immune system to partly repair itself.
Theres no cure for HIV and AIDS, but if youre careful to take your HIV medicines regularly, youre likely to live a long, healthy life, like most HIV-positive people in Australia.
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Youve Come A Long Way Baby
Antiretroviral therapy has indeed come a long way in the last 25 years. ART has allowed for individuals who are HIV-positive to live longer lives. New ART medicines and classes of ART have been created to help in the fight against HIV. The development of new classes of ART allows for the virus to be attacked in different ways. Not attacking the virus from different directions at one time has shown us time and again to not work. So combining ART has worked, but at a price.
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Switching Antiretroviral Drugs Due To Adverse Effects
Some patients experience treatment-limiting toxicities associated with ART. In these cases, ART must be modified. ART-associated adverse events can range from acute and potentially life-threatening to chronic and insidious. Serious life-threatening events require the immediate discontinuation of all ARV drugs and re-initiation of an alternative regimen without overlapping toxicity. Toxicities that are not life-threatening can usually be managed by substituting another ARV agent for the presumed causative agent without interrupting ART. Other chronic, nonlife-threatening adverse events can be addressed either by switching the potentially causative agent for another agent or by managing the adverse event with pharmacological or nonpharmacological interventions. Management strategies must be individualized for each patient.
Table 21 lists several major ART-associated adverse events and the options for appropriate switches between agents in an ARV regimen. The table focuses on the ARVs most commonly used in the United States and lists substitutions that are supported by ARV switch studies, the findings of comparative ARV trials and observational cohort studies, or expert opinion. Switching agents in an effective ARV regimen should be done carefully and only when the potential benefits of the change outweigh the potential risks of altering treatment.
| Adverse Event |
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