Prevention And Treatment Of Opportunistic Infections
Opportunistic infections are infections that do not usually affect healthy individuals. However, because HIV kills CD4+ immune cells, the immune system of HIV-positive individuals is weakened which gives certain infections the opportunity to infect them. A key way to avoid opportunistic infections is by getting up-to-date vaccinations. In order to avoid sexually-transmitted diseases, always practice safe sex. In addition, eating healthy and staying well-rested can help give your immune system the energy it needs to prevent opportunistic infections from taking hold. Quitting smoking, drinking, and other drugs will also help your immune system. If you need help with lifestyle changes, talk to your doctor about resources geared toward people living with HIV/AIDS.
One of the most common OIs for HIV-positive people is pneumocystis pneumonia . PCP is treated with antibiotics. If your CD4 count is especially low, your doctor may recommend that you start taking antibiotics as a preventative measure to avoid PCP infection. Other OIs include thrush, meningitis and herpes. Keep close tabs on your health, it is important to carefully track all of your symptoms in order to communicate them clearly to your doctor. OIs should not go untreated, as they can allow HIV to replicate faster.
Treatment Of Kaposi Sarcoma
For patients with epidemic Kaposi sarcoma, antiretroviral treatment for HIV/AIDS is usually used before any other treatment options to treat the tumor and reduce the patients symptoms. ART may be given alone or in combination with therapies using cancer medication, depending on the spread of the disease and the patients symptoms.
Rarely, ART can make preexisting infections and the Kaposi sarcoma worse. This reaction is called immune reconstitution inflammatory syndrome . If symptoms get worse in the first few weeks after starting ART, talk with your doctor.Specific treatments can include the following:
Is There A Cure For Hiv/aids
Currently, there is no cure for HIV/AIDS. However, there are many anti-HIV/AIDS treatment options available to help manage the disease. Also, there are ongoing research efforts to identify a cure or vaccine for HIV/AIDS. With the available treatment options, many HIV-positive individuals can lead long, healthy lives. Immediate treatment is critical for new patients. Each patients disease will be different so it is important to talk to your health care provider to determine the best treatment options, some of which are described below.
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How Do Hiv Medicines Work
HIV attacks and destroys the infection-fighting CD4 cells of the immune system. Loss of CD4 cells makes it hard for the body to fight off infections and certain HIV-related cancers.
HIV medicines prevent HIV from multiplying , which reduces the amount of HIV in the body . Having less HIV in the body gives the immune system a chance to recover and produce more CD4 cells. Even though there is still some HIV in the body, the immune system is strong enough to fight off infections and certain HIV-related cancers.
By reducing the amount of HIV in the body, HIV medicines also reduce the risk of HIV transmission. A main goal of HIV treatment is to reduce a persons viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partners through sex.
What Are The Symptoms Of Hiv
After the first month or so, HIV enters the clinical latency stage. This stage can last from a few years to a few decades.
Some people dont have any symptoms during this time, while others may have minimal or nonspecific symptoms. A nonspecific symptom is a symptom that doesnt pertain to one specific disease or condition.
These nonspecific symptoms may include:
- headaches and other aches and pains
- swollen lymph nodes
- recurrent oral or vaginal yeast infections
As with the early stage, HIV is still transferable during this time even without symptoms and can be transmitted to another person.
However, a person wont know they have HIV unless they get tested. If someone has these symptoms and thinks they may have been exposed to HIV, its important that they get tested.
HIV symptoms at this stage may come and go, or they may progress rapidly. This progression can be slowed substantially with treatment.
With the consistent use of this antiretroviral therapy, chronic HIV can last for decades and will likely not develop into AIDS, if treatment was started early enough.
The cause of the rash determines:
- how it looks
- how it can be treated depends on the cause
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Antiretroviral Therapy For Hiv/aids
Antiretroviral drugs are a successful treatment for reducing the amount of virus in the bloodstream, improving patient health, reducing mortality rates, preventing AIDS, and reducing rates of HIV transmission. ARVs work by preventing the HIV virus from getting its genetic information to human cells. Different ARVs work in different ways but they all result in blocking the virus from replicating itself to produce more virus and infect more human cells. ART effectively lowers viral counts and increases CD4+ T cell counts, thereby preventing progression to AIDS. Antiretroviral therapy typically consists of a combination of three or more ARV drugs. Combination treatment is sometimes called highly active antiretroviral therapy or a coctail. Some combinations of ARVs are available in a single pill, enhancing the ease of drug administration. Your doctor will determine the best combination of ARVs for you based on your HIV status, your viral load, CD4 count, lifestyle, other disease conditions, other medications you are currently taking and possible drug resistance. Now that there are multiple new ARV drugs which are highly effective in combination, many people who were previously considered un-treatable can now receive effective anti-HIV treatment. A list of approved ARVs is available here.
Side Effects And Costs
Side effects of antiretroviral therapy vary and may include nausea, headache, and dizziness. These symptoms are often temporary and disappear with time.
Serious side effects can include swelling of the mouth and tongue and liver or kidney damage. If side effects are severe, the medications can be adjusted.
Costs for antiretroviral therapy vary according to geographic location and type of insurance coverage. Some pharmaceutical companies have assistance programs to help lower the cost.
To develop AIDS, a person has to have contracted HIV. But having HIV doesnt necessarily mean that someone will develop AIDS.
Cases of HIV progress through three stages:
- stage 1:acute stage, the first few weeks after transmission
- stage 2: clinical latency, or chronic stage
- stage 3: AIDS
As HIV lowers the CD4 cell count, the immune system weakens. A typical adults CD4 count is 500 to 1,500 per cubic millimeter. A person with a count below 200 is considered to have AIDS.
How quickly a case of HIV progresses through the chronic stage varies significantly from person to person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it can last indefinitely.
Theres currently no cure for HIV, but it can be managed. People with HIV often have a near-normal lifespan with early treatment with antiretroviral therapy.
Also, treatment can typically help manage opportunistic infections.
HIV and AIDS are related, but theyre not the same thing.
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Symptoms Of Hiv Infection
Some people may not develop any symptoms after contracting HIV and could remain undiagnosed until the symptoms of AIDS appear. This could be up to 10 years later.
However, 50% or more of people living with HIV may develop mild flu-like symptoms within 2 to 4 weeks. Early symptoms may include:
- muscle aches
- swollen glands
The symptoms of HIV infection may last from a few days to weeks. They may go away on their own.
Misdiagnosis of early HIV infection is common. If you think you have HIV, speak with your health care provider about being tested.
Having A Medication Routine
Taking HIV medication as prescribed is essential missing even a few doses might jeopardize the treatment.
A person should design a daily medication-taking routine that fits their treatment plan and schedule.
Sometimes, side effects keep people from sticking with their treatment plans. If any side effect is hard to manage, contact a healthcare professional. They can recommend a more easily tolerated drug and suggest other changes to the treatment plan.
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Recommended Treatments For Hiv
- The British HIV Association provides guidelines for people starting or changing HIV treatment.
- There are several different options in the guidelines, including some two-drug regimens.
- The choice of medication should be individualised, taking into account side effects, other health issues, drug interactions and personal preferences.
Draft guidelines from the British HIV Association list a range of options for people taking HIV treatment. The draft was published in May 2022 and is open for consultation until 9 June 2022 the finalised guidelines will be published some time after that.
The guidelines include recommendations for the drug combinations to choose from when starting HIV treatment or when switching with undetectable viral load.
reverse transcriptase
A retroviral enzyme which converts genetic material from RNA into DNA, an essential step in the lifecycle of HIV. Several classes of anti-HIV drugs interfere with this stage of HIVs life cycle: nucleoside reverse transcriptase inhibitors and nucleotide reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors .
generic
In relation to medicines, a drug manufactured and sold without a brand name, in situations where the original manufacturers patent has expired or is not enforced. Generic drugs contain the same active ingredients as branded drugs, and have comparable strength, safety, efficacy and quality.
Except when mentioned below, the recommended medications need to be taken once a day.
Treatment Care And Prevention For People With Hiv
Clinicians: View CDCs clinical considerations for prevention and treatment of monkeypox in people with HIV.
Routine care and treatment is the best way to keep people with HIV healthy. PWH who take medication as prescribed can achieve and maintain an undetectable viral load will not transmit HIV to their sexual partners.
Access tools and resources from Prevention IS Care to help health care providers start the conversation with patients about HIV treatment, care, and transmission prevention.
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Starting And Staying On Antiretroviral Treatment
Antiretroviral treatment has transformed HIV infection from an almost uniformly fatal infection into a manageable chronic condition. Starting daily antiretroviral therapy as soon as possible after diagnosis and staying on treatment are essential for keeping HIV under control, which benefits individual health and prevents HIV transmission to others. NIAID-supported research has played a key role in optimizing antiretroviral drug regimens and in establishing the importance of early treatment and strict adherence. .
When To Start Treatment
Regular checkups will help your doctor monitor your health. Your checkups will likely include a physical exam and lab tests. Tests will check your CD4 count, viral load, and may see if your HIV strain is resistant to any HIV drugs. This information will help your doctor recommend a time to start treatment and come up with a plan. While there is ongoing debate and research about the best time to start, generally, you should start treatment if:
- You have severe symptoms of HIV infection or have been diagnosed with AIDS.
- You have had an AIDS-defining illness.
- Your CD4 count is 350 cells per cubic millimeter or less. Your CD4 count is a measure of your immune systems strength. Treatment should be started before HIV has done too much damage to your immune system. Your doctor may recommend that you start treatment when your CD4 drops below 500. Some experts recommend starting at even earlier stages of HIV disease, when CD4 counts are above 500. Ask your doctor about the benefits and risks of starting treatment at an earlier stage of HIV disease. Make sure to also ask about the importance of sticking to treatment.
- You are pregnant.
- You have HIV-related kidney disease.
- You are being treated for hepatitis B or hepatitis C.
Once you start treatment, you may need to continue taking HIV medicines for the rest of your life. So other things you will need to think about before starting treatment include:
Content last updated July 1, 2011.
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Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat the specific type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.
Adequate Quality Of Hiv Drugs Must Be Ensured
- Supplementary Materials
- References
EditorA large global health and AIDS fund would have a lasting impact on morbidity and mortality only if the potency of antiretroviral drugs and the quality of diagnostic tools were adequately monitored in the field.
With the exception of ritonavir, antiretroviral drugs require constant storage in a controlled temperature not exceeding 25-30oC.1 Inadvertent exposures to extremes of high temperature and humidity can affect drug potency. For example, in Nigeria and Thailand an assessment of the quality of chloroquine, amoxycillin, co-trimoxazole, ampicillin, and cloxacillinwhich have similar storage requirements to antiretroviral drugsfound that 35.5% of samples were substandard.2 Six samples of chloroquine contained no active ingredient at all. Substandard and fake drugs are found in Latin America, Africa, and Asia.3 If the quality of antiretroviral drugs was poor this might lead to therapeutic or prophylactic failure and the emergence of resistant strains of HIV.
Establishing an effective HIV treatment service requires high quality kits and reagents for diagnosing and monitoring HIV/AIDS. The sensitivity and specificity of HIV assays decline if they are inappropriately stored or used after their expiry date. This decline compromises the reliability of blood testing for HIV before blood transfusions.4
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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
- cabotegravir
- dolutegravir
- elvitegravir
- raltegravir
These drugs belong to a well-established category of integrase inhibitors known as INSTIs. Other, more experimental categories of integrase inhibitors include integrase binding inhibitors , but there are no FDA-approved INBIs to treat HIV.
NRTIs are sometimes referred to as nukes. They work by interrupting the life cycle of HIV as it tries to copy itself. These drugs also have other actions that prevent HIV from replicating in the body.
The following drugs are NRTIs:
- 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.
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.
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