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.
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
The Difference Between Aids And Hiv
Before looking at treatments of HIV and AIDS, one should know characteristics of each virus and the difference between the two. HIV is the virus that infects the body and destroys white blood cells in the body which leaves your body defenseless against incoming opportunistic infections. AIDS, also known as Acquired Immunodeficiency Syndrome is the final stage of HIV. One has AIDS when they acquire a disease or infection while having HIV or their CD4 cell levels drop below 200/cc. Not everyone who has HIV has AIDS, but everyone who has AIDS will have HIV . It is similar to the fact that every square is a rectangle, but not every rectangle is a square. Concluding sentence
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What Is The Best Hiv Treatment To Start With
The drugs used to treat HIV are called antiretroviral drugs . There are several different types and they work in different ways. HIV treatment is made up of three or more antiretroviral drugs normally combined into one pill.
There are lots of antiretroviral drugs, and they can be combined in different ways. The World Health Organization recommends that adults and adolescents starting HIV treatment take a combination of HIV drugs with dolutegravir as one of the main components. Your healthcare worker will help you to find the best treatment for you.
General Prevention Guidelines By Type Of Epidemic
Generally, it is more important to change the behavior of people who have highlevels of risk behavior than it is to change that of people with lower levels ofrisk behavior. However, the difference in the effectiveness between the twofalls as epidemics become more generalized, and as the average and maximum sizeof the connected components . Thus, in heavilyaffected countries, or those where the virus has the potential to spreadrapidly, prevention interventions are likely to become extremely cost-effectiveeven when targeted at individuals with relatively low levels of risk behavior.Consequently, countries with low-level and concentrated epidemics shouldemphasize interventions that target individuals at especially high risk ofbecoming infected or of transmitting the virus, whereas countries withgeneralized epidemics should also invest heavily in interventions that targetentire populations or population subgroups. Thus, any determination of thelikely effectiveness and cost-effectiveness of specific interventions inparticular circumstances requires an accurate understanding of the stage andnature of the national epidemic.
Generalized Low-Level Epidemic
In a generalized low-level epidemic, such as in some countries in Sub-SaharanAfrica , the emphasis on targeted interventions mustbe maintained or even strengthened. Interventions for broader populationsmust also be aggressively implemented. These prevention priorities shouldinclude the following:
Generalized High-Level Epidemic
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Drugs When Starting Treatment
- ART is recommended for all people with HIV to reduce the chances of severe illness, death, and transmission.
- People with a new diagnosis of HIV should start ART as soon as possible.
- Genetic testing is recommended at the beginning of treatment to screen for potential drug resistance.
- Medical professionals should discuss future pregnancy plans with patients who are able to become pregnant. A pregnancy test may be performed before starting HIV treatment.
Does Art Cause Side Effects
Like most medicines, antiretroviral therapy can cause side effects. However, not everyone experiences side effects from ART. The HIV medications used today have fewer side effects, fewer people experience them, and they are less severe than in the past. Side effects can differ for each type of ART medicine and from person to person. Some side effects can occur once you start a medicine and may only last a few days or weeks. Other side effects can start later and last longer.
If you experience side effects that are severe or make you want to stop taking your HIV medication, talk to your health care provider or pharmacist before you miss any doses or stop taking the medication. Skipping doses or starting and stopping medication can lead to drug resistance, which can harm your health and limit your future treatment options.
Some side effects of ART that are most commonly reported include:
- Nausea and vomiting,
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Starting Antiretroviral Treatment For Hiv
FAST FACTS;
- Antiretroviral treatment keeps HIV under control, protecting your immune system so that you can stay healthy and live a long life.
- People living with HIV are advised to start treatment straight away, but some people may need time to process their diagnosis before they feel ready.
- There are lots of different antiretroviral drug combinations. Your healthcare worker will help you find the right one for you.
Its normal to have lots of questions before starting HIV treatment. Your healthcare workers are there to talk to you about any concerns you have and answer your questions. The information on this page should help you to think through what you need to know and the questions youd like to ask.
What Are The Current Dhhs Guidelines For Treating Hiv
The main goal of the DHHS guidelines is to offer recommendations to healthcare professionals on the best treatment options for people with HIV. The guidelines are written and updated based on the most recent scientific evidence.
Doctors can consult these guidelines to determine the right treatment at various stages of HIV. For example, the guidelines provide recommendations on when to start antiretroviral therapy , which drugs should be used, and what to do if initial treatment isnt working.
The full guidelines provide a long list of recommendations you can read here. Weve summarized some key points below so you can get an idea of the type of information these guidelines include.
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What Health Professionals Need To Know About Hiv And Aids
The human immunodeficiency virus is a blood-borne infection that can be transmitted:
- sexually
- to an unborn child during pregnancy or delivery
- through sharing substance use equipment
Acquired immune deficiency syndrome is a long-term sequela of infection.
Consider and discuss HIV testing as part of routine medical care. Early diagnosis and initiation of antiretroviral therapy can lead to reduced morbidity and mortality associated with:
- HIV infection
- disease progression to AIDS
Timely awareness of serostatus can reduce HIV transmission due to reduction in risk behaviour. In addition, ART reduces transmission. People who adhere to treatment and who achieve and maintain an undetectable viral load have effectively no risk of transmitting the infection sexually.
Why Is Hiv Treatment Important
Getting and staying on HIV treatment because it reduces the amount of HIV in your blood to a very low level. This keeps you healthy and prevents illness. There is also a major prevention benefit. People living with HIV who take HIV medication daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners. This is called treatment as prevention.
If left untreated, HIV attacks your immune system and can allow different types of life-threatening infections and cancers to develop. If your CD4 cell count falls below a certain level, you are at risk of getting an opportunistic infection. These are infections that dont normally affect people with healthy immune systems but that can infect people with immune systems weakened by HIV infection. Your health care provider may prescribe medicines to prevent certain infections.
HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV and manage it effectively.
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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 .
What Is An Undetectable Viral Load
The aim of HIV treatment is to make you undetectable. This means that your viral load is so low that it cant be detected by the tests used to measure it.
Different laboratories may have different cut off points when classifying an undetectable viral load. However, most clinics in the UK classify undetectable as being below 20 copies/ml.
When you’re on effective treatment and have an undetectable viral load, you cannot pass on the virus and HIV is not able to damage your immune system.
A large study called PARTNER looked at 888 gay and straight couples where one partner was HIV positive and one was HIV negative. Results found that where the HIV positive partner was on treatment and had an undetectable viral load, there were no cases of HIV transmission whether they had anal or vaginal sex without a condom.
A follow-up study PARTNER 2 also reported zero transmissions after almost 800 gay couples had sex more than 77,000 without condoms.
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The Evolution Of Hiv Treatments
Thirty years ago, healthcare professionals didnt have encouraging news to offer people whod received a positive diagnosis of HIV. Today, its a manageable health condition.
Theres no HIV or AIDS cure yet. However, remarkable advancements in treatments and clinical understanding of how HIV progresses are allowing people with HIV to live longer, fuller lives.
Lets look at where HIV treatment is today, the effects new therapies are having, and where treatment may be headed in the future.
What Are The Current Treatments For Hiv/aids How Effective Are They
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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
Pharmacologic Enhancers Or Drug Boosters
Ritonavir , taken in a low dose, increases blood levels of lopinavir and the drug LPV/r .
- Zidovudine + Lamivudine or ZDV/3TC
Descovy and Truvada have also been approved as ways to prevent HIV infection for people who are at high risk. But if you take either of them, you have to practice safe sex, too.
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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.
Gaining More Coverage For Hiv Prevention Medication
As the HIV community awaits for the approval of long-acting injectable cabotegravir, a new rule will make current HIV prevention treatments more accessible. Private insurers are now gearing up to offer full coverage for these treatments, also known as PrEP, including Gileads Truvada and Descovy, as well as Tevas newly available generic version of Truvada, for patients at high risk of acquiring HIV.
Coverage of PrEP, which reduces the risk of acquiring by HIV by more than 90%, will likely have significant implications for many patients at risk of HIV, as out-of-pocket costs for the treatments can run patients $1,000 each year even with insurance because insurance does not always cover the full price of the treatment.
The move follows the U.S. Preventive Services Task Forcean independent panel that reviews the effectiveness of and provides recommendations for preventive servicesgiving PrEP for HIV prevention an A recommendation back in 2019. Under the ACA, most insurers must cover preventive services that receive an A or B rating from the group.
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Living With Hiv Doesnt Mean A Lifetime Of Monitoring
If you have HIV, you learn to live with it, but having to go for regular blood tests can get in the way of leading your life.
Experts now agree that if you have been taking your HIV combination treatment for at least 2 years, with consistent viral suppression, and your CD4 counts are >500 cells/mm3 then monitoring is optional. If your CD4 count remains between 300 and 500 cells/mm3 then regular monitoring every 12 months is still recommended.
Newly Approved Hiv Medications
Ian Villaluz, PharmD Candidate 2021Florida A&M College of PharmacyCrestview, Florida
Glenn R. Grantner, PharmD, BCPSClinical PharmacistSacred Heart HospitalPensacola, Florida
ABSTRACT: The available antiretroviral drugs for the treatment of HIV have expanded since 2018. Novel types of ARVs with new mechanisms of action have been approved, including ibalizumab-uiyk and fostemsavir. There have also been approvals of combination tablets of previously available drugs, such as bictegravir/emtricitabine/tenofovir alafenamide and dolutegravir/lamivudine. Finally, there has been an expansion in approved indications for previously available ARVs themselves, such as emtricitabine/tenofovir alafenamide for use in pre-exposure prophylaxis.
US Pharm. 2020:45:17-25.
While novel drugs are often the most exciting new drug approvals, ARVs have improved in other ways. Given the enormous pill burden of many HIV regimens, newly approved combination ARVs can make life much easier for patients. Use of such agents and limiting the necessary pill burden have demonstrated improved adherence and overall outcomes.8,9 There have also been expansions in approved indications for previously available ARVs ,offering new options for certain patient populations and indications.10-14
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Start Treatment As Soon As Possible After Diagnosis
- HIV medicine is recommended for all people with HIV, regardless of how long theyve had the virus or how healthy they are.
- Talk to your health care provider about any medical conditions you may have or any other medicines you are taking.
- Let your health care provider know if you or your partner is pregnant or thinking about getting pregnant. They will determine the right type of HIV medicine that can help prevent transmitting HIV to your baby.
What if I delay treatment?
- HIV will continue to harm your immune system.
- This will put you at higher risk for developing AIDS. Learn more about AIDS and opportunistic infections.
- This will put you at higher risk for transmitting HIV to your sexual and injection partners.
What are the benefits of taking my HIV medicine every day as prescribed?
What Are The Most Recent Updates To The Guidelines
At the time this article was written, the DHHS guidelines were most recently updated on .
Researchers are continuing to improve their understanding of how to best treat and manage HIV. The guidelines are updated periodically to include the latest research and expert opinions.
Heres an overview of the most recent changes included in the 2021 update.
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B Inching Closer To A Twice
Gilead is expected to complete regulatory filings this year for their long-acting self-injectable HIV treatment lenacapavir. Gileads long-acting injectable only has to be injected once every six months, a far cry from the daily oral treatments.
If approved, the HIV-1 capsid inhibitor will be the first approved treatment of its kind and is meant for heavily treated patients who have become resistant to multiple drugsa particularly difficult-to-treat group of patientsin combination with other treatments.
The anticipated regulatory filings will come on the heels of Gilead releasing topline results from the phase 2/3 CAPELLA trial of 36 patients. The data showed that patients receiving lenacapavir were significantly more likely to meet the studys primary endpoint of a 0.5 log10 or greater reduction in viral loada marker chosen to measure a relevant change in the amount of virus a patient hascompared with placebo.