Classes Of Hiv Medications
Evidence shows early HIV treatmentregardless of CD4 countleads to fewer complications and possibly even deaths. As a result, current expert guidelines recommend starting HAART for anyone with HIV. HAART with at least three drugs is standard care for HIV infection. There are several classes of HIV drugs doctors can use when designing HAART:
- Nucleoside reverse transcriptase inhibitors . These drugs block reverse transcriptase, an enzyme the virus needs to make new viruses. NRTIs block new virus production by inserting themselves into the viruss DNA as it tries to copy itself. NRTIs were the first class of HIV drugs. In general, an initial HAART regimen will include two of these drugs.
- Non-nucleoside reverse transcriptase inhibitors . This class binds to reverse transcriptase and changes the enzyme in way that makes it unable to function. Doctors may use an NNRTI as the third drug in an initial HAART regimen.
- Protease inhibitors . These drugs block protease, another enzyme the virus needs to reproduce. PIs can be part of an initial HAART regimen. However, they need the addition of a pharmacokinetic enhancera drug that boosts the effects of PIs on HIV.
- Integrase strand transfer inhibitors . INSTIsor simply integrase inhibitorsblock from making copies of itself. HIV inserts its DNA into the CD4 cells DNA in order to replicate. Integrase inhibitors block the HIV enzyme that allows the transfer. INSTIs can be the third drug in an initial HAART regimen.
How Do We Know Treatment As Prevention Works
Large research studies with newer HIV medications have shown that treatment is prevention. These studies monitored thousands of male-female and male-male couples in which one partner has HIV and the other does not over several years. No HIV transmissions were observed when the HIV-positive partner was virally suppressed. This means that if you keep your viral load undetectable, there is effectively no risk of transmitting HIV to someone you have vaginal, anal, or oral sex with. Read about the scientific evidence.
How Does Dapsone React With Other Drugs
Dapsone is broken down by the liver. It can interact with other drugs that also use the liver. Scientists have not yet studied all the possible interactions. Dapsone probably interacts with some blood thinners, heart medications, seizure medications, and other antibiotics. Be sure your health care provider knows about all the medications you are taking.
Your health care provider should watch carefully for drug interactions if you are taking dapsone along with the protease inhibitors amprenavir or saquinavir , or the non-nucleoside reverse transcriptase inhibitordelavirdine .
Blood levels of dapsone can be reduced if you take rifampin, a drug used to treat tuberculosis or MAC . Also, ddI can reduce absorption of dapsone. Take dapsone at least 2 hours before or after you take ddI.
The risk of developing anemia is higher if you take dapsone at the same time as other drugs that can cause anemia, such as AZT .
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When Is It Time To Start Taking Hiv Medicines
People with HIV should start taking HIV medicines as soon as possible after an HIV diagnosis. It is especially important for people with AIDS-defining conditions or early HIV infection to start HIV medicines right away.
Women with HIV who become pregnant and are not already taking HIV medicines should also start taking HIV medicines as soon as possible.
Keep Taking Your Hiv Medication To Stay Undetectable
HIV is still in your body when your viral load is suppressed, even when it is undetectable. So, you need to keep taking your HIV medication daily as prescribed. When your viral load stays undetectable, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. If you stop taking HIV medication, your viral load will quickly go back up.
If you have stopped taking your HIV medication or are having trouble taking all the doses as prescribed, talk to your health care provider as soon as possible. Your provider can help you get back on track and discuss the best strategies to prevent transmitting HIV through sex while you get your viral load undetectable again.
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Talk To A Healthcare Provider
Theres no cure for HIV yet, but prescription medications can help slow the progression of the virus. Drugs can also improve HIV symptoms and make living with the condition more comfortable.
This medication list is a brief overview of the types of drugs that are available to treat HIV. Talk to a healthcare provider about all of these options. They can help you determine your best treatment plan.
Understanding Hiv Drug Resistance
A different type of side effect can occur when your HIV medication no longer works effectively. Drug resistance is a major issue in HIV treatment. It typically occurs when HIV mutates, or makes new variations of itself, and can no longer be controlled by a medicine that was previously effective.
Failing to take a prescribed HIV medication exactly as directed can increase the risk for drug resistance. Skipping doses or starting and stopping use of an antiretroviral drug may allow the virus to multiply, which gives it more opportunities to mutate.
If an HIV treatment plan that was once effective no longer seems to be controlling your disease, tell your doctor. Blood tests can identify drug resistance and help determine other effective HIV treatment options for you.
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What Happens When You Stop Taking Hiv Medications
What Happens to a Patient Who Suddenly Stops Taking HIV Medications?The medications used to control HIV help the body to produce and retain the white blood cells necessary to fight infection. Once a patient stops that medication, the virus will begin attacking those cells again, leaving the patient susceptible to infection. It is those secondary infections which typically result in the death of the patient, not the AIDS virus.
Nurses who regularly treat patients with HIV should be aware of the implications of stopping treatment and be schooled in talking to patients about them. HIV medication is a life-long commitment on the part of the patient, where missing even one dose could have harmful consequences. Recognizing patients who are at risk for stopping medications and developing counseling skills are invaluable assets of a nurse for effective HIV treatment.
Missing a dose of HIV medication could lead to resistance to the drug which will make the virus harder to treat in the patient. Provide patients with information on how to stick with their drug regime. This could include advice such as:
- Refilling prescriptions in advance
- Setting alarms to remind them of the right time to take meds
- Taping notes as reminders
- Keeping medications easily accessible and organized
- Letting a trusted friend or family member know where medication is kept in case of an emergency
- Traveling with HIV medications in carry-on luggage
HIV Patients are at a High Risk For Stopping Medication
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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How To Manage Side Effects Of Hiv Treatment
Side effects from HIV treatment have decreased dramatically with recent, more-targeted therapies. Today, simple remedies can ease most minor side effects.
Advances in antiretroviral therapies to treat the human immunodeficiency virus mean you can live longer and with fewer complications from the infection than ever before. But that also means years of taking potent antiretroviral medications. Thats why its important to have good communication with your doctor about side effects from HIV treatment and how to manage them.
HIV treatment today is easier and often involves a single pill once a day, says Paul Volberding, MD, a professor in the department of medicine at the University of California in San Francisco and the director of the universitys AIDS research institute. The expectation is that people with HIV will have few, if any, side effects from treatment.
What If Your Treatment Isn’t Working
Sometimes the HIV medications don’t work. This may occur because the drugs don’t completely stop the virus from reproducing. As the virus makes copies of itself, changes sometimes occur. These changes may result in a new strain of the virus that is resistant to the action of the drugs. If your providers think this has happened, they will do a blood test that can help show which drugs the virus has become resistant to. This can help identify other drugs that might still work against your virus.
If a person has a strain of HIV that is resistant to most or all available drugs, that person may want to consider joining a clinical trial that is testing new drugs that have not yet been approved by the U.S. Food and Drug Administration . See Clinical Trials.
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An Hiv Drug You Only Take Twice A Year
WEDNESDAY, July 1, 2020 — Scientists are reporting an early step toward an HIV drug that could potentially be taken only a couple of times per year.
A single injection of the experimental drug, called lenacapavir, was able to lower blood levels of HIV in a small group of patients. And it was capable of maintaining active levels in the blood for more than six months.
It all raises the possibility of one day having an HIV treatment that only needs to be taken twice a year.
The current treatment regimens for HIV — combinations of oral drugs often called “cocktails” — generally work quite well, said study co-author Dr. Martin Rhee.
“But patients often say that over time, taking daily pills can be a burden,” said Rhee, director of clinical research for Gilead Sciences, Inc. — which is developing lenacapavir.
So the hope is that longer-acting HIV medications could “free people from daily pills,” Rhee said.
Beyond that, he noted, longer-acting drugs could potentially offer a simpler way to prevent HIV in high-risk people: Right now, that’s done with a daily pill regimen known as PrEP .
However, much more work remains ahead. The new study, published July 1 in the journal Nature, offers a “proof of principle” that a dosing interval of every six months is possible, Rhee said.
It’s encouraging that the drug is “amenable to dosing every six months,” said Dr. Rajesh Gandhi, an infectious disease physician at Massachusetts General Hospital, in Boston.
What Are The Symptoms Of Hiv
The symptoms of HIV and AIDS vary, depending on the phase of infection.
When you first acquire HIV it may take a month or two before symptoms show and these may last a week or two. Even then these may easily be confused with another type of viral illness, such as the flu, or so mild as not to be noticed initially. Symptoms of an initial acute HIV infection may include:
- Muscle aches and joint pain
- Painful mouth sores
- Swollen lymph glands, mainly on the neck.
The infection is easily spread during this stage.
The next stage of HIV infection is called clinical latent infection. Generally, there are few signs or symptoms during this stage which may last approximately 10 years, although some people may develop persistent swelling of the lymph nodes or more severe disease sooner. HIV persists in the bloodstream and white blood cells.Infections start to become more common as the virus continues to multiply and destroy your immune cells. Signs and symptoms of symptomatic HIV infection include:
- Yeast infection
- Swollen lymph nodes.
If left untreated, HIV usually progresses to AIDS in about 10 years, although some people never develop AIDS despite never having treatment. A person is said to have AIDS when their CD4 count falls below 200 or when they develop certain opportunistic infections or cancers.
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What Are Some Challenges I Might Face Taking My Hiv Medication Every Day
Taking medication every day can be difficult. That is why it is important to understand some of the challenges you may face and to think through how you might address them before they happen. For example, remembering when to take your medication can be complicated. Some medication regimens involve taking several pills every daywith or without foodor before or after other medications. Making a schedule of when and how to take your medicines can be helpful. Or ask your health care provider about the availability of multiple drugs combined into one pill.
Other factors can make it difficult to take your HIV medications every day, including:
Your health care provider will help you identify barriers to keeping up with your HIV medication regimen and ways to address those barriers. Understanding issues that can make keeping up with your HIV medication regimen difficult will help you and your health care provider select the best treatment for you.
Tell your health care provider right away if youre having taking your HIV medication every day. Together you can identify the reasons why youre skipping medications and make a plan to address those reasons. Joining a peer support group of others taking HIV medication, or enlisting the support of family and friends, can also help you.
Mild Side Effects Of Hiv Treatment
When starting HIV treatment, there may be some milder side effects that can last a couple of weeks and then resolve as your body adjusts to the medication. You can manage these short-term side effects with a few self-care steps:
- Fatigue. Try to schedule extra rest, and if needed when fatigue sets in, temporarily scale back on strenuous workouts.
- Nausea. Eating smaller meals and limiting spicy foods may help. Try to avoid being around overpowering cooking aromas.
- Diarrhea. Be sure to drink plenty of water and other healthy beverages to replace lost fluids. Try cutting back on raw foods and whole grains as well as spicy dishes. Focus on bland food until you feel better.
- Rash. Skip scented body products and try to wear only natural, soft fibers like cotton and linen.
Other temporary side effects may include headache, fever, muscle pain, and dizziness. Ask your doctor if over-the-counter pain relievers are safe to take to help relieve these minor side effects.
However, be aware that sometimes side effects that seem mild like a rash, fever, or nausea may be a sign of a more serious medical problem that needs treatment. When starting a new HIV medication, be sure to ask your doctor how long you should wait for mild side effects to subside before seeking medical attention.
Also note that any allergic reaction to your medications like swelling on your face or around the eyes, lips, or tongue may be life-threatening and require immediate medical attention.
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Treatment Helps Prevent Transmission To Others
- If you have an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- Having an undetectable viral load may also help prevent transmission from injection drug use. We dont have data about whether having an undetectable viral load prevents transmission through sharing needles, syringes, or other injection equipment . It very likely reduces the risk, but we dont know by how much.
- Having an undetectable viral load also helps prevent transmission from mother to baby. If a mother with HIV takes HIV medicine as prescribed throughout pregnancy, labor, and delivery and gives HIV medicine to her baby for 4 to 6 weeks after birth, the risk of transmitting HIV to her baby can be 1% or less.
- Having an undetectable viral load reduces the risk of transmitting HIV to the baby through breastfeeding, but doesnt eliminate the risk. The current recommendation in the United States is that mothers with HIV should not breastfeed their babies.
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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Does Antiretroviral Treatment Have Side
As with all medication, starting to take ARVs can cause some side-effects, particularly in the first few days of treatment. This is another topic you could discuss with your doctor, as it might also affect your choice of drugs. Your treatment will be monitored and you may be recommended to switch drugs if they aren’t working for you or if you’re finding the side effects difficult to manage.
How Is Tmp/smx Taken
TMP/SMX is available in tablets that contain 80 milligrams of trimethoprim and 400 mg of sulfamethoxazole. There is also a “double strength” tablet with 160 mg of trimethoprim and 800 mg of sulfamethoxazole. The dose you take depends on the type of infection you are trying to treat or prevent.
The treatment continues as long as your CD4 cell count is low enough for you to develop toxo or PCP.
TMP/SMX is generally taken with food, but the single-strength tablets can be taken with or without food. Drink plenty of water when taking TMP/SMX.
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