Updates in HIV medications

While the world is battling the COVID-19 pandemic, there have been advances in the care of people with Human immunodeficiency virus (HIV).

People with HIV are now living longer due to advances in therapeutics and treatment protocols.

Treatment protocols and medications control the viral load and improve the CD4 count so that people live longer; This does not equate to cure. An undetectable viral load means less HIV transmissibility or spread from person to person; U=U. Watch the video below to find out more.

Undetectable equals Untransmittable (U=U)

This article is based on the 2020 recommendations of the International antiviral society-USA panel.

The limitations of the recommendation, include that the protocols mentioned are for middle- and high-income countries. Due to the limitation of resources in low-income countries some of the medications mentioned may not be available. Another limitation of the article is that due to the dynamic nature of the HIV field and medical advances, treatment protocols are constantly changing.

However, as of this present moment, these are the current protocols.

Recommendations include to treat all persons with viremia with antiretroviral therapy (ART ) as noted by a detectable viral load, irrespective of the CD4 count.

Terms like Rapid ART, Immediate ART and Same-day ART are in use.

Rapid ART means starting treatment within 7 days. While immediate ART and same-day ART mean treatment at the time of diagnosis or at the first visit to the medical facility.

Recommended for most people who are ready to start treatment is the 3 drug regimen or the 2 drug regimen to include an integrase strand transfer inhibitor. Other options include an injection for HIV treatment. The injection is also used for prevention (pre-exposure prophylaxis). Oral therapy is discussed for pre-exposure prophylaxis (PrEP) of HIV as well as postexposure prophylaxis (PEP).

There are unique situations such as opportunistic infections with tuberculosis or pregnancy for which other specific regimens are recommended.

It is suggested that clinicians globally can reduce the incidence of HIV in their communities by screening for HIV, linking people with HIV to care, and by prescribing PrEP to people at high risk.

References:

Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2020 Recommendations of the International Antiviral Society–USA Panel. JAMA. 2020;324(16):1651–1669. doi:10.1001/jama.2020.17025

https://viivhealthcare.com/en-gb/media/press-releases/2020/october/viiv-healthcare-receives-positive-chmp-opinion-for-long-acting-r/

https://www.drugs.com/drug-class/integrase-strand-transfer-inhibitor.html

Written for the purpose of education and information to improve health literacy. Protocols may change at anytime. Refer to your doctor or healthcare team for any care.

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