Treatment Options

Antiretroviral Therapy (ART) is the cornerstone of HIV treatment. It involves using a combination of HIV medicines to effectively control the virus and improve immune function.

How ART Works

ART works by targeting different stages of the HIV lifecycle to prevent the virus from replicating and spreading in the body:

Entry Inhibitors: Block HIV from entering CD4 cells, preventing infection.
Reverse Transcriptase Inhibitors (RTIs): Interfere with HIV's ability to replicate its genetic material.
Integrase Inhibitors: Block integrase, an enzyme that HIV uses to insert its genetic material into CD4 cells.
Protease Inhibitors: Prevent HIV from producing mature infectious viral particles.

ART is typically prescribed as a combination of these medications, known as an ART regimen. This approach is called Highly Active Antiretroviral Therapy (HAART) and aims to:

Reduce viral load (amount of HIV in the blood) to undetectable levels.
Restore immune function by increasing CD4 cell counts.
Prevent HIV-related complications and opportunistic infections.
Reduce the risk of transmitting HIV to others (Undetectable = Untransmittable, U=U).

Adherence to ART

Adherence to ART is crucial for its effectiveness:

Take medications exactly as prescribed, every day without missing doses.
Follow-up regularly with healthcare providers for monitoring and adjustments.
Report any side effects or challenges with adherence to healthcare providers.

Managing Side Effects

ART may cause side effects, which can vary depending on the medications used. Common side effects include:

Nausea, vomiting, or diarrhea.
Headaches or dizziness.
Changes in body fat distribution (lipodystrophy).
Increased cholesterol or blood sugar levels.

Healthcare providers can help manage side effects and adjust treatment regimens as needed.

Drug Resistance

Drug resistance occurs when HIV mutates and becomes resistant to the antiretroviral medications used in treatment. Factors contributing to drug resistance include:

Inconsistent adherence to medication regimens.
Incorrect use of medications, such as missing doses or not taking them as prescribed.
Prolonged use of the same treatment regimen without monitoring viral load and CD4 counts.
Pre-existing drug-resistant strains of HIV.

Healthcare providers monitor drug resistance through regular viral load tests and adjust treatment regimens accordingly.

Adherence Challenges

Adherence challenges can impact treatment effectiveness. Common reasons for adherence issues include:

Complex medication schedules.
Side effects that affect quality of life.
Stigma associated with HIV and its treatment.
Access barriers to healthcare and medications.

Support from healthcare providers, peer groups, and adherence counseling can help individuals overcome these challenges and adhere to their treatment plans.

Treatment Regimens

Antiretroviral Therapy (ART) involves the use of combinations of HIV medicines to effectively control the virus and improve immune function. The regimens are categorized into:

First-Line ART Regimens: These are typically recommended as the initial treatment for people diagnosed with HIV. They are effective, well-tolerated, and have fewer side effects. Examples include Tenofovir disoproxil fumarate (TDF) + Emtricitabine (FTC) + Dolutegravir (DTG), Abacavir (ABC) + Lamivudine (3TC) + Dolutegravir (DTG), and Tenofovir alafenamide (TAF) + Emtricitabine (FTC) + Bictegravir (BIC).
Second-Line ART Regimens: These are used when first-line treatments fail due to drug resistance or intolerability. They may involve different drug classes or combinations such as Zidovudine (AZT) + Lamivudine (3TC) + Atazanavir (ATV) + Ritonavir (RTV), Tenofovir disoproxil fumarate (TDF) + Emtricitabine (FTC) + Lopinavir (LPV) + Ritonavir (RTV), and Abacavir (ABC) + Lamivudine (3TC) + Darunavir (DRV) + Ritonavir (RTV).
Third-Line ART Regimens: These are used when second-line treatments fail or are not tolerated. They often include drugs from new classes or experimental treatments like Tenofovir alafenamide (TAF) + Emtricitabine (FTC) + Raltegravir (RAL) + Darunavir (DRV), Dolutegravir (DTG) + Lamivudine (3TC) + Atazanavir (ATV) + Ritonavir (RTV), and Darunavir/cobicistat (DRV/c) + Raltegravir (RAL) + Emtricitabine/tenofovir alafenamide (FTC/TAF).

Each ART regimen is tailored based on individual factors such as viral load, CD4 count, drug resistance, and patient preferences. Regular monitoring and adherence are essential for successful HIV management.

For personalized information about treatment options or to start ART, please contact us.