Once you’ve started HIV treatment, CD4 cell count and viral load tests are used to monitor whether your HIV medicines are working effectively to control your HIV. If the test indicates your medicines aren’t working, your doctor can prescribe different ones that may work better. Other Important Lab Tests
How is initial therapy for HIV infection (HIV) selected?
Initial therapy should be with two NRTIs combined with an INSTI, the combination of DTG/3TC or, in some individuals, a combination including two NRTIs plus an NNRTI or an RTV- or COBI-boosted PI. When selecting a regimen for a person with HIV, a number of patient- and regimen-specific characteristics should be considered.
What tests can help determine the stage of HIV/AIDS?
If you receive a diagnosis of HIV / AIDS, several tests can help your doctor determine the stage of your disease and the best treatment, including: CD4 T cell count. CD4 T cells are white blood cells that are specifically targeted and destroyed by HIV.
When is it time to start taking HIV medicines?
When is it time to start taking HIV medicines? Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. People with HIV should start taking HIV medicines as soon as possible after their HIV is diagnosed. A main goal of HIV treatment is to reduce a person’s viral load to an undetectable level.
What should I do if I've been diagnosed with HIV?
If you've been diagnosed with HIV, it's important to find a specialist trained in diagnosing and treating HIV to help you: Determine which HIV antiretroviral therapy (ART) will be best for you Monitor your progress and work with you to manage your health
What is the recommended initial regimen for most people with HIV?
The initial ARV regimen for a treatment-naive patient generally consists of two NRTIs, usually abacavir/lamivudine (ABC/3TC) or either tenofovir alafenamide/emtricitabine (TAF/FTC) or tenofovir disoproxil fumarate/emtricitabine (TDF/FTC), plus a drug from one of three drug classes: an INSTI, an NNRTI, or a boosted PI.
When do you start medication for HIV?
People with HIV should start taking HIV medicines as soon as possible after HIV is diagnosed. A main goal of HIV treatment is to reduce a person's 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.
What is the initial treatment for HIV?
Four INSTIs (raltegravir, elvitegravir, dolutegravir, bictegravir) are effective in patients who are starting their first HIV regimen, as well as certain patients who have been treated in the past. INSTIs are a preferred part of initial treatment for most patients.
What is the most important factor to consider when deciding to initiate ARV?
[17,18] Regardless of CD4 cell count, the decision to initiate ART should always include consideration of any co-morbid conditions, the willingness and readiness of the patient to initiate therapy, and the availability of resources.
When do you start antiretroviral CD4 count?
As a priority, ART should be initiated among all adults with severe or advanced HIV clinical disease (WHO clinical stage 3 or 4) and adults with CD4 count ≤350 cells/mm3 (strong recommendation, moderate-quality evidence).
What is a first-line regimen?
A treatment that is accepted as best for the initial treatment of a condition or disease. The recommended first-line HIV treatment regimens include antiretroviral (ARV) drugs that are safe, effective, and convenient for most people with HIV who have never taken ARVs before. Related Term(s) Treatment-Naive.
What is the first-line regimen in SA?
The preferred first-line ART regimen is tenofovir disoproxil fumarate-lamivudine-dolutegravir (TLD) for those clients ini a ng ART, experiencing side-effects to EFV, or for those who prefer to use DTG after being given all the necessary informa on.
What is first-line drug?
a drug that is the first choice for treating a particular condition because it is considered a very effective treatment for that condition with the least likelihood of causing side effects. A first-line medication may be a class of drugs (e.g., SSRIs for depression) as well as a single drug.
What is treatment initiation?
Treatment initiation was defined as a completed psychotherapy visit or a filled prescription for antidepressant medication within 90 days of diagnosis. Depression severity was measured with Patient Health Questionnaire (PHQ-9) scores on the day of diagnosis.
When do you start taking highly active antiretroviral therapy?
Currently, the standard of care for a treatment-naïve patient with HIV-1 is a three-drug, highly active antiretroviral therapy (HAART) regimen that is started as soon as possible after a patient tests positive for HIV.
What is HIV treatment?
HIV treatment (antiretroviral therapy or ART) involves taking medicine as prescribed by a health care provider. HIV treatment reduces the amount of...
When should I start HIV treatment?
Start HIV treatment as soon as possible after diagnosis. All people with HIV should take HIV treatment, no matter how long they’ve had HIV or how h...
What if I delay HIV treatment?
If you delay treatment, HIV will continue to harm your immune system. Delaying treatment will put you at higher risk for transmitting HIV to your p...
Are there different types of HIV treatment?
There are two types of HIV treatment: pills and shots. Pills are recommended for people who are just starting HIV treatment. There are many FDA-app...
What are HIV treatment shots?
HIV treatment shots are long-acting injections used to treat people with HIV. The shots are given by your health care provider and require routine...
Can I switch my HIV treatment from pills to shots?
Talk to your health care provider about changing your HIV treatment plan. Shots may be right for you if you are an adult with HIV who has an undete...
What are the benefits of taking my HIV treatment as prescribed?
HIV treatment reduces the amount of HIV in the blood (viral load). Taking your HIV medicine as prescribed will help keep your viral load low. HIV t...
Does HIV treatment cause side effects?
HIV treatment can cause side effects in some people. However, not everyone experiences side effects. The most common side effects are Nausea and vo...
What should I do if I’m thinking about having a baby?
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...
Can I take birth control while on HIV treatment?
You can use any method of birth control to prevent pregnancy. However, some HIV treatment may make hormone-based birth control less effective. Talk...
How to diagnose HIV?
Diagnosis. HIV can be diagnosed through blood or saliva testing. Available tests include: Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are substances on the HIV virus itself and are usually detectable — a positive test — in the blood within a few weeks after exposure to HIV.
What is the treatment for HIV?
However, there are many medications that can control HIV and prevent complications. These medications are called antiretroviral therapy (ART). Everyone diagnosed with HIV should be started on ART, regardless of their stage of infection or complications.
What test can help determine if you have HIV?
If you receive a diagnosis of HIV / AIDS, several tests can help your doctor determine the stage of your disease and the best treatment, including: CD4 T cell count. CD4 T cells are white blood cells that are specifically targeted and destroyed by HIV. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 T cell count dips ...
What is HIV RNA?
Viral load (HIV RNA). This test measures the amount of virus in your blood. After starting HIV treatment the goal is to have an undetectable viral load. This significantly reduces your chances of opportunistic infection and other HIV -related complications.
How long does it take to get tested for HIV?
Most rapid HIV tests, including self-tests done at home, are antibody tests. Antibody tests can take three to 12 weeks after you're exposed to become positive. Nucleic acid tests (NATs). These tests look for the actual virus in your blood (viral load). They also involve blood drawn from a vein.
What are some examples of anti-HIV drugs?
Examples include efavirenz (Sustiva), rilpivirine (Edurant) and doravirine (Pifeltro).
What to do if you think you have HIV?
If you think you might have HIV infection, you're likely to start by seeing your family doctor. You may be referred to an infectious disease specialist — who additionally specializes in treating HIV / AIDS.
Why is it important to take HIV medication?
Taking HIV medication consistently, as prescribed, helps prevent drug resistance. Drug resistance develops when people with HIV are inconsistent with taking their HIV medication as prescribed. The virus can change (mutate) and will no longer respond to certain HIV medication. If you develop drug resistance, it will limit your options ...
What is the amount of HIV in the blood called?
The amount of HIV in the blood is called viral load . Taking your HIV medicine as prescribed will help keep your viral load low and your CD4 cell count high. HIV medicine can make the viral load very low (called viral suppression ). Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood.
What does it mean when your HIV is suppressed?
Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood. HIV medicine can make the viral load so low that a test can’t detect it (called an undetectable viral load ). If your viral load goes down after starting HIV treatment, that means treatment is working.
How long does it take for a mother to give her baby HIV?
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.
How long does it take to get rid of HIV?
There is no effective cure for HIV. But with proper medical care, you can control HIV. Most people can get the virus under control within six months. Taking HIV medicine does not prevent transmission ...
What to do if substance use is interfering with your ability to keep yourself healthy?
If substance use is interfering with your ability to keep yourself healthy, it may be time to quit or better manage it. If you need help finding substance use disorder treatment or mental health services, use SAMHSA’s Treatment Locator. external icon. .
Does HIV harm the immune system?
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 is the treatment for HIV?
HIV treatment involves taking medicines that slow the progression of the virus in your body. HIV is a type of virus called a retrovirus, and the combination of drugs used to treat it is called antiretroviral therapy (ART). ART is recommended for all people living with HIV, regardless of how long they’ve had the virus or how healthy they are.
Why do you prescribe HIV?
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.
What is drug resistance in HIV?
What Is HIV Drug Resistance? Drug resistance can be a cause of treatment failure for people living with HIV. As HIV multiplies in the body, it sometimes mutates (changes form) and produces variations of itself. Variations of HIV that develop while a person is taking ART can lead to drug-resistant strains of HIV.
How long do HIV side effects last?
Some side effects can occur once you start a medicine and may only last a few days or weeks.
How soon can you start ART for HIV?
Treatment guidelines from the U.S. Department of Health and Human Services recommend that a person living with HIV begin ART as soon as possible after diagnosis. Starting ART slows the progression of HIV and can keep you healthy for many years.
Is HIV treatment a prevention?
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.
Can HIV be drug resistant?
A person can initially be infected with drug-resistant HIV or develop drug-resistant HIV after starting HIV medicines. Drug-resistant HIV also can spread from person to person. Drug-resistance testing identifies which, if any, HIV medicines won’t be effective against your specific strain of HIV.
Why is it important to start taking HIV medicine?
To reduce their viral load, it’s important for people with HIV to start taking HIV medicines as soon as possible. Starting HIV medicines right away is especially important for people with HIV who have certain conditions.
What is the best treatment for HIV?
Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. HIV medicines help people with HIV live longer, healthier lives and reduce the risk of HIV transmission.
Why is medication adherence important?
Medication adherence is key to maintaining an undetectable viral load, which protects the immune system and reduces the risk of HIV transmission. Before starting HIV treatment, it’s important to talk to your health care provider about any issues that can make adherence difficult.
Why should pregnant women take HIV?
AIDS-defining conditions. Pregnancy. All pregnant women with HIV should take HIV medicines to protect their health and prevent mother-to-child transmission of HIV. All pregnant women with HIV should start taking HIV medicines as soon as possible during pregnancy. In most cases, women who are already on an effective HIV regimen when they become ...
Can you get HIV while pregnant?
Women with HIV who become pregnant and are not already taking HIV medicines should start taking HIV medicines as soon as possible. The risk of mother-to-child transmission of HIV during pregnancy and childbirth is lowest when a woman with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep ...
Does HIV medicine reduce the risk of transmission?
In addition, starting HIV medicines during early HIV infection reduces the risk of HIV transmission. AIDS-defining conditions. AIDS-defining conditions are certain infections and cancers that are life-threatening in people with HIV.
What are the drugs that are approved for HIV?
These seven classes include the nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrase strand transfer inhibitors (INSTIs), a fusion inhibitor, a CCR5 antagonist, and a CD4 T lymphocyte (CD4) post-attachment inhibitor. In addition, two drugs, ritonavir (RTV) and cobicistat (COBI) are used as pharmacokinetic (PK) enhancers (or boosters) to improve the PK profiles of PIs and the INSTI elvitegravir (EVG).
How much RAL should I take for HIV?
On the basis of these clinical trial data, the Panel considers RAL given as 1,200 mg (two 600-mg tablets) once daily or as 400 mg twice daily plus TDF/FTC (BI) or TAF/FTC (BII) as a Recommended Initial Regimen for Most People with HIV.
What is the panel on antiretroviral guidelines for adults and adolescents?
The Panel on Antiretroviral Guidelines for Adults and Adolescents (the Panel)’s recommendations are primarily based on clinical trial data published in peer-reviewed journals and data prepared by drug manufacturers for FDA review. In select cases, the Panel considers data from abstracts presented at major scientific meetings. The Panel considers published information from a randomized, prospective clinical trial with an adequate sample size that demonstrates that an ARV regimen produces high rates of viral suppression, increases CD4 count, and has a favorable safety profile to be the strongest evidence on which to base recommendations. Comparative clinical trials of initial treatments generally show no significant differences in HIV-related clinical endpoints or survival. Thus, assessment of regimen efficacy and safety are primarily based on surrogate marker endpoints (especially rates of HIV RNA suppression) and the incidence and severity of adverse events.
Is 400 mg EFV good for HIV?
EFV-based regimens (using either 400 mg or 600 mg dosing) have excellent virologic efficacy, 35 including in patients with high HIV RNA (except when EFV is used with ABC/3TC); however, the relatively high rate of central nervous system (CNS)-related side effects reduces the tolerability of EFV-based regimens.
Is TAF/FTC a recommended NRTI combination for initial ART in most persons with HIV?
On the basis of clinical trial safety and efficacy data, supportive bioequivalence data, 76 and its availability as a component of various FDCs, the Panel considers TAF/FTC a recommended NRTI combination for initial ART in most persons with HIV when prescribed with BIC, DTG, and RAL.
About this Lesson
List the major classes of antiretroviral medications and describe the mechanism of action with each class of drugs
Activities in this Lesson
The Check-on-Learning Questions are short and topic related. They are meant to help you stay on track throughout each lesson and check your understanding of key concepts.
Diagnosis
- HIVcan be diagnosed through blood or saliva testing. Available tests include: 1. Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are substances on the HIV virus itself and are usually detectable — a positive test — in the blood within a few weeks after exposure to HIV.Antibodies are produced by your immune sy...
Treatment
- Currently, there's no cure for HIV/AIDS. Once you have the infection, your body can't get rid of it. However, there are many medications that can control HIV and prevent complications. These medications are called antiretroviral therapy (ART). Everyone diagnosed with HIV should be started on ART, regardless of their stage of infection or complications. ART is usually a combina…
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and Home Remedies
- Along with receiving medical treatment, it's essential to take an active role in your own care. The following suggestions may help you stay healthy longer: 1. Eat healthy foods.Make sure you get enough nourishment. Fresh fruits and vegetables, whole grains, and lean protein help keep you strong, give you more energy and support your immune system. 2. Avoid raw meat, eggs and mo…
Alternative Medicine
- People who are infected with HIV sometimes try dietary supplements that claim to boost the immune system or counteract side effects of anti-HIVdrugs. However, there is no scientific evidence that any nutritional supplement improves immunity, and many may interfere with other medications you're taking. Always check with your doctor before taking any supplements or alter…
Coping and Support
- Receiving a diagnosis of any life-threatening illness is devastating. The emotional, social and financial consequences of HIV/AIDScan make coping with this illness especially difficult — not only for you but also for those closest to you. But today, there are many services and resources available to people with HIV. Most HIV/AIDSclinics have social workers, counselors or nurses wh…
Preparing For Your Appointment
- If you think you might have HIV infection, you're likely to start by seeing your family doctor. You may be referred to an infectious disease specialist — who additionally specializes in treating HIV/AIDS.