HIV 2 – Treatment

There is no cure for HIV, but treatment with HIV medicines, called antiretroviral therapy (ART), can slow or prevent HIV from advancing from one stage to the next. HIV medicines help people live longer, healthier lives.^4a
People on antiretroviral therapy take a specific combination of HIV medicines every day, called an ART regimen.^4b These regimes are based on World Health Organisation and Infectious Disease Specialist recommendations. The recommendations again are based on their ongoing monitoring of data of HIV infection and treatment patterns and are subject to change as new information and drug developments become available.  HIV medicines are grouped into different drug classes according to how they fight HIV at different stages of the HIV life cycle.^4b

All people living with HIV are eligible to be provided with lifelong treatment, regardless of age, clinical status or CD4 count, including children, adolescents and adults, and pregnant and breastfeeding women.^1b,5a
Treatment can offer the following benefits to patients:^4a,c,6a

• slow down and prevent the progression of HIV through the stages 1 to 4
• help people with HIV live longer and healthier
• reduce the risk of transmission to HIV-negative people.  One of the main goals of treatment is to reduce a person’s viral load to an undetectable level. People with HIV who maintain an undetectable level of virus in their blood have no risk of transmitting HIV to others, including their HIV-negative sexual partner

The World Health Organisation and National guidelines recommends ART for all people with HIV as soon as possible after diagnosis without any restrictions of CD4 counts.^1a,6b
Certain steps must be taken to decide on appropriate therapy for each individual patient. These are:^1c

1. Determine the timeframe for starting treatment
2. Decide on first- or second-line treatment
3. Choose the drugs in the regimen
4. Provide education to encourage adherence to medication

In some instances, treatment will not be started immediately after diagnosis. Special screening (testing) will be done to find out if a patient has tuberculosis (TB) or any other chronic condition or infection that may affect the type of medication that can be prescribed.^1d
For example, if a patient is found to have TB at the time of testing for HIV, antiretroviral therapy will only be started after a minimum of 2 weeks after starting TB treatment when a person is stable on the TB treatment.^1e For further information on HIV and co-infection with TB.
Starting daily antiretroviral therapy as soon as possible after diagnosis and staying on treatment are essential for keeping HIV under control, which benefits individual health and prevents HIV transmission to others.^7a

Because of antiretrovirals, HIV infection has transformed from an almost uniformly fatal infection into a manageable chronic condition!⁷

Continual research takes place to discover new ARV options with:

• improved efficacy with rapid viral suppression
• reduced resistance
• better tolerability and fewer side effects
• combining medications into single and smaller tablets to reduce the pill burden
• single daily dosing