HIV Infection Treatment and Antiretroviral Medicines
HIV is a virus that attacks the immune system. Without treatment, it can reduce the body’s ability to fight infections and other illnesses. HIV treatment can control the virus and help people live healthy lives.
The main treatment is called antiretroviral therapy, or ART. It uses a combination of HIV medicines to reduce the amount of virus in the blood. Treatment must be chosen and monitored by a qualified healthcare professional.
What is HIV infection?
HIV infection happens when the human immunodeficiency virus enters the body and begins affecting immune cells. The virus mainly attacks CD4 cells, which help the body fight infections.
A person may have HIV for years without clear symptoms. This is why HIV testing is important after a possible exposure or when recommended by a healthcare professional.
HIV is not spread through hugging, sharing food, shaking hands or using the same toilet. It can spread through infected blood, semen, vaginal fluids, breast milk or shared needles. Medical care can greatly reduce the chance of passing HIV to another person.
HIV symptoms
Some people develop flu-like symptoms a few weeks after infection. These may include fever, sore throat, rash, swollen glands, headache, tiredness or muscle pain.
Other people have no early symptoms. Without treatment, HIV may gradually weaken the immune system. Later symptoms can include repeated infections, night sweats, unexplained weight loss, long-lasting diarrhoea, mouth infections or extreme tiredness.
These symptoms can have many other causes. Only an HIV test can confirm an HIV infection.
How is HIV diagnosed?
HIV testing may use an antibody test, antigen/antibody test or nucleic acid test. A positive screening result usually needs a follow-up test for confirmation.
Healthcare professionals may also check the viral load and CD4 count. The viral load shows how much HIV is in the blood. The CD4 count helps show how strongly the immune system is working.
These results help the healthcare team choose and monitor an HIV treatment regimen.
Primary antiretroviral medicines
Antiretroviral medicines stop HIV from making copies of itself. Most treatment plans combine medicines from different drug classes. Some are available as a single daily tablet, while others may be given as long-acting injections.
Common medicine groups include:
Nucleoside or nucleotide reverse transcriptase inhibitors: These block an enzyme HIV needs to multiply.
Integrase inhibitors: These stop HIV from placing its genetic material into human cells.
Protease inhibitors: These prevent the virus from making mature copies of itself.
Non-nucleoside reverse transcriptase inhibitors: These block another part of the virus-making process.
Entry, attachment or capsid inhibitors: These stop HIV from entering cells or completing important steps in its life cycle.
The correct combination depends on previous treatment, resistance testing, kidney and liver health, pregnancy, other medicines and personal needs.
Prevention medicines and supportive treatment
Antiretroviral medicines can also help prevent HIV.
PrEP is taken by people who do not have HIV but may be exposed to it. It may be available as tablets or injections and requires HIV testing and regular follow-up.
PEP is emergency medicine after a possible exposure. It must be started as soon as possible, usually within 72 hours, and requires urgent medical assessment.
Medicines may also be prescribed to treat or prevent infections that become more likely when the immune system is weak.
PrEP and PEP do not prevent every sexually transmitted infection. Condoms and other prevention methods may still be advised.
HIV treatment side effects
HIV treatment side effects may include nausea, diarrhoea, headache, tiredness, dizziness, skin changes or sleep problems. Many side effects improve with time or can be managed by changing the treatment plan.
Tell the healthcare professional about severe or continuing symptoms. HIV medicines may interact with other prescriptions, supplements, recreational drugs and herbal products. Do not stop treatment suddenly because missed doses can allow drug resistance to develop.
HIV prevention and long-term care
Taking HIV medicines exactly as prescribed helps keep the viral load low. When a person maintains an undetectable viral load, HIV is not sexually transmitted.
Regular appointments may include viral load tests, CD4 count checks, kidney and liver tests, sexual health screening and medicine reviews. Pregnancy, breastfeeding, fertility treatment and other health conditions should always be discussed with the healthcare team.