Understanding Current Treatments for HIV

Human Immunodeficiency Virus (HIV) has transformed from a fatal diagnosis to a manageable chronic condition thanks to significant medical advances. Modern treatments focus on controlling the virus and maintaining a healthy immune system.

Antiretroviral Therapy (ART)

Antiretroviral therapy is the cornerstone of HIV treatment, combining different medications to:

• Reduce viral load to undetectable levels
• Increase CD4 cell count
• Prevent HIV transmission
• Improve quality of life and life expectancy

How ART Works

ART works by reducing the viral load in the body, helping to:

• Prevent the progression of HIV to AIDS
• Reduce the risk of HIV transmission to others
• Improve the quality of life for those living with HIV

Common ART Drug Classes

1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

   • Examples include Truvada and Descovy
   • Often used as the backbone of HIV treatment regimens

2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

   • Include medications like efavirenz and rilpivirine
   • Block reverse transcriptase, an enzyme HIV needs to replicate

3. Protease Inhibitors (PIs)

   • Such as darunavir and atazanavir
   • Prevent viral maturation

4. Integrase Inhibitors

   • Newer class including Biktarvy and dolutegravir
   • Block integrase, an enzyme HIV uses to integrate its genetic material

5. Entry or Fusion Inhibitors

   • Prevent HIV from entering the host cells

Single-Tablet Regimens

Modern HIV treatment often involves single-tablet regimens (STRs), combining multiple medications into one daily pill:

Medication	Components	Dosing
Biktarvy	bictegravir/emtricitabine/tenofovir alafenamide	Once daily
Triumeq	dolutegravir/abacavir/lamivudine	Once daily
Genvoya	elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide	Once daily

Preventive Treatments

Pre-Exposure Prophylaxis (PrEP)

PrEP involves taking HIV medicines before potential exposure to prevent infection. Options include:

• Daily oral tablets
• Long-acting injectable medications
• Vaginal rings (in some countries)

Post-Exposure Prophylaxis (PEP)

PEP is a short-term antiretroviral treatment that must be started within 72 hours of potential HIV exposure.

Challenges and Considerations

While ART is highly effective, there are important considerations:

• Adherence: Consistent adherence is crucial to prevent drug resistance
• Side Effects: May include nausea, diarrhea, and fatigue
• Access and Cost: Limited availability in some regions
• Regular Monitoring: Requires ongoing viral load tests and CD4 count measurements

The Future of HIV Treatment

"The future of HIV treatment looks promising with several innovative approaches in development." - National Institutes of Health

Research continues in several areas:

• Long-acting injectables like Cabenuva
• Gene therapy approaches using technologies like CRISPR
• Therapeutic vaccines
• Broadly neutralizing antibodies
• Novel drug delivery systems

For the latest updates on HIV research and treatment guidelines, visit the Department of Health and Human Services Guidelines or the Centers for Disease Control and Prevention (CDC).