Human Immunodeficiency Virus (HIV) Infection - Treatment Overview
The most effective treatment for
highly active antiretroviral therapy (HAART)-a
combination of several antiretroviral medicines that aims to control the amount
of virus in your body. Other steps you can take include keeping your
immune system strong, taking medicines as prescribed,
and monitoring your
CD4+ (white blood cells) counts to check the effect of
the virus on your immune system. If HIV is not treated, it eventually
AIDS, the last and most severe stage of HIV infection.
People with AIDS are more likely to develop certain illnesses, called
opportunistic infections. Examples include
Pneumocystispneumonia and some cancers. These illnesses are
common in people who have weakened immune systems.
Treatment to prevent infection (postexposure prophylaxis)
Health care workers
who are at risk for HIV because of an accidental needlestick or other
exposure to body fluids may need medicine to prevent infection.6 Medicine may also prevent HIV infection in a person who
has been raped or was accidentally exposed to the body fluids of a person who
may have HIV.7 This type of treatment is usually
started within 72 hours of the exposure.
If you are diagnosed with
HIV infection during the initial symptoms of early HIV
(acute retroviral syndrome), discuss the use of
highly active antiretroviral therapy (HAART) with your
doctor. Information about treatment of early HIV from
clinical trials suggests that
treatment of early HIV with antiretroviral medicines have long-term
HAART medicines that are most often used to treat HIV infection
Nucleoside/nucleotide reverse transcriptase inhibitors, such as tenofovir, emtricitabine, and abacavir.
Nonnucleoside reverse transcriptase inhibitors (NNRTIs), such as efavirenz, nevirapine, or etravirine.
Protease inhibitors (PIs), such as atazanavir,
ritonavir, or darunavir.
Fusion and entry inhibitors, such as enfuvirtide and maraviroc.
Integrase inhibitors, such as raltegravir.
The U.S. National Institutes of Health recommends one of the following programs for people who begin treatment for HIV:5
- Efavirenz + tenofovir + emtricitabine
- Ritonavir-boosted atazanavir + tenofovir + emtricitabine
- Ritonavir-boosted darunavir + tenofovir + emtricitabine
- Raltegravir + tenofovir + emtricitabine
The decision whether to start HAART before your health
starts to decline is complicated. Consider the potential benefits and risks of
early treatment and discuss all the issues with your doctor before starting
treatment of HIV may:5
- Decrease the severity of early HIV
- Affect the rate at which the disease
- Reduce the rate at which the virus multiplies in the
immune system function.
- Lower the risk of
drug resistance with complete viral suppression.
- Reduce the risk
of HIV spreading. Even with early treatment, the
risk of HIV transmission still exists. Antiretroviral therapy cannot substitute
for prevention measures, such as condom use and safer sex
- Extend life.8
Risks. Early treatment
of HIV may:5
- Cost a lot and cause side
- Lead to
drug resistance to antiretroviral medicines, which may limit future treatment
- Result in the need for continuing therapy
- Reduce future medicine options when HIV disease risk is