AIDS - Treatment

If you've tested positive for HIV/AIDS, what treatments or medications have you received?

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What is the treatment for HIV/AIDS?

Medications that fight HIV are called anti-retroviral medications. Different antiretroviral medications attack the virus in different ways. When used in combination with each other, they are very effective at suppressing the virus. These effective combinations are called highly active antiretroviral therapy, also known as HAART or ART. It is important to note that there is no cure for AIDS or for HIV. HAART only suppresses reproduction of the virus. All people with a diagnosis of AIDS should receive HAART therapy. Of course, it is even better to give the medications earlier in HIV infection to prevent progression to AIDS.

There are six major classes of antiretroviral medications: (1) nucleoside reverse transcriptase inhibitors (NRTIs), (2) non-nucleoside reverse transcriptase inhibitors (NNRTIs), (3) protease inhibitors (PIs), (4) fusion (entry) inhibitors, (5) integrase inhibitors, and (6) CCR5 antagonists. These drugs are used in different combinations according to the needs of the patient and depending on whether the virus has become resistant to a specific drug or class of drugs. Treatment regimens usually consist of three to four medications at the same time. Combination treatment with HAART is essential because using only one class of medication by itself allows the virus to become resistant to the medication. There are now available pills that contain multiple classes of HAART which are helpful in decreasing the daily pill burden and in improving compliance to medications.

Before starting HAART, blood tests usually are done to make sure the virus is not already resistant to the chosen medications. These resistance tests may be repeated if it appears the drug regimen is not working or stops working. Patients are taught the importance of taking all of their medications as directed and are told what side effects to watch for. Noncompliance with medications is the most common cause of treatment failure and can cause the virus to develop resistance to the medication. Because successful therapy often depends on taking several pills, it is important for the patient to understand that this is an "all or nothing" regimen. If the person cannot tolerate one of the pills, then he or she should call their physician, ideally prior to stopping any medication. Taking just one or two of the recommended medications is strongly discouraged because it allows the virus to mutate and become resistant. It is best to inform the doctor quickly about any problems so that a better-tolerated combination can be prescribed.

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