From the Guidelines
HIV treatment should begin immediately after diagnosis with an antiretroviral therapy (ART) regimen that typically combines three or more medications to suppress the virus, with the preferred initial regimen being an integrase strand transfer inhibitor (InSTI) plus 2 nucleoside reverse transcriptase inhibitors (NRTIs) 1. The standard first-line regimen often includes two NRTIs like tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), plus an InSTI such as dolutegravir, all taken once daily. Some key points to consider when treating HIV include:
- Starting treatment as soon as possible after diagnosis, with immediate initiation (eg, rapid start) if clinically appropriate 1
- Selecting a regimen based on unique patient circumstances, such as concomitant diseases and conditions, potential for pregnancy, and cost 1
- Monitoring CD4 cell count, HIV RNA level, genotype, and other laboratory tests for general health and co-infections at specified points before and during ART 1
- Assessing treatment history, tolerability, adherence, and drug resistance history before switching regimens, and using 2 or 3 active drugs in a new regimen 1
- Providing counseling about prevention strategies, regular STI screening, and management of comorbidities, as well as promoting strict adherence to medication schedules to achieve treatment success. Regular monitoring includes viral load testing every 3-6 months, CD4 count assessments, and screening for medication side effects and drug interactions. Modern HIV treatment can lead to an undetectable viral load, effectively preventing transmission to others and allowing for a normal lifespan.
From the FDA Drug Label
1 INDICATIONS & USAGE Efavirenz in combination with other antiretroviral agents is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and in pediatric patients at least 3 months old and weighing at least 3.5 kg.
1 INDICATIONS AND USAGE 1. 1 HIV-1 Infection Tenofovir disoproxil fumarate is indicated in combination with other antiretroviral agents for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and pediatric patients 2 years of age and older weighing at least 10 kg.
1 INDICATIONS AND USAGE ‑ TIVICAY and TIVICAY PD are indicated in combination with: other antiretroviral agents for the treatment of human immunodeficiency virus type 1 (HIV‑ 1) infection in adults (treatment-naïve or -experienced) and in pediatric patients (treatment-naïve or -experienced but integrase strand transfer inhibitor [INSTI]-naïve)aged at least 4 weeks and weighing at least 3 kg
The treatment of HIV-1 infection can be done using efavirenz 2, tenofovir disoproxil fumarate 3, or dolutegravir 4 in combination with other antiretroviral agents.
- Efavirenz is indicated for adults and pediatric patients at least 3 months old and weighing at least 3.5 kg.
- Tenofovir disoproxil fumarate is indicated for adults and pediatric patients 2 years of age and older weighing at least 10 kg.
- Dolutegravir is indicated for adults and pediatric patients aged at least 4 weeks and weighing at least 3 kg.