From the Guidelines
The treatment of HIV involves initiating antiretroviral therapy (ART) as soon as possible after diagnosis, with a recommended regimen of an integrase strand transfer inhibitor (InSTI) plus 2 nucleoside reverse transcriptase inhibitors (NRTIs) 1. The goal of ART is to suppress the viral load to undetectable levels, thereby improving the quality of life and reducing the risk of morbidity and mortality. Key considerations in selecting an ART regimen include the patient's medical history, potential for pregnancy, and cost 1. Regular monitoring of CD4 cell count, HIV RNA level, genotype, and other laboratory tests is crucial for assessing the effectiveness of the treatment and making any necessary adjustments 1. Some important aspects of HIV treatment to consider include:
- Initiating treatment immediately after diagnosis, regardless of CD4 count
- Using a combination of three drugs from at least two different classes
- Regular monitoring every 3-6 months to check viral load, CD4 count, kidney and liver function, and potential drug interactions
- Adherence to the treatment regimen is crucial to prevent drug resistance
- Patients should also receive prophylaxis for opportunistic infections if CD4 counts are low The recommended initial therapy is an InSTI plus 2 NRTIs, with unique patient circumstances guiding the treatment choice 1.
From the FDA Drug Label
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. 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. ISENTRESS is indicated in combination with other antiretroviral agents for the treatment of human immunodeficiency virus (HIV-1) infection in patients 4 weeks of age and older.
The treatment of HIV patients involves the use of antiretroviral agents in combination. Tenofovir disoproxil fumarate 2, efavirenz 3, and raltegravir 4 are all indicated for the treatment of HIV-1 infection in combination with other antiretroviral agents.
- The recommended dosage and administration of these medications vary based on the patient's age, weight, and renal function.
- It is essential to follow the recommended dosages and to monitor patients closely for potential side effects and interactions with other medications.
- Key considerations for treatment include:
- Using these medications in combination with other antiretroviral agents
- Monitoring patients for potential side effects and interactions
- Adjusting dosages based on patient age, weight, and renal function
From the Research
Treatment Options for HIV Patients
- The efavirenz/emtricitabine/tenofovir disoproxil fumarate single-tablet regimen (Atripla®) is a once-daily, single-tablet, triple antiretroviral therapy (ART) formulation available for the treatment of HIV infection 5.
- Combination treatment with emtricitabine and tenofovir plus the integrase inhibitor elvitegravir or raltegravir shows high levels of synergy in vitro, suggesting enhancement of individual anti-HIV-1 activities within cells 6.
- Raltegravir produces durable and consistent viral suppression and immune restoration compared with efavirenz when combined with tenofovir/emtricitabine in treatment-naïve HIV-1-infected patients 7.
Antiretroviral Therapy (ART) Backbones
- Emtricitabine+tenofovir is considered one of the best backbones for HIV prevention, treatment, and elimination 8.
- Long-acting injectable (LAI) antiretroviral therapy (ART) is approved both as a complete treatment regimen (cabotegravir/rilpivirine) and as an additional treatment option (lenacapavir) for those with multidrug resistant HIV-1 9.
Patient Adherence and Satisfaction
- The efavirenz/emtricitabine/tenofovir DF single-tablet regimen provides a convenient once-daily regimen for use in treatment-experienced adults that may confer an advantage over more complex or frequently administered regimens for which adherence to treatment is an issue 5.
- Long-acting injectable (LAI) antiretroviral therapy (ART) offers an alternative treatment approach to daily oral ART for people with HIV-1 infection that is associated with high rates of patient satisfaction when compared to daily oral ART 9.