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Comprehensive HIV Treatment: Strategies and Medications

Discover the latest advancements in HIV treatment, including the six classes of ARV drugs and how to achieve treatment success through adherence and regimen selection.

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Comprehensive HIV Treatment: Strategies and Medications

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  1. This training program is funded through an unrestricted educational grant from Janssen Therapeutics.

  2. ART 101 • Successful HIV treatment usually consists of at least three drugs from two different “classes” of ARV drugs • There are now six classes of ARV drugs: • NRTIs (nucleoside reverse trascriptase inhibitors) • NNRTIs (non-nucleoside reverse trascriptase inhibitors) • PIs (protease inhibitors) • Integrase inhibitors • CCR5 antagonists • Fusion inhibitors • Each works somewhat differently at stopping HIV from multiplying

  3. ART goals • Improving your quality of life • Extending, enhancing your life • Reducing your chance of developing OIs (opportunistic infections) • Restoring and/or preserving your immune system • Maximizing and sustaining a suppression in the amount of HIV in your blood (your “viral load”)

  4. Tools to achieve ART goals • Selection of potent ARV regimen • Preservation of future treatment options • Rational sequencing of ARV regimens • Maximizing adherence • Use of resistance testing

  5. Defining ART success • Within about two weeks after starting ART, your viral load will decrease dramatically • Within two to six months, you will probably be told that your HIV is “undetectable” • Undetectable means that even though you are still HIV positive, your viral load is so low that tests are not sensitive enough to detect it in your blood

  6. Defining ART success • Your CD4 count will increase, and your immune system can recover and do its job • With more CD4 cells, there is less of a chance of developing an OI, such as thrush • If you take all your ARV drugs on time, your chances of remaining undetectable are EXCELLENT

  7. What if I am detectable? • If you are on your third, fourth, or fifth ARV regimen, reaching undetectable status is sometimes difficult • Fortunately, many recent studies show there is a benefit to keeping your viral load as low as you can, even if itis detectable

  8. Current ARV medications

  9. Constructing ARV regimens • 25 individual ARV drugs and 9 co-formulated ARV drugs are currently FDA-approved in the United States • Theoretically thousands of ARV regimens can be constructed/prescribed • ART success can be improved by: • Constructing an appropriate ARV regimen • Preserving future treatment options • Maximizing adherence • Testing for drug resistance

  10. FDcsandstrs • Fixed-dose combination (FDC): Two or more drugs contained in a single doseage form, such as a capsule or tablet • Single-tablet regimen (STR): An FDC capsule or tablet containing all drugs that comprise an ARV regimen • By reducing the number of pills a person takes each day, FDC drugs can help improve adherence to HIV treatment Currently FDA-approved FDCs, including STRs:

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