Living with HIV

HIV Treatment and Antiretroviral Therapy

Getting treatment and staying on it is very important and here is some useful information about why it is so important.

Today, HIV is something you can live a long and healthy life with. 1 Being able to achieve this predominantly comes from the scientific advancements made in managing HIV, including new antiretroviral therapies (ARTs) and the combination of ARTs that have evolved over the past 30 years, and importantly, starting treatment soon after diagnosis.

Research shows that a 20 year old starting ART can expect to have a life expectancy similar to that of the general population 2.

What does being undetectable mean?

There are 6 classes of HIV treatment

  • Entry inhibitors ⁴

    Interfere with the virus’ ability to bind to the outer surface of the CD4+ T-cell co-receptor and inhibits HIV from entering the CD4+ T-cell.

  • Fusion inhibitors ⁵

    Interfere with the virus's ability to fuse with the outer surface of the CD4+ T-cell membrane and prevent HIV from entering the CD4+ T-cell.

  • Nucleoside reverse transcriptase inhibitors (NRTIs) ⁶

    In order for HIV-1 to make more copies of itself, HIV needs to convert its RNA to DNA by using reverse transcriptase (RT) enzyme. NRTIs are fake DNA building blocks. When one of the fake building blocks is added to a growing HIV-1 DNA chain, the real DNA building blocks cannot be added on and the building of HIV-1 DNA stops. Thus, HIV-1 RNA cannot be converted into HIV-1 DNA.

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) ⁷

    In order for HIV-1 to make more copies of itself, HIV needs to convert its RNA to DNA by using RT enzyme. NNRTIs bind to the RT enzyme, interfering with its ability to convert HIV-1 RNA into HIV-1 DNA.

  • Integrase strand transfer inhibitors (INSTIs) ⁶

    Interfere with the HIV enzyme integrase, which the virus uses to insert (‘integrate’) its genetic material (HIV-1 DNA) into the genetic material (DNA) of the CD4+ T-cell it has infected.

  • Protease inhibitors (PIs) ⁸

    Interfere with the HIV enzyme called protease. When protease does not work properly, new HIV virus particles cannot be assembled.

HIV treatment includes a combination of these agents, typically from at least 2 classes.

How do I make sure I am on the right treatment?

There are many HIV treatment options available and talking to your doctor will help you find the best treatment for you. Read the ‘Talking to your doctor’ page for more information.

Unity Tool

Effective communication with doctors can significantly enhance treatment outcomes.10

ViiV Healthcare, alongside an expert panel of PLHIV and doctors has created a simple 10-minute questionnaire that generates a personalised guide for you to take to your next appointment.

This appointment guide is tailored for you, and aims to build a picture of your current quality of life related to your HIV, whilst highlighting any concerns that you may have.

 

All responses to the questionnaire are anonymous and it is completely optional whether you choose to share the guide with your doctor, but many people have found it useful.

 

Why not try it out for yourself?

1 See how satisfied the 1,085 participants in the Positive Perspectives survey are with their treatment, the key factors they considered when they switched treatment and who’s decision switching treatment was. 9

When did PLHIV start their treatment?

52%

of participants were on treatment within the first 6 months of diagnosis

Whose decision was it to switch treatment?

55%

of participants who changed their HIV treatment believed it to be a joint decision between them and their doctor

What were the most important factors when changing HIV treatment?

43%

of participants changed their HIV treatment to reduce severity/frequency of side effects

  • 2 See below how this 52% (571) of PLHIV who started treatment within 6 months of being diagnosed differs by region, gender, age and sexual orientation:
  • 2 See below how this 55% (460) of PLHIV who changed their HIV treatment believed it to be a joint decision between them and their doctor differs by region, gender, age and sexual orientation:
  • 2 See below how this 43% (355) of PLHIV who changed their HIV treatment to reduce severity/frequency of side effects differs by region, gender, age and sexual orientation:

Region

Age

Gender

Sexual Orientation +

Applied filters

Region

Age

Gender

Sexual Orientation

0%

0%

0%

0%

The Positive Perspectives survey report

You can download the Positive Perspectives survey report here. This report is focused on the attitudes and perspectives of PLHIV around diagnosis, disclosure, treatment and communicating with your doctor. New partner/significant other perspectives coming in 2018!

DOWNLOAD REPORT

(PDF 8MB)

Perceptions from participants that took part in the Positive Perspectives survey

Your stories relevant to treatment

How can treatment regimens be tailored to make treatment work?

Listen to how Sophie and her doctor improved her adherence

Sophie and Juno both ardently believe that ‘knowledge is power’ when it comes to living well with HIV and finding the right antiretroviral treatment for their own circumstances. From researching potential side effects and knowing which treatments could cause them, Sophie was determined to understand what HIV medicines she should avoid.

VIEW JUNO'S FULL STORY

How would you feel if a change to your treatment regimen was proposed?

Find out how Somchai and George would react

When George was diagnosed twenty years ago, he was taking more than 20 tablets a day. Today George only takes two tablets per day and he’d always discuss changing treatment with Somchai.

VIEW GEORGE'S FULL STORY

Where is HIV medication going?

See what Sarah thinks

Sarah’s recently changed her HIV medication and says that she and the doctor are happy. She discusses how medication is getting better and how PLHIV can enjoy life because you know it is not over

VIEW SARAH'S FULL STORY

References

  1. Murungi A, et al. Experience of living with HIV: Diagnosis & Disclosure – findings from the Positive Perspectives study. Presented at the IAS Conference on HIV Science (IAS 2017), 23 26 July 2017, Paris, France. Abstract: WEPED1423.
  2. Katz I and Maughan-Brown B. Improved life expectancy of people living with HIV: who is left behind? Lancet HIV. 2017 Available at: http://thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30086-3/fulltext. Last accessed: April 2017.
  3. Pebody R. NAM AIDSmap. Undetectable viral load. January 2017. Available at: http://www.aidsmap.com/Undetectable-viral-load/page/1320141/. Last accessed: July 2017.
  4. Briz V, et al. HIV entry inhibitors: mechanisms of action andresistance pathways. J Antimicrob Chemother 2006;57:619–27.
  5. Medicine Net. Fusion Inhibitors. Available at: http://www.medicinenet.com/script/main/art.asp?articlekey=32105. Last accessed: September 2017
  6. Chang S-Y, et al. Prevalence of Integrase Strand Transfer Inhibitors (INSTI) Resistance Mutations in Taiwan. Scientific Reports (Nature) 6, Article number: 35779 (2016).
  7. Wainberg MA, et al. The Need for Development of New HIV-1 Reverse Transcriptase and Integrase Inhibitors in the Aftermath of Antiviral Drug Resistance. Scientifica Volume 2012 (2012).
  8. Encyclopaedia Britannica. Protease Inhibitor. Available at: https://www.britannica.com/science/protease-inhibitor. Last accessed: September 2017
  9. Young B, et al. Patient Experience & Views on Antiretroviral Treatment − Findings from the Positive Perspectives Survey. Presented at the Infectious Disease Week (ID Week), 4−8 October 2017, San Diego, USA. Abstract number #1393.
  10. Thomson C, et al (2015). Identifying Priorities for HIV Consultations among Healthcare Providers (HCPs) across Europe: Results of a Pan-European Survey. In: 15th European AIDS Conference (EACS), 21 24 October 2015, Barcelona, Spain, PE8/69.