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HIV treatment and prevention 2019: current standards of care
Nittaya Phanuphak1, Roy M Gulick
1Chief of PREVENTION, Thai Red Cross AIDS Research Centre, Pathumwan, Bangkok, Thailand Rochelle Belfer Professor of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA.
Insights
Current HIV treatment and prevention strategies utilize potent antiretroviral regimens for effective viral suppression and reduced transmission. Early treatment and pre-exposure prophylaxis (PrEP) are key components of HIV care and epidemic control.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Human Immunodeficiency Virus (HIV) remains a significant global health challenge.
- Advances in antiretroviral therapy (ART) have transformed HIV management.
- Effective prevention strategies are crucial for controlling HIV transmission.
Purpose of the Study:
- To review the 2019 standards of care for HIV treatment.
- To summarize current HIV prevention strategies.
Main Methods:
- Review of current clinical guidelines and scientific literature on HIV treatment and prevention.
- Synthesis of data on antiretroviral regimens and prophylaxis.
Main Results:
- Current HIV treatment involves daily oral antiretroviral regimens (typically three drugs) initiated promptly.
- Antiretroviral therapy leads to normal life expectancy with virologic suppression.
- HIV prevention includes early treatment, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP).
- PrEP is highly effective when adhered to.
Conclusions:
- Modern antiretroviral therapy is potent, convenient, well-tolerated, and durable.
- Antiretroviral-based strategies significantly decrease HIV transmission.
- Further research is needed to assess the impact of early ART and PrEP on overall HIV epidemic control.
Purpose Of Review:
The purpose of this review is to summarize the current standards of care for both HIV treatment and HIV prevention in 2019.
Recent Findings:
Current HIV treatment is started as soon as feasible in a person with HIV infection and consists of a three-drug oral daily antiretroviral regimen, consisting of two nucleoside analogue reverse transcriptase inhibitors combined with a third drug, either an integrase inhibitor, a non-nucleoside reverse transcriptase inhibitor, or a protease inhibitor. Present treatment regimens are potent, convenient, generally well tolerated and durable, and lead to a normal life expectancy. Present antiretroviral-based HIV prevention strategies focus on treating people with HIV infection with antiretrovirals as soon as feasible to reduce their risk of transmitting to others, and providing two-drug pre-exposure prophylaxis (PrEP) and three-drug post-exposure prophylaxis (PEP) to those HIV-uninfected individuals who are at risk for HIV infection. PrEP is highly effective when used correctly. Further data on early antiretroviral therapy and PrEP are needed to demonstrate any impact on HIV epidemic control.
Summary:
HIV treatment and HIV prevention have improved markedly in recent years due to the development of oral antiretrovirals that are potent, convenient, and generally well tolerated, and lead to virologic suppression and decreased HIV transmission.
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