India’s Battle Against HIV

AIDS is a debilitating disease that is prevalent worldwide and India has the third largest AIDS epidemic in the world. People living with HIV in India often access treatment late. The Minister of Health and Family Welfare has announced a new test-and-treat policy that commits to providing access to HIV treatment for everyone living with HIV in the country. Prior to this, people living with HIV could only access antiretroviral medicine for free if their CD4 cells had decreased to less than 500 cells/mm3. This change in policy will keep individuals communities healthy and ensure that India ends its AIDS epidemic by 2030.

HIV attacks and destroys the infection-fighting CD4 cells of the immune system. Loss of CD4 cells makes it hard for the body to fight off infections and full-blown AIDS develops.

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Mechanism of action of HIV Therapies

Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines every day. HIV Therapies is recommended for everyone infected with HIV. ART can’t cure HIV, but help patients live longer, healthier lives and reduce the risk of HIV transmission.

HIV therapies prevent HIV from multiplying thereby reducing the amount of HIV in the body. Having less HIV in the body gives the immune system a chance to recover. Even though there is still some HIV in the body, the immune system is strong enough to fight off infections.

Drugs used in HIV Therapies

People infected with HIV should start ART as soon as possible. During AIDS in pregnancy, certain HIV-related illnesses and coinfections, and early HIV infection, the HIV therapy is started immediately.

Classes of HIV Drugs

There are many HIV medicines available for HIV regimens. The HIV medicines are grouped into different according to how they fight HIV. A person’s initial HIV regimen usually includes three HIV medicines from at least two different HIV drug classes.

The six drug classes are:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • Nucleoside reverse transcriptase inhibitors (NRTIs)
  • Protease inhibitors (PIs)
  • Fusion inhibitors
  • CCR5 antagonists (CCR5s) (also called entry inhibitors)
  • Integrase strand transfer inhibitors (INSTIs)

In general, a person’s first HIV regimen includes two NRTIs plus an INSTI, an NNRTI, or a PI boosted with cobicistat (brand name: Tybost) or ritonavir (brand name: Norvir). Cobicistat or ritonavir increase (boost) the effectiveness of the PI.

Selection of an HIV regimen depends on several factors like side effects of HIV medicines and potential drug interactions between medicines. Because the needs of people with HIV vary, there are several HIV regimens to choose from.

Duration of HIV Therapies

Viral load is the amount of HIV in a person’s blood. A main goal of ART is to reduce a person’s viral load to an undetectable level. Once effective ART is started, it usually takes 3 to 6 months for a person’s viral load to reach an undetectable level. Having an undetectable viral load doesn’t mean a person’s HIV is cured.