Although there is no cure for human immunodeficiency virus (HIV) infection, treatment is still a necessary step to prolong the life of an infected individual. Before a treatment regimen is recommended, however, the individual has to undergo HIV testing at one of the clinics or hospitals in Singapore or perform an anonymous HIV test using a test kit available at pharmacies.
HIV Testing as a Primary Step
HIV screening will determine the progress of the virus so that appropriate medication can relieve some of the symptoms, if there are any. There are various methods for HIV testing in Singapore, but most can be categorized into three types; testing for HIV antibodies, testing for HIV antigens, and a combination of the two tests.
The first and succeeding HIV screenings should be performed within a three-month window period from the time of the infection. Why does an individual need more than one HIV test? That is because the virus or the antibodies for the virus might not show up in the sample during the first HIV testing. If an individual tested negative (not infected) the first time, the test must be repeated to confirm the results. There are also rare cases where the initial result was positive (HIV-infected), but the second test revealed that it was false.
The individual might need additional testing for sexually-transmitted diseases (STDs) as well, because a co-infection is also highly probable. Additional tests and confidential human immunodeficiency virus check in Singapore will also be needed to determine if the HIV-positive person also has an opportunistic illness (OI), or an infection other than STDs that has taken advantage of the weakened immune system.
How HIV is Treated
The goals of HIV treatment are to slow down the progress of the virus, prevent the spread of the infection, and to prevent symptoms from reducing the quality of life of the individual. Therefore, HIV treatment involves not just one type of medication, but other types of treatment that make up an HIV regimen.
• Antiretroviral Therapy (ART)
All HIV-positive individuals need ART as soon as possible regardless of the CD4 cell count, because it can be highly effective during the early stages of HIV. ART refers to the combination of antiretroviral (ARV) drugs that will act to stop the progression of the disease by suppressing the actions of the virus itself. ART will not kill the virus, but it’s possible to slow the down the destruction of the CD4 cells and the replication of the virus. This will give the immune system a chance to recover and still be able to fight off infections and HIV-related cancers.
• HIV Drug Classes
ARV drugs included in the therapy are divided into six classes based on how they affect the life cycle of HIV. A typical HIV regimen will include 3 HIV medicines and an additional 2 or more drug classes. Therefore, even if you have already confirmed that you are HIV-positive, your doctor will tell you to keep monitoring your condition through scheduled HIV testing.
The six classes of HIV drugs are as follows:
1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs) will block the virus’s reverse transcriptase proteins that it needs to make copies of itself.
2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) will bind and disable the reverse transcriptase proteins in the virus.
3. Protease Inhibitors (PIs) will inhibit an enzyme from the virus that is needed for replication.
4. Fusion and Entry Inhibitors will stop the virus from entering the CD4 cells.
5. Pharmacokinetic Enhancers will act as booster of another HIV medication.
6. Integrase Strand Transfer Inhibitors (NSTIs) will block the enzyme from the virus needed to infect the CD4 cells with its genetic material.
• Common Side Effects
HIV medication have side effects, but the effects vary among patients, that is why you will need to collaborate with your doctor to come up with the best HIV regimen. You should also take note of possible drug interactions among HIV medicines and HIV drugs with other vitamins, supplements, and herbal products. It is possible for any one of the non-HIV medication to reduce the effect of HIV drugs, so always consult the doctor before trying other products.
• Possible Drug Resistance
HIV can mutate as it slowly takes over your immune system, that is why drug resistance is a huge threat. As a result, some strains of HIV may not be affected by your current medication. Such a risk, however, can be avoided if you strictly follow your HIV regimen and you undergo drug-resistance testing to identify which medicines will not work anymore.
Treating Infants and Children with HIV
Newborns of HIV-positive mothers will need postpartum ARV drugs; specifically, infant ARV prophylaxis should be administered within 6 to 12 hours after birth, while the four-week neonatal zidovudine prophylaxis regimen is given for full-term babies if the mother has received ART during pregnancy. For babies whose mothers did not receive the same ARV drugs, a combination infant prophylaxis regimen is advisable. Premature babies on the other hand, will need either nevirapine (or prophylaxis) or zidovudine (or treatment and prophylaxis).
For babies and children older than 14 days, the dosage of HIV drugs (such as zidovudine, maraviroc, and raltegravir) will depend on the weight. That means the dosage and type of HIV drugs will change as the child grows.