Updated: Mar 29
HIV is treated with Antiretroviral Therapy (ART) which is made up of a regimen of a few different medications. Though ART does not completely cure HIV, it suppresses viral replication in the body, which allows the immune system to slowly regain strength and regain the capacity to respond to infections appropriately. Additionally, once the virus has been suppressed, the risk of passing the virus to someone else reduces by 96%
The World Health Organization recommends that all people living with HIV should be given lifelong ART, regardless of clinical status or CD4 count. This helps prevent onward transmission of the virus and also prevents further deterioration of the immune system, which means that the person will not enter the AIDS stage of HIV infection.
An important thing to know about ART is that it’s only effective if taken consistently, as your doctor will also tell you. If this advice is not followed carefully, the virus will eventually become resistant to the medication, requiring alternate treatments to be considered, which can be very costly.
In Malaysia, the first line of treatment for HIV infection is based on a low dose of Efavirenz paired with two other ARV medications. It is highly effective and is usually able to achieve viral suppression within 6 months of initiation. Efavirenz has the advantage of being relatively cheap, and highly effective but has been associated with intolerable side effects for some patients. Dolutegravir (DTG) is the second line of treatment for HIV infection in Malaysia. Studies indicate that Dolutegravir is associated with much fewer side effects and, while both DTG and Efavirenz are effective in suppressing the virus, DTG is able to suppress the virus in a shorter time frame. A major disadvantage of DTG, however, is the cost. As such, it is not currently a feasible option for first-line medication for many patients.
Another important aspect of HIV treatment is testing for and treating opportunistic infections. Clients who present with low CD4 counts are recommended to receive a package of care in addition to ART that includes testing and preventative measures for infections such as tuberculosis or meningitis. This package usually takes the form of a battery of tests and prophylactic antibiotics.