NEW HIV MEDICINES / ARV MEDICINES REGIMES TO CONTROL HIV /AIDS

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NEW ANTI HIV  OR AIDS MEDICINES OR HAART / ART /ARV MEDICINES HAVE COME TO USE  IN MODERN TIMES AND THEY ARE REPLACING THE OLD ONES BUT IF A PATIENT DOING GOOD WITH OLD REGIME HE DOESNOT REQUIRE TO CHANGE IT BUT IF NEW PATIENT OR SOME ONE NOT IMPROVING CD4 COUNT OR CLINICALLY BETTER OR DECREASING VIRAL LOAD THEN SUCH REGIME CAN BE CHANGED AFTER PROPER EXAMINATION,BLOOD TESTS AND HISTORY OF PATIENT BY A QUALIFIED DOCTOR ONLY.They include:
  • Dolutegravir (DTG) plus abacavir (ABC) plus lamivudine (3TC);
  • Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) with DTG;
  • Elvitegravir/cobicistat (EVG/c) plus TDF/FTC; andcreated on: 07/18/15created on: 07/18/15created on: 07/18/15created on: 07/18/15
  • Raltegravir (RAL) plus TDF/FTC.
There is a fifth option and that is TDF/FTC plus darunavir/ritonavir (DRV/r)—a ritonavir-boosted protease inhibitor–based regimen.
Not in the list of recommended regimens but placed in the alternative section are TDF/FTC/efavirenz and TDF/FTC/atazanavir/ritonavir. Both of these have excellent virologic activity.
The reason that the last two regimens are not in the "recommended" section any longer is because of tolerability or safety. With efavirenz-based regimens there are concerns about central nervous system toxicity and a possible association with suicidal ideation.[2] With atazanavir/ritonavir it is primarily due to the results of the randomized, open-label study ACDG 5257,[3,4] which found that both RAL and DRV/r were better tolerated.
However, for patients who are doing well on those regimens, there is no mandate to change, and the guidelines are explicit about this.
Other changes in the guidelines[2] include a section on virologic failure that has been greatly revised. There is a section on poor CD4 recovery in the setting of virologic suppression, with the important message that there is no proven intervention that can reverse this process; that is an ongoing research agenda. There is also a revised section on acute and early HIV infection, a section on drug-drug interactions, and, of course, an expanded section discussing the drug-drug interactions with new HCV therapies.

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