Treatment strategies

Choosing a treatment strategy

There are many factors to consider when choosing an effective antiretroviral regimen, including:

  • Host factors: viral load, CD4 cell count, overall health, genetics, adherence abilities, and treatment history
  • Viral factors: tropism and drug resistance
  • Antiretroviral: side-effects, dosing, drug interactions/pharmacokinetics, drug cost/availability
  • Other: opportunistic infections and other HIV- and non-HIV-related clinical events.

The goal of antiretroviral therapy is to durably suppress viral load to an undetectable level in order to restore and maintain immune function, as indicated by a rising CD4 cell count; extend disease-free length of survival; and limit transmission.

Using current antiretroviral drugs, HIV cannot be completely eradicated from the body and treatment will probably need to be life-long. But individuals who are already using highly active antiretroviral therapy (HAART) also have options to consider, including switching to simpler regimens that are able to provide more potent viral suppression, fewer side-effects, improved convenience, or lower cost. With more than 20 antiretroviral drugs approved for marketing or available through expanded access programmes, there are now new choices for constructing effective HAART regimens.

Researchers have explored various treatment strategies, including regimen simplification, induction and maintenance therapy, and switching between regimens that are non-nucleotide reverse transcriptase inhibitor (NNRTI)-containing or protease inhibitor (PI)-based.

One therapy that is not recommended is a structured treatment interruption, unless in the context of a clinical trial. Otherwise, interrupting therapy may cause rapid viral rebound, CD4 cell loss, and clinical progression. For further information on switching regimens, see Changing HIV treatment

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.