There is ongoing debate about whether people should start HIV treatments earlier or later. Historically many people have waited to start treatments to avoid side effects, or until they really needed them and to avoid the lifestyle cost of a rigid regime of taking pills. But how does taking pills play out today?
In February this year, at the 17th Conference on Retroviruses and Opportunistic Infections, European studies were presented that found many people diagnosed with HIV today would live a normal life expectancy. So imagine being 35 and diagnosed with HIV and the question of starting treatments comes up with all the attached anxiety. Whether a person starts treatments immediately or in 4 years time, within the context of taking pills for 40 years, it may not be worth the energy to worry. For many people with HIV, there is growing evidence which favours starting treatments earlier. Obviously, these questions are best answered in a consultation with your Doctor and according to your own clinical results.
The pharmaceutical industry has responded to the problems associated with pill burden on lifestyle for people living with HIV. This has had the benefit of improved adherence to medication and reducing complications associated with the development of resistance in the future. Some have conducted studies that prove a once a day regime is equally effective as a twice daily regime of which Viramune is an example. Others have reformulated their pills into a once a day pill such as Kaletra. Isentress is a relatively new pill that has entered the HIV market and has started out as a two pill once a day regime. Some HIV pills are re-combinations of older treatments. For example Efavirenz, Tenofovir and Emtricitabine have been combined into the one pill taken once a day and marketed as Atripla. In the USA, Darunavir is already approved for both treatment-experienced and treatment-naive patients in a once daily dose (800/100mg) with Norvir. So the trend is clear. Fewer pills taken less often without a reduction in potency.
Given that regimes can last for many years, from the consumers’ perspective advances in the reduction of pills are still balanced with the side effects that each regime brings. As a person living with HIV I find it’s important to remain open to new HIV medications that are not only are easier to take but have reduced side effects. This may mean that from time to time I will need to switch. This is likely if I am going to be taking HIV medication for 40 plus years. Thanks to medical advancement HIV continues to progress towards a lifetime chronic manageable disease. However my preference for a complete cure remains naturally strong.
Cipri Martinez
