HIV

Introduction Pre-exposure prophylaxis (PrEP) refers to the use of anti-retroviral therapy (ART) to prevent the new acquisition of HIV. Prevention of new infections is fundamental to the management of HIV. There have been a number of studies which show, with excellent adherence, PrEP offers marked reduction in the risk of contracting the virus. There are a number of indictions for PrEP which typically takes the form of Tenofovir Disoproxil / Emtricitabine (TD-FTC). It can be given in two ways depending on the individuals requirements and risks: Daily tablet On demand (e.g. two tables 2-24 hours prior to sex, and one tablet daily

Introduction Human immunodeficiency virus (HIV) is a retrovirus that, when untreated, causes progressive immunodeficiency with resulting susceptibility to opportunistic infections and malignancies. HIV was first identified in 1983, two years after the first description of acquired immunodeficiency syndrome (AIDS). AIDs refers to a state of immunodeficiency that results from infection with HIV, typically taking several years (median 8-10) following exposure to develop. In the UK there has been a move away from the term AIDs, which is still bound by significant stigma, to late-stage HIV. It is characterised by a CD4 count < 200 and/or AIDs defining illnesses. Prior to effective

Introduction Antiretroviral therapies (ART) have revolutionised HIV care, transforming what was once an almost invariably fatal illness into a treatable chronic disease. ARTs enable those with HIV, in many cases, to live near-normal lives (depending on factors such as stage at diagnosis). There are six major classes of medication; entry inhibitors, nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase inhibitors, protease inhibitors and post-attachment inhibitors. The options available allow for changes to be made in light of resistance patterns, experienced side effects and personal risk factors. As a general rule, regimens consist of: Two nucleoside reverse transcriptase