HIV Management and Drug Treatments and HIV Prophylaxis

Over the past 30 years, the prognosis associated with HIV-positive status has changed from impending death to a generally manageable illness. Currently more than 30 different FDA approved single formulation and combination ARVs are available to manage HIV infection.

Pharmacists can use their medication expertise to ensure correct dosing, recommend  appropriate combinations, and conduct screening for drug interaction,  and monitor for and help manage adverse effects of treatment. A combination  of at least 3 highly active ARVs is necessary to suppress the virus and prevent mutations that cause resistance.

HIV Prophylaxis: Truvada (emtricitabine/tenofovir).

    • More patients will get Truvada to prevent HIV infection before exposure because of new CDC PRE-exposure prophylaxis guideline.
    • This is different from POST-  exposure prophylaxis that is used AFTER exposure due to an accidental needle stick. or broken condom, etc.
    • PRE-exposure prophylaxis is recommended for adults at high risk due to having sex or sharing injection equipment’s with HIV-infected or risky partners.
    • Truvada can decrease HIV risk by 92%, however, protection will be much less if it is not taken every day. .Pharmacist could warn patients about “start-up syndrome” which are nausea, abdominal pain, flatulence, and headache that is usually resolve after the first month.
    • Pharmacist could recommend acetaminophen if needed, but with caution, that taking high dose, or multiple NSAIDs with Truvada is linked to acute renal failure.
    • Patients could be encourage to also use condoms to reduce the risk of HIV and other sexually transmitted diseases.