HIV Treatment Guidelines 2019 | What is undetectable HIV?

HIV treatment guidelines
Best HIV treatment guidelines 2019
HIV symptoms: I'm sure this question has been asked many times, but for the sake of putting my mind at rest, is that possible to know within 48 hours? If I ask one question to you that could HIV symptoms appear within 48 hours of infection? What do you think? The symptoms of HIV are mostly the same for men and women, and you can feel this also. But they can vary from person to person.

Now a day’s HIV is easy to manage, HIV is a long term health condition which is now very easy to manage. HIV stands for Human Immunodeficiency Virus. The virus targets our Immune system and if untreated, weakens your ability to fight infections and disease.
  1. The starting or early stage HIV Infection symptoms include a ‘flu-like’ illness and a dark skin rash.
  2. This can be followed by a period of feeling completely healthy, which could last for up to 10 years after being infected by HIV.
  3. In addition, Advanced HIV Infection symptoms can include fungal nail infections, recurrent colds, dementia or confusion.
  4. If you are sure HIV positive, If you believe you have been infected with HIV then you should get tested.
  5. The HIV positive person feels several problems like, Severe headaches problem, Fever (with temperatures over 100 degrees F), Chills and sweats, Fatigue, Severe muscle ache, Sickness and diarrhea, Rapid weight loss without any reason.
The HIV symptoms that men will experience are not all that totally different from those found in women. If I say for men and women then apart from vaginal or menstrual changes all the tell-tale signs are the same in men and women.

HIV Treatment Guidelines

The new guidelines now recommend the use of safer and more effective antiretroviral medicines that will not only help persons living with HIV live better quality lives due to fewer side effects but also rapidly helps them suppress the virus.
An International Antiviral Society-USA revealed new guidelines for treatment and prevention of HIV infection in adults.
HIV is a rapidly changing and complex topic. This new guideline updates the society’s 2016 publication. It contains recommendations on when to start antiretroviral therapy for people who are HIV positive and recommendation on appropriate combinations of antiretroviral drugs. In detail it also pre- and post-exposure prophylaxis strategies for preventing HIV infection in those at risk.

MAC Treatment of HIV

Mycobacterium avium complex (MAC) prophylaxis. Indicated for the bar of disseminated Mycobacterium Avium Complex (MAC) disease in patients with advanced HIV infection.
(MAC) Mycobacterium Avium Complex is a bacterial infection that can cause life-threatening symptoms in people(men-women) with weakened immune systems. People who have healthy immune systems or have a healthy lifestyle can also be infected but their symptoms are not usually serious. People who are with advanced HIV disease, mac usually cause disease in the liver, spleen, and bone marrow.

Dosage Modifications

Nausea, vomiting, or GI upset: 150 mg PO BID with food

Renal impairment
Mild or moderate: No dose adjustment required

Severe (CrCl <30mL/min): reduce dose by 500th
Hepatic impairment

Mild: No dose adjustment required
Moderate-to-severe: Not studied

Mycobacterium avium complicated Treatment (Orphan)

Orphan designation for the treatment of disseminated Mycobacterium avium complex disease

There are two MAC bacteria—M. avium and M. intracellulare—and both can be found virtually anywhere in the environment. They live in water, soil, food, bird droppings, and many animals. As a result, it's difficult to avoid coming into contact with them. If infection occurs, it's usually through water or food or the lungs. It cannot be passed from person to person.
However, mac disease is preventable. With its help, One of the best ways to prevent it is to avoid CD4 counts from dropping below 100 by starting potent HIV treatment. In people whose CD4 counts do not respond adequately, preventive drugs are taken. MAC generally occurs or generates in 2 out of 5 people with HIV and low CD4 counts.

HIV Semen

We have undertaken an analysis of semen from HIV infected men with regard to sperm counts (sperm quantity) and motility, non-spermatozoal cells, and viral nucleic acid. Regression analysis showed us that sperm concentration and motility was positively associated or connected with blood CD4 cell count. By contrast, non-spermatozoal cell concentration (round cells) was inversely (from the opposite side) related to CD4 count. Extracellular HIV RNA was detected in the majority of semen samples and proviral DNA in a minority or less.
Percoll gradient washing of 12 semen samples yielded six samples containing adequate sperm concentration for analysis purpose. This washing procedure reduced prewash extracellular RNA to below detectable limits in all the given cases; proviral DNA present in two of the six prewash samples was also reduced to below detectable limits after washing. After all, we conclude that semen washing before artificial insemination may reduce the risk or overcome the risk of HIV transmission(spread) from an infected man to an uninfected woman. However, further evidence from prospective analyses of such an approach is more required.
HIV Risk: The risk of acquiring HIV during oral sex (sucking the penis of an HIV-positive person) is may pretty low, but it is not zero. Here if you are Taking your partner's ejaculate (cum or pre-cum) in your mouth appears to make transmission more likely. Almost all of the individuals or people who say that oral sex must have been the way or one of the methods that they acquired HIV and whose cases have been medically evaluated mention or given there that they took ejaculate in the mouth.
In addition, It is not actually the swallowing that matters, it's probably having the ejaculate in your mouth (especially if there are any cuts or ulcers there). In the stomach, digestive enzymes and acidity may also inactivate HIV.
But here is the risk of acquiring HIV during vaginal or anal sex is far, far higher than during oral sex or having oral sex. It's also worth remembering that when a person with HIV receives antiretroviral treatment(One type of treatment), the amount of(lots of HIV) HIV in his body fluids falls dramatically. If I sat in detail then just put simply there will be very little HIV in his semen, so transmission is highly unlikely. This applies to all forms of sex(for all types of sex positions or in body parts), including oral sex.

What is undetectable HIV

Can a person with HIV positive on treatment with an undetectable viral load transmit HIV?
No. No any person living with HIV on antiretroviral therapy (ART) with an undetectable HIV viral load that is maintained over time and monitored every 4-6 months cannot transmit HIV through sex. There is effectively no risk of transmitting HIV sexually to any other person.
If we go in the past then there was a big study published in 2000, 18 years ago, which showed us that the level of virus in the HIV person’s blood directly(person to person) relates to the more chances of passing the virus on.
It is now well known for everyone that the use of HIV treatment not only improves the health of people living with HIV but is also a highly effective and perfect strategy to prevent HIV transmission. This is because HIV treatment can reduce or overcome the amount of virus (viral load) in the blood and other bodily fluids (such as semen and vaginal and rectal fluids) to undetectable levels. To become and remain undetectable, people living with HIV (Who has HIV positive) need to take their HIV treatment as prescribed. In addition to taking HIV medications, regular medical visits (for a regular checkup) are important to monitor (to see the status or HIV) viral load to make sure it stays undetectable, and to receive other medical support and help.
Evidence shows that HIV-positive people who are on treatment or who are taking the HIV treatment, engaged in care or in touch with the doctor, and have an ongoing undetectable viral load:
  1. Do not transmit HIV to their sexual partners through any medium or doing sex;
  2. Do not transmit HIV to their baby during pregnancy and delivery – do not do sex during pregnancy if HIV-positive (if they maintain an undetectable viral load throughout pregnancy and childbirth);
  3. Have a reduced chance of transmitting HIV through breastfeeding, sometimes breast milk can transmit HIV; however, breastfeeding is not recommended in Canada (formula feeding is the current recommendation);
  4. Have a reduced chance of transmitting HIV to people they share injection drug (injected injection is dangerous to use by other people) use equipment with, but there is currently not enough evidence or chance to conclude that there is no risk. In short, do not use an injection drug.
  5. The first study to show us that ART and an undetectable viral load have a major prevention benefit in serodiscordant heterosexual couples was the randomized controlled trial known as HPTN 052.
In addition, in the final analysis, which included 1,763 serodiscordant heterosexual couples (half of who were followed for over five and a half years), there is no chance or no HIV transmissions occurred or spread between couples in the study when the HIV-positive partner was on ART and had an undetectable viral load. In total, eight transmissions occurred or generate between couples while the HIV-positive (HIV+) partner was on ART; but, all told eight cases the viral load was detectable, despite being on ART. Four transmissions occurred or generate in the first 3 months after the all HIV-positive partner (HIV affected partner) started treatment before the viral load was undetectable.

The other four happened when the treatment failed to maintain the viral load at undetectable levels. In addition to those eight transmissions, there were 26 those that acquired HIV infection from a sex partner outside of the primary or first relationship, showing that in a very serodiscordant couple in which the HIV-positive partner is on ART with an undetectable viral load, the main risk of HIV transmission comes from outside the relationship, it means in relationship with outside person.

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