Drug interactions
Treatment with anti-HIV drugs can mean you’re able to live a long and healthy life.
To get the most benefit from HIV treatment, it’s important to take it properly.
This means taking all (or nearly all) of the doses, observing any food restrictions, and watching out for interactions with other drugs.
Anti-HIV drugs can interact with other medicines prescribed by a healthcare professional, as well as those bought over the counter, herbal and alternative remedies, and recreational drugs.
Interactions can cause the levels of your anti-HIV drugs to increase, meaning that the risk of side-effects is increased. Or drug levels can be lowered, and this can mean that your medicines don’t work properly.
In a third of cases, these potential interactions hadn’t been spotted by their HIV doctor.
Your doctor and HIV pharmacist should check for interactions whenever you are prescribed a new drug. It's therefore very important that you make sure your doctor knows all the drugs you are taking, including those prescribed by other doctors and any you buy yourself.
HIV prevention
There are large numbers of new HIV infections in the UK and other countries.
There’s a lot of debate about which groups of people with HIV are transmitting the virus.
Some research suggests that a large number of new infections originate in people who have only recently been infected with HIV. But other studies have suggested that many new infections have their source in people with longer-term, untreated HIV.
Some groups of people with HIV also have high rates of other sexually transmitted infections, so patients with HIV would often benefit from sexual health and safer sex information.
US researchers found that healthcare professionals providing safer sex information at routine HIV clinic appointments reduced the amount of risky sex reported by patients.
The provision of safer sex information by prevention specialists also reduced rates of risky sex in the short term.
The researchers think that providing regular “doses” of HIV prevention can help reduce sexual risk behaviour.
If you would like to talk to someone about sexual health and safer sex, there will be people such as health advisers at your HIV clinic who can help. The Terrence Higgins Trust, in partnership with NAM, offers an HIV Health Support Service in six UK cities. Visit THT's website for more information.
Mother-to-child transmission of HIV
Some major changes are being proposed to UK guidelines for the prevention of mother-to-child transmission of HIV.
Taking HIV treatment during pregnancy, having an appropriately managed delivery, and not breastfeeding can reduce the risk of mother-to-child transmission to very low levels. For women on combination therapy and with a viral load of less than 50 copies/ml the transmission rate from mother to baby is 0.1%.
Current UK guidelines recommend that women who do not need to take HIV treatment for their own health, should start taking anti-HIV drugs between weeks 20 and 28 of their pregnancy. The aim is to have an undetectable viral load at the time of delivery.
They also recommend that breastfeeding should be avoided.
Sexual transmission of hepatitis C
There is a growing number of cases of sexually transmitted hepatitis C amongst HIV-positive gay men in the UK.
The main way hepatitis C is transmitted is through contact with infected blood.
Sexual transmission of hepatitis C is rare in HIV-negative gay men and heterosexual people.
Unprotected sex has been identified as a risk factor for sexual transmission of the virus in gay men with HIV, but so too have other risk factors, such as rougher sex that can involve contact with blood (for example, fisting), group sex, the presence of other sexually transmitted infections, and drug use.
But the research didn’t include men who’d been infected with hepatitis C very recently. Levels of the virus in body fluids are highest at this time.
HIV testing for children
If you’re an HIV-positive parent, it’s very important that your children are tested for HIV. Ideally, this should be done soon after they are born, but if that didn't happen, they should be tested whatever their age.
Treatment and care can mean that your child has a good chance of living a long and healthy life.
There have been cases of children infected with HIV at birth not being diagnosed until many years later and dying because of this late diagnosis and lack of treatment.
Boosted protease inhibitor monotherapy
Recommended HIV treatment consists of a combination of three different anti-HIV drugs.
But some doctors think that treatment with just a ritonavir-boosted protease inhibitor could be an option for some patients.
These drugs have a very powerful anti-HIV effect. In addition, even when such treatment fails and viral load becomes detectable, it very rarely leads to resistance.
And the proportion of patients who maintained an undetectable viral load after switching to monotherapy (80 to 85%), was lower than that for patients who continued to take three drugs.
Advice for people stranded because of volcano-related travel ban
Although airports have now reopened following the cloud of volcanic ash that caused serious travel problems, some people are still delayed in being able to return home.
If you are experiencing problems because of this, and you are running out of supplies of antiretroviral drugs, you can find more detailed advice on how to get hold of anti-HIV drugs here, or search for an HIV clinic for help and advice on finding emergency drug supplies here.