Dear Shirla
I have often heard about first and second-line ARV drugs in relation to antiretroviral therapy (ART). Could you explain the difference, and advise whether there is third-line treatment as well?
JB Dear JB
Let me first explain that antiretroviral drugs are those used in the treatment and prevention of HIV infection. They work against HIV by stopping or interfering with the reproduction of virus in the body.
The first combination of drugs taken by a person living with HIV (PLHIV) is usually called the ‘first-line’ regimen. When this no longer works to block HIV, meaning that when the treatment has failed for that person, another regimen made up of new medicines is required. This new regimen is referred to as the ‘second-line’ regimen, and is usually much more costly than first-line drugs. If this regimen also fails, a third-line or ‘salvage cocktail’ of medicines is usually recommended. This is what is referred to as ‘third-line’ antiretroviral drugs.
One of the main reasons ARTs fail is because persons do not use their medication as prescribed or instructed by their doctors. Failure to take one’s medication consistently results in eventual treatment failure.
HIV is a clever virus that quickly adapts to whatever medicines are being taken, and tries to change itself through mutation, so that these medicines no longer work, and then the virus can start to reproduce to the same extent as before.
And please note that antiretroviral drugs should only be taken under medical supervision.
Shirla
Dear Shirla
What are the body fluids that transmit HIV?
Roy
Dear Roy
The body fluids that transmit HIV are: Blood, semen, vaginal fluid, breast milk, and other body fluids containing blood taken from HIV-positive people, which can contain high concentrations of HIV. The virus might also be present in the fluid surrounding the brain and the spinal cord, fluid surrounding bone joints, and fluid surrounding the fetus of an HIV-positive pregnant woman.
HIV has been found in the saliva and tears of some HIV-positive people, but in very low quantities. A small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-positive people. Contact with saliva, tears, or sweat has never been shown to result in HIV transmission.
Source: Global Health Reporting.org
Dear Shirla
What is it that makes women more vulnerable to HIV infection than men?
Amanda
Dear Amanda,
A combination of biological, social, cultural and economic factors contribute to women’s increased vulnerability. In particular, gender inequalities prevent women from asserting power over their own lives and controlling the circumstances that increase their vulnerability to infection. For example in the case of women being powerless to negotiate condom use. Women are also physiologically more susceptible to becoming infected with HIV than men.
Source: Global Health Reporting .org
