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He Medical Clinic

HIV Treatment in Malaysia: Comprehensive Care and Options

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What is HIV infection and AIDS?

HIV is a sexually transmitted illness that affects both men and women. It can also be passed from mother to child through infected blood during pregnancy, childbirth, or breast-feeding. It could take years without treatment for HIV to compromise your immune system to the point where you develop Acquired Immune Deficiency Syndrome or also known as AIDS.

HIV is a contagious virus that’s spread most commonly through sexual contact or sharing needles with HIV-positive people. With modern screening measures, contracting HIV after a blood transfusion or organ transplant today is extremely rare.


HIV infection cannot be transmitted through normal interaction. That means you can’t get HIV or AIDS from someone who has it by hugging, kissing, dancing, or shaking hands with them. HIV cannot spread via air, water, or insect bites.


Although there is no cure for HIV/AIDS, medications can significantly slow the disease’s progression. In many developed countries, these medications have lowered AIDS deaths. In fact, today’s HIV treatments are so effective that if someone stays on them long enough, they can live as long as someone who doesn’t have the virus.

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What is HIV treatment?

The treatment regime involves taking several medications to slow the progression of the virus in your body. HIV is a retrovirus and the combination of drugs used to treat HIV is called antiretroviral therapy (ART). All patients living with HIV, regardless of how long they’ve had the infection or how healthy they are, should get on antiretroviral therapy.

Although there is no cure for HIV, antiretroviral therapy can keep you healthy for many years and enable HIV patients enjoy longer, better, and more satisfying lives. The risk of HIV transmission is also reduced with ART.


Many people who have recently been diagnosed with HIV are terrified and concerned with the disease. This is because HIV infection was formerly an unmanageable disease that quickly progressed to AIDS and death.


HIV treatment, on the other hand, is now simple and successful. Infection with HIV is no longer fatal. HIV-positive people often live full, healthy, and productive lives.


Why is HIV treatment important?

Getting and staying on HIV treatment is very important as it lowers the amount of HIV virus in your blood or what is known as viral load.

HIV-positive people who take their medication as directed and maintain an undetectable viral load have virtually minimal chance of sexually transferring the virus to their HIV-negative partners.


HIV destroys your immune system if you don’t get treatment, and it can lead to a variety of life-threatening illnesses and malignancies. You’re at danger of contracting an opportunistic infection if your CD4 cell count drops below a certain threshold.


There are illnesses that ordinarily do not harm those with healthy immune systems, but can infect people whose immune systems have been damaged by HIV. Your doctor may prescribe medications to help you avoid these infections.


When you know what to expect from your HIV treatment and are committed to taking your medications exactly as prescribed, the treatment is more likely to be effective. Working with your health-care provider to build a treatment plan will assist you in learning more about HIV and effectively managing it.


How does HIV treatment work?

It is important to note that antiretroviral drugs are unable to eradicate the HIV virus. HIV treatment consists of a combination of drugs that work together to break the HIV life cycle. To put it another way, these drugs stop the HIV virus from multiplying.

When the HIV virus is unable to multiply, it will not infect, harm, or destroy the CD4 cell, which is an important aspect of the immune system. A patient will not develop AIDS as long as his or her CD4 cells stay healthy.


HIV drugs lessen the risk of HIV transmission by lowering the amount of HIV in the body. The reduction of a person’s viral load to undetectable levels is one of the key goals of HIV treatment. A viral load that is undetectable suggests that the level of HIV in the blood is too low for a viral load test to detect.


As stated earlier, ART is unable to eradicate the HIV infection but they can only suppress the disease from progressing further. As a result, as long as a person living with HIV is on antiretroviral therapy, he or she can live a life similar to that of someone who is not infected with HIV.


When a person stops taking the medication, the virus multiplies again, damaging CD4 cells, weakening the immune system, and eventually leading to AIDS and death.

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When should you start HIV treatment?

The US Department of Health and Human Services recommends that people with HIV start antiretroviral therapy as soon as possible after being diagnosed. Starting antiretroviral therapy early can slow the progression of HIV and keep you healthy for many years.

If you don’t get treatment right away, the virus will continue to weaken your immune system and put you at risk for opportunistic infections, which can be fatal.


What is the process of treating HIV?

A person living with HIV may have to visit the doctor frequently at the beginning of treatment to have blood tests done. This is done to ensure that the patient is responding well to treatment. Once a patient has reached a state of stability, visits to the doctor can be as infrequent as once a year or even less frequently. During these sessions, the doctor will perform a variety of tests.

The HIV Viral Load test and the CD4 Cell Count test are the two most common testing performed.

  • HIV Viral Load


The HIV Viral Load test determines the number of HIV viruses in each millilitre of a patient’s blood. We rarely find any HIV virus in the blood of patients who take their HIV treatment on a regular basis. This level of undetectable viral load indicates that the patient is receiving appropriate treatment and that the HIV infection is under control.

  • CD4 Cell Count


Doctors use the CD4 Cell Count test to determine the health of the immune system. The higher the number, the better the immune system of a person. The CD4 Cell Count of HIV patients frequently rises slowly as treatment progresses. The CD4 Cell Count, however, can be affected by a variety of causes, including various illnesses. As a result, we expect it to change from time to time. Do not panic if your CD4 count drops a little and consult with your doctor to look out for the possible causes.


To determine your response to HIV medication, your doctor will track your viral load and CD4 cell counts. These will be checked every three to six months at first, then every two to four weeks.


Previously, HIV treatment consisted of a variety of medicines. A person living with HIV had to take a lot of pills every day. This heavy tablet load was frequently a source of anxiety. Patients also had a hard time remembering which tablet to take at what time.


HIV therapy has now been simplified to as little as one tablet per day. This considerably boosts a person’s ability and willingness to comply with therapy, making them more likely to take it on a regular basis and thus control their HIV infection and stay healthy.


Previously, HIV treatment was reserved for people whose immune systems had already been shown to be severely compromised. Now, on the other hand, antiretroviral treatment is started as soon as possible. This is because scientific studies have shown that starting HIV treatment early leads to significantly better health outcomes for HIV patients.


Antiretroviral medications can be classified into several types which include:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs): turn off a protein that HIV uses to replicate itself. E.g.: efavirenz (Sustiva), rilpivirine (Edurant) and doravirine (Pifeltro).

  • Nucleoside or nuclueotide reverse transcriptase inhibitors (NRTIs): they are the false versions of the building blocks required for the virus to make copies of itself. E.g.: tenofovir (Viread), emtricitabine (Emtriva). Combination of drugs are available as well such as emtricitabine/tenofovir (Truvada) and emtricitabine/tenofovir alafenamide (Descovy).

  • Protease inhibitors (PIs): these drugs inhibit a protein that HIV uses to replicate which is HIV protease. E.g.: lopinavir/ritonavir (Kaletra).

  • Integrase inhibitors: they work by inactivating a protein integrase which is essential for HIV to insert its genetic materials into CD4 cells. E.g.: raltegravir (Isentress) and dolutegravir (Tivicay).


Does ART have any side effects?

Antiretroviral therapy (ART), like most drugs, can produce negative effects. ART, on the other hand, does not cause adverse effects in everyone. Today’s HIV drugs have fewer adverse effects, experienced by fewer people, and are milder than in the past. Each type of ART treatment has its own set of side effects, which might vary from person to person.


Some of the most commonly reported side effects of ART include:

  • Nausea

  • Vomiting

  • Diarrhea

  • Difficulty to sleep

  • Dry mouth

  • Headache

  • Dizziness

  • Fatigue

  • Development of rashes


If you have severe adverse effects or wish to stop taking your HIV medicine, talk to your health care provider or pharmacist before missing any doses or stopping the drug. Drug resistance can develop as a result of skipping doses or abruptly starting and stopping medicine, putting your health at risk and limiting your treatment options in the future.


What is HIV drug resistance?

For those living with HIV, drug resistance can lead to treatment failure. HIV mutates (changes form) and develops different versions of itself as it multiplies in the body. HIV strains that emerge when a person is on antiretroviral therapy can become drug-resistant.

The antiretroviral therapy that formerly controlled a person’s HIV are no longer effective against new, drug-resistant HIV as a result of drug resistance. To put it another way, HIV medications used previously can’t prevent drug-resistant HIV from multiplying. Drug resistance can lead to the failure of HIV treatment.


HIV that is resistant to drugs can also transmit from person to person. Drug-resistance testing determines which HIV medications, if any, are ineffective against your individual strain of HIV.


Preventing drug resistance is as simple as taking HIV medication every day, exactly as directed. HIV infection is no longer a death sentence.


If you’re having problems sticking to your treatment regimen, tell your doctor straight away. You can work together to figure out why you’re skipping medications and devise a strategy to address them.