Question

Questions about starting treatment in the UK…

14 October 2016. Related: All topics, Side effects, Starting treatment.

Hi, I am just about to start treatment and I have a few questions I would like answered. my CD4 count of 600 and viral loaf of about 6000. If my HIV strain carries no resistance, what drug/s would I mostly likely be prescribed if all healthy I.e Truvada= tenofovir DF + emtricitabine plus an integrase?

If I am on one set of drugs that I am very happy with but then need to go on a different set due to baby and hormones, would I be able to go back to my originals after baby, or would I now have a resistance?

Is the combination of dolutegravir plus TDF/FTC available to NHS patients?

What is currently the most popular and effective drug/s for treating HIV?

Am I likely to gain trunk fat on ART? Does weight gain happen to everyone? Some are saying there is very little chance of body fat change and yet I’m hearing lots of people talking about visceral and trunk fat.

Thank you very much.

Answer

Answer: Simon Collins

Hi

Most of your questions are answered in the i-Base Introduction to ART:
https://i-base.info/guides/starting

There are sections on the main drugs that are prescribed in the UK and alternatives.

All HIV meds can be used during pregnancy, but if you need or want to switch for other reasons, then as long as your viral load is undetectable you can always go back to use them again in the future.

Dolutegravir is now available in the UK – either with abacavir/3TC or with tenofovir-DF/FTC. With your low viral load, abacavir/3TC is more likely to be used, so long as a blood test shows you are likely to tolerate it well.

Alll the UK recommended combinations (in the booklet link above) are good. Flexibility to chance or use alternative is important though as your care needs to be individualised for you.

Fat accumulation occurs less with modern HIV meds than in the past. Close monitoring should help see whether your combination causes this. Diet and exercise are the main ways this can be managed.