chronic – long-term.
Glossary
Selected words and phrases
revertant mutation – this term is used in two ways.
Firstly when referring to a genetic change that shows the virus is returning from a drug resistant mutation back to a wild-type genotype. This can sometimes take several stages. For example, T215E/D/E and S are revertant mutations that can indicate the drug resistant mutation T215Y is being replaced by wild-type (i.e. T215T).
It can also refer to the fitness of a virus. A revertant mutation can refer to an additional mutation that allows the virus to regain viral fitness (most drug mutations also make the vurs less fit). The second example is called a compensatory mutation as is compensates for the reduced fitness caused by the first mutation.
elite controller (EC) – if your viral load stays undetectable for more than five years without ART you are an elite controller.
Elite controllers also have a very good CD4 count (always above 500 cells/mm3) that stays at a similar level over many years.
Even with this good immune response, ART is still generally recommended in the long-term.
This is because over decades – some ECs have been undetectable for more than 20 years – there is a concern that low level HIV in different body compartments like the brain, might lead to accumulative serious damage that isn’t easy to detect until it is too late.
This is a real concern, though evidence is limited because of the rarity of ECs.
See: long-term slow progressor (LTSP)/long-term non-progessor (LTNP).
DAA (direct acting antiviral) – new hepatitis C drugs that work directly against the hepatitis C virus (HCV).
The following links are to UK prescribing information for DAA combinations plus ribavirin.
Elbasvir/grazoprevir
https://bnf.nice.org.uk/drugs/elbasvir-with-grazoprevir/
Sofosbuvir/ledipasvir
https://bnf.nice.org.uk/drugs/ledipasvir-with-sofosbuvir/
Glecaprevir/pibrentasvir
https://bnf.nice.org.uk/drugs/glecaprevir-with-pibrentasvir/
Sofosbuvir/velpatasvir
https://bnf.nice.org.uk/drugs/sofosbuvir-with-velpatasvir/
Sofosbuvir/velpatasvir/voxilaprevir
https://bnf.nice.org.uk/drugs/sofosbuvir-with-velpatasvir-and-voxilaprevir/
Ribavirin (RBV)
https://bnf.nice.org.uk/drugs/ribavirin/
Additional information is available from the MHRA website.
https://products.mhra.gov.uk/
toxoplasmosis (toxo) – an opportunistic infection caused by a protozoa. The risk to develop toxo increases after CD4 counts fall below 100 cells/mm3.