Highly active antiretroviral therapy (HAART) is also sometimes called combination antiretroviral therapy, or antiretroviral therapy.
In this article, we take look at the effects of HAART, the official guidelines of its use, and a list of HAART drugs.
What is HAART?
Specialists introduced HAART in 1996 in response to the poor success rate among those taking only one HIV medication at a time.
The beginnings of three-drug antiretroviral treatment marked a turning point in the history of HIV treatment. The new treatment design transformed what used to be a diagnosis with a very poor outlook into a manageable condition.
HAART has a twofold effect on the body. It increases the number of immune cells while also decreasing the number of virus cells present in the body.
There are seven classes of HIV drug, including around 30 different medications:
- non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- nucleoside reverse transcriptase inhibitors (NRTIs)
- post-attachment inhibitors
- protease inhibitors (PIs)
- CCR5 antagonists
- integrase strand transfer inhibitors (INSTIs)
- fusion inhibitors
Initial treatment regimens usually include two NTRIs combined with a third active antiretroviral drug, which may be in the INSTI, NNRTI, or PI class. They may sometimes include a booster, which may be cobicistat (Tybost) or ritonavir (Norvir).
The HAART starting regimen for adults and adolescents with HIV is usually one of the following:
- bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy)
- dolutegravir (Tivicay) plus tenofovir/emtricitabine (Truvada)
- raltegravir (Isentress) plus tenofovir/emtricitabine (Truvada)
- abacavir/dolutegravir/lamivudine (Triumeq), but not for those with a genetic sensitivity to abacavir
Once the healthcare provider finds an effective regimen, it takes around 3–6 months before the viral load reaches an undetectable level. This is not a cure, as the virus will remain in certain body tissues. However, the levels will be substantially lower.
For HAART to be effective, a person must take the medication exactly as a healthcare provider prescribes. Avoid missing doses or stopping medication for any period of time. Adhering to the regimen will prevent HIV from multiplying in the blood and affecting the immune system.
When discussing the most suitable treatment regimen, talk to the healthcare provider about any possible difficulties with taking the medication, such as a busy lifestyle or a lack of health insurance. They can help address and solve these issues.
Healthcare providers will take the following into consideration when choosing a person’s HAART regimen:
- other health conditions
- whether the person is pregnant
- possible side effects of the HIV medications
- possible interactions between HIV medications and other medications a person is taking
- the cost of HIV medications
- a person’s ability to adhere to their medication regimen
HAART, or combined antiretroviral therapy, refers to HIV treatment that uses a combination of two or more antiretroviral drugs. HAART revolutionized HIV treatment upon its introduction in 1996.
HAART is an effective treatment for HIV. It does not cure the condition, but it can reduce the viral load to undetectable levels. This means that the virus is not transmittable through sexual activity and a person’s immune system can recover.
It usually takes around 3–6 months for the viral load to reach undetectable levels.
Strict adherence to the HAART regimen is important, as this will prevent HIV from multiplying in the blood and tissues and damaging the immune system.
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