return to the COT homepage

    Website of the HIV Special Interest Group

    -as part of the College of Occupational Therapists Specialist Section - HIV/AIDs, Oncology & Palliative Care

Following is a summary of pharmacological management of people with HIV.

As understanding develops in this area at a rapid pace, users are recommended to consult with online resources such as:

Aidsmap

Clinical Care Options

HIV i-base

HIV and Medication

There are four main groups of drugs used with people with HIV

1. Anti-HIV Drugs - that target the virus itself and aim to improve a patient's underlying HIV health. See below.

2. Medications aimed at treating opportunistic infections or other illnesses  that have affected a patient secondary to HIV disease, for example antibiotics to treat bacterial illness, antifungal medications to treat fungal infections, or chemotherapy to treat malignancies.

3. Prophylactic medicines that are taken in order that patients are not as susceptible to opportunistic infections, such as Septrin (co-trimoxazole) which is given so that patient's avoids PCP (a common dangerous pneumonia).

4. Medications that treat the side effects of other medications, such as anti-emetics for nausea or analgesics (pain relief) for pain from peripheral neuropathies.

Antiretrovirals

Also known as

"Combination Therapy" refers to using two or more (typically three or "triple combination" therapy) antiretroviral drugs at the same time.

The aims of these drugs is to reduce the action of HIV itself and to restore immune function. Different classes of drugs operate at different stages of cell replication. This is explained in detail on the following website: Clinical Care Options

Choice of drug depends on stage of disease, resistance testing, interactions with other drugs being taken and side effects experiences, which may vary considerably from individual to individual.

Resistance to a drug of class of drug may have come with infection if the HIV strain had resistance; it can also develop to poor adherence. Some drugs require very strict adherence to timings in order to avoid developing resistance.

Side effects vary enormously between person to person but common side effects, particularly when starting or changing to a new regime can include nausea, vomiting, diarrhoea and night sweats. More serious side effects can be peripheral neuropathy (sometimes irreversible), vivid dreams / disturbed sleep leading to mental health problems, Stevens-Johnson syndrome, and altered liver and kidney function.

Most medications are in tablet or capsule format, some quite large and difficult to swallow. Some are available in liquids although the taste of the liquid can be quite foul. T-20, a relatively new drug in general use, is currently via injection only.

The five main classes of drugs commonly available in the UK (as of early 2005) are:

New drugs currently (late 2005) undergoing clinical trials are CCR5 antagonists.

There is little point in going in to further detail as this topic is covered in much more detail elsewhere on the net, and information dates quickly!- see websites for more detail.

Compiled by:

Will Chegwidden, Specialist Senior Occupational Therapist

St. Bartholomew's Hospital

October 2005

Send mail to will.chegwidden@bartsandthelondon.nhs.uk with questions or comments about this web site.                           
Last modified: 16 May 2007