How does PrEP help to prevent the spread of HIV infection?

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HIV stands for human immunodeficiency virus. HIV infects and destroys cells of your immune system, making it hard to fight off other diseases. When HIV has severely weakened your immune system, it can lead to acquired immunodeficiency syndrome (AIDS).

AIDS is the final and most serious stage of an HIV infection. People with AIDS have very low counts of certain white blood cells and severely damaged immune systems. They may have additional illnesses that indicate that they have progressed to AIDS. Without treatment, HIV infections progress to AIDS in about 10 years.

HIV infects white blood cells of your immune system called CD4 (cluster of differentiation 4) cells, or helper T cells. It destroys CD4 cells, causing your white blood cell count to drop. This leaves you with an immune system that cannot fight off infections, even those that would not normally make you sick.

HIV initially makes you feel sick with flu-like symptoms. Then it can hide in your body for a long time without causing noticeable symptoms. During that time, it slowly destroys your T-cells. When your T-cells get very low or you begin to get certain illnesses that people with healthy immune systems do not get, HIV has progressed to AIDS.

HIV is transmitted by -

1. Sexual intercourse.

2. Homosexual.

3. Blood transfusion.

4. Needle use.

Investigations include the following -

1. HBsAg (hepatitis B surface antigen).

2. Anti-HCV ( antibodies against hepatitis C virus).

3. HIV test by PCR (polymerase chain reaction).

Take advice from an MDT (multidisciplinary team) which includes a physician, HIV expert, psychologist, and psychotherapist. Treatment includes the following -

1. NRTIs (nucleoside reverse transcriptase inhibitors) are faulty versions of the building blocks that HIV needs to make copies of itself.

2. Examples include Abacavir (Ziagen), Tenofovir disoproxil fumarate (Viread), Emtricitabine (Emtriva), Lamivudine (Epivir) and Zidovudine (Retrovir). Retrovir is no longer suggested for routine use in the U.S. (United States) because of its high rates of toxic effects.

3. Mixes of medicines also are available, such as Emtricitabine-Tenofovir disoproxil fumarate (Truvada) and Emtricitabine-Tenofovir alafenamide fumarate (Descovy).

4. Protease inhibitors (PIs) make HIV protease inactive. HIV protease is another protein that HIV needs to make copies of itself. Examples include Atazanavir (Reyataz), Darunavir (Prezista), and Lopinavir-Ritonavir (Kaletra).

PrEP stands for pre-exposure prophylaxis The word “prophylaxis” means to prevent or control the spread of an infection or disease. Three HIV medicines are approved by the U.S. Food and Drug Administration (FDA) for use as PrEP: Truvada (Emtricitabine and Tenofovir disoproxil fumarate), Descovy (Emtricitabine-Tenofovir alafenamide fumarate), and Apretude (Cabotegravir extended-release injectable suspension). The type of PrEP medication used is determined by the individual's situation.

If a person is exposed to HIV (human immunodeficiency virus) through sex or injection drug use, having the PrEP medicine in the bloodstream can stop HIV from taking hold and spreading throughout the body. However, if PrEP is not taken as prescribed, there may not be enough medicine in the bloodstream to block the virus.

PrEP is used by people who are HIV-negative and at high risk of being exposed to HIV through sex or injection drug use. If you have HIV, PrEP medicine is not for you.

Specifically, the Centers for Disease Control and Prevention (CDC) recommends that you should consider PrEP if you are HIV-negative,

1. Have had anal or vaginal sex in the past six months, and

2. Have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load),

3. Have not consistently used a condom, or

4. Have been diagnosed with an STD in the past six months.

PrEP is also recommended if you inject drugs and you have an injection partner with HIV or

share needles, syringes, or other equipment to inject drugs. PrEP should also be considered for people without HIV who have been prescribed non-occupational post-exposure prophylaxis (NPEP).

I hope I have answered your questions.

Let me know if I can assist you further.

Regards.