multidrug

What is HIV?

HIV stands for human immunodeficiency virus. It harms your immune system by destroying CD4 cells. These are a type of white blood cells that fight infection. The loss of these cells makes it hard for your body to fight off infections and certain HIV-related cancers.

Without treatment, HIV can gradually destroy the immune system and advance to AIDS. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS.

What is antiretroviral therapy (ART)?

The treatment of HIV with medicines is called antiretroviral therapy (ART). It involves taking a combination of medicines every day. ART is recommended for everyone who has HIV. The medicines do not cure HIV infection, but help people with HIV live longer, healthier lives. They also reduce the risk of spreading the virus to others.

How do HIV medicines work?

HIV medicines reduce the amount of HIV (viral load) in your body, which helps by:

• Giving your immune system a chance to recover. Even though there is still some HIV in your body, your immune system should be strong enough to fight off infections and certain HIV-related cancers.
• Reducing the risk that you will spread HIV to others.

What are the types of HIV medicines?

There are many different types (called classes) of HIV medicines. Some work by blocking or changing enzymes that HIV needs to make copies of itself. This prevents HIV from copying itself, which reduces the amount of HIV in the body. Several types of medicines do this:

• Nucleoside reverse transcriptase inhibitors (NRTIs) block an enzyme called reverse transcriptase
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs) bind to and later change reverse transcriptase
• Integrase inhibitors, also called integrase strand transfer inhibitors (INSTIs), block an enzyme called integrase
• Protease inhibitors (PIs) block an enzyme called protease

Some types of HIV medicines interfere with HIV's ability to infect CD4 immune system cells:

• Fusion inhibitors block HIV from entering the cells
• CCR5 antagonists and post-attachment inhibitors block different molecules on the CD4 cells. To infect a cell, HIV has to bind to two types of molecules on the cell's surface. Blocking either of these molecules prevents HIV from entering the cells.
• Attachment inhibitors bind to a specific protein on the outer surface of HIV. This prevents HIV from entering the cell.

Pharmacokinetic enhancers are another type of medicine. They are sometimes taken along with certain other HIV medicines. Pharmacokinetic enhancers increase the effectiveness of the other medicine. They work by slowing the breakdown of the other medicine. This allows that medicine to stay in the body longer at a higher concentration.

There are also multidrug combinations, which include a combination of two or more different types of HIV medicines.

When do I need to start taking HIV medicines?

It's important to start taking HIV medicines as soon as possible after your diagnosis, especially if you:

• Are pregnant
• Have AIDS
• Have certain HIV-related illnesses and infections
• Have an early HIV infection (the first 6 months after infection with HIV)

What else do I need to know about taking HIV medicines?

You and your health care provider will work together to come up with a personal treatment plan. This plan will be based on many factors, including:

• The possible side effects of HIV medicines
• Potential drug interactions with any other medicines you take
• How many medicines you will need to take every day
• Any other health problems you may have

It's important to take your medicines every day, according to the instructions from your provider. If you miss doses or don't follow a regular schedule, your treatment may not work, and the HIV virus may become resistant to the medicines.

HIV medicines can cause side effects. Most of these side effects are manageable, but a few can be serious. Tell your provider about any side effects that you are having. Don't stop taking your medicine without first talking to your provider. There may be steps you can take to help manage the side effects. In some cases, your provider may decide to change your medicines.

What are HIV PrEP and PEP medicines?

HIV medicines are not just used for treatment. Some people take them to prevent HIV. PrEP (pre-exposure prophylaxis) is for people who don't already have HIV but are at very high risk of getting it. PEP (post-exposure prophylaxis) is for people who have possibly been exposed to HIV.

NIH: Office of AIDS Research

What is tuberculosis (TB)?

Tuberculosis (TB) is a bacterial disease that usually attacks the lungs. But it can also attack other parts of the body, including the kidneys, spine, and brain.

Not everyone infected with TB bacteria (germs) becomes sick. So, there are two types of TB conditions:

• Latent TB infection, where the TB germs live in your body but don't make you sick.
• TB disease (active TB) where you get sick from the TB germs. TB disease can almost always be cured with antibiotics. But if it's not treated properly, it can be fatal.

TB is found in the U.S., but it is more common in certain other countries.

What causes tuberculosis (TB)?

TB is caused by bacteria (germs) called Mycobacterium tuberculosis. The germs spread from person to person through the air. People who have TB disease in their throat or lungs spread the germs in the air when they cough, sneeze, talk, or sing. If you breathe in the air that has the germs, you can get TB. TB is not spread by touching, kissing, or sharing food or dishes.

You're more likely to catch TB from people you live or work with than from people you see for shorter amounts of time.

Who is more likely to get infected with tuberculosis (TB) germs?

Anyone who is near a person with TB disease can get infected with the germs. You are more likely to be near someone with TB disease if you:

• Were born in or often travel to countries where TB disease is common
• Are a health care worker
• Work or live in a place where TB is more common, such as shelters for people without homes, jails, and nursing homes

Who is more likely to develop TB disease?

Certain people are more likely to get sick with TB disease after they get infected. They include people who:

• Have HIV
• Became infected with TB in the last 2 years
• Have other diseases, such as diabetes, that make it hard for your body to fight TB germs
• Have alcohol use disorder or inject illegal drugs
• Were not treated correctly for TB in the past
• Are under age 5
• Are an older adult

What are the symptoms of tuberculosis (TB)?

Most people who have TB germs in their bodies don't get sick with TB disease. Instead, they have latent TB infection. With a latent TB infection, you:

• Don't have symptoms
• Can't spread TB to others
• Could get sick with active TB disease in the future if your immune system becomes weak for another reason
• Need to take medicine to prevent getting sick with active TB disease in the future

If you have TB disease, the TB germs are active, meaning that they are growing (multiplying) inside your body and making you sick. If the TB is growing in your lungs or throat, you can spread the TB germs to other people. You can get sick with TB disease weeks to years after you're infected with TB germs.

With TB disease, your symptoms will depend on where the TB is growing in your body:

• General symptoms may include:
  • Chills and fever
  • Night sweats (heavy sweating during sleep)
  • Losing weight without trying
  • Loss of appetite
  • Weakness or fatigue
• Symptoms from TB disease in your lungs may include:
  • A cough that lasts longer than 3 weeks
  • Coughing up blood or sputum (a thick mucus from the lungs)
  • Chest pain

How is tuberculosis (TB) diagnosed?

Your health care provider or your local health department can test you to find out if you have TB germs in your body. They will give you either a TB skin or blood test.

If your test shows that you have TB germs, you'll need to have other tests to see if the germs are actively growing:

• Tests for TB disease in the lungs usually include testing samples of your sputum and having chest x-rays.
• Tests for TB disease in other parts of your body may include tests of urine and tissue samples.

You may need a TB test if you have symptoms of TB disease or if you are at high risk because you are more likely to be near someone with TB disease.

What is the treatment for tuberculosis (TB)?

The treatment for both latent TB infection and TB disease is antibiotics. To make sure you get rid of all the TB germs in your body, it's very important to follow the directions for taking your medicine.

If you don't follow the directions, the TB germs in your body could change and become antibiotic resistant. That means the medicine may stop working and your TB may become hard to cure.

• For latent TB infections, you usually take medicines for 3 to 9 months. Treatment helps make sure you don't get TB disease in the future.
• For active TB disease, you usually need to take medicines for 6 to 12 months. Treatment will almost always cure you if you take your pills the right way.
• For TB disease in your lungs or throat, you'll need to stay home for a few weeks, so you don't spread disease to other people. You can protect the people you live with by:
  • Covering your nose and mouth.
  • Opening windows when possible.
  • Not getting too close to them.

By following medical advice for TB testing and treatment, you can keep yourself healthy and help stop the spread of TB.

Centers for Disease Control and Prevention