What is the future of HIV treatment?
It has been 30 years since the advent of antiretroviral therapy; a remarkable 28 drugs have been developed, but about half of them are no longer used as safer and more effective alternatives were made available.
Although a cure does not exist, there have been many significant strides in reducing the cost and improving the effectiveness of treatment. What do experts in the field think about the future of HIV treatment? These statements are taken from studies and internet articles that posed the question to experts.
Therapy will be initiated as soon as possible once a person is diagnosed. The sooner therapy is initiated, the more likely that it will be highly effective, durable, convenient and, above all, well tolerated, with minimal evidence of long-term toxicity. HIV activists are hoping that new ARVs will be cheaper and equally or even more effective.
Current drug regimens use triple therapy. Studies are underway on the effectiveness of dual therapy. It is unlikely that triple therapy will be phased out or that single drugs will be effective.
In the future, it is likely that dosage will be reduced to once a day pills or even less. New methods of administering medication such as long acting injections or slow released drug patches under the skin could be a reality in the future.
Most current ARVs have fewer short term side effects; they do have a range of long term complications that affect the heart, kidney and bones. New ARVs will reduce toxicity and have fewer long term complications. Currently, second line treatments can be quite complex, the future may herald simplified second line treatments.
Also related to new treatments is increasing diagnosis of undiagnosed HIV and improvements in laboratory methods to measure the response to treatment—tests that are more comprehensive that viral load and CD4 counts.
A critical question: although there is current and planned progress in the treatment of HIV, how long before these improvements make their way to Malawi to improve the care and treatment of persons living with HIV? And what will it take to accelerate access to improved treatment?
