HIV treatment and prevention 2019: current standards of care.

Overview

PURPOSE OF REVIEW: The purpose of this review is to summarize the current standards of care for both HIV treatment and HIV prevention in 2019. RECENT FINDINGS: Current HIV treatment is started as soon as feasible in a person with HIV infection and consists of a three-drug oral daily antiretroviral regimen, consisting of two nucleoside analogue reverse transcriptase inhibitors combined with a third drug, either an integrase inhibitor, a non-nucleoside reverse transcriptase inhibitor, or a protease inhibitor. Present treatment regimens are potent, convenient, generally well tolerated and durable, and lead to a normal life expectancy. Present antiretroviral-based HIV prevention strategies focus on treating people with HIV infection with antiretrovirals as soon as feasible to reduce their risk of transmitting to others, and providing two-drug pre-exposure prophylaxis (PrEP) and three-drug post-exposure prophylaxis (PEP) to those HIV-uninfected individuals who are at risk for HIV infection. PrEP is highly effective when used correctly. Further data on early antiretroviral therapy and PrEP are needed to demonstrate any impact on HIV epidemic control. SUMMARY: HIV treatment and HIV prevention have improved markedly in recent years due to the development of oral antiretrovirals that are potent, convenient, and generally well tolerated, and lead to virologic suppression and decreased HIV transmission.