HIV Treatment

HIV treatment (antiretroviral therapy) lowers how fast the virus multiplies, so the amount of virus in the blood (viral load) falls and the immune system can recover. Common regimens combine three medicines in one tablet: dolutegravir blocks the virus enzyme integrase, and two NRTI medicines stop the virus copying its genetic material. They keep the virus under control but do not remove it, so they must be taken every day. The labels also advise continuing precautions against passing HIV on through sex or blood.

Both regimens contain dolutegravir 50 mg; they differ in the NRTI pair. Acriptega (TLD) has tenofovir disoproxil (TDF) 300 mg and lamivudine 300 mg, while Kocitaf has tenofovir alafenamide (TAF) 25 mg and emtricitabine 200 mg; TAF is a tenofovir derivative given at a lower dose. Per the labels, TLD is not recommended when creatinine clearance (CrCl) is below 50 mL/min, whereas DTG/FTC/TAF can be used down to 30 mL/min. Both are one tablet once daily and the doses cannot be adjusted separately, so each person's kidney results and other conditions decide which suits them.

Take one tablet a day at the same time, swallowed whole with water, with or without food. For the TLD regimen, WHO guidance says a missed dose should be taken if it is less than 12 hours late; if later, skip it and take the next on time, and never double up. If you vomit within 1 hour of a dose, take one extra tablet. No missed-dose rule was found in the documents checked for the DTG/FTC/TAF tablet, so ask a pharmacist or your care team. Frequent missed doses raise resistance risk. Keep tablets in the original bottle, tightly closed, at or below 30 degrees Celsius.

Antacids with magnesium or aluminium, and sucralfate, cut dolutegravir levels sharply: take the HIV tablet 2 hours before or 6 hours after them. Calcium, iron and multivitamins containing them follow the same rule, or can be taken together with food. Metformin levels rise with dolutegravir, so the doctor may adjust the dose. Rifampicin lowers HIV drug levels: with TLD, dolutegravir goes to twice daily; with DTG/FTC/TAF it is not recommended. Carbamazepine, phenytoin, phenobarbital and St. John's wort also lower levels. Tell your pharmacist everything you take.

Common side effects are nausea, diarrhoea, vomiting, headache, dizziness, rash and tiredness, often in the first weeks. Stop the medicine and see a doctor straight away for: a severe rash or a rash with fever, blisters, mouth sores, facial swelling, difficulty breathing, yellow skin or eyes, dark urine, fast breathing with severe tiredness and nausea (signs of lactic acidosis), severe abdominal pain, new bone or joint pain, or a sharp fall in urine. Creatinine can rise slightly in the first week without kidney damage, but have a doctor assess every change.

Before starting, hepatitis B should be tested. During treatment, the labels call for kidney tests (creatinine and CrCl), phosphate, urine glucose and protein, liver tests for people with hepatitis B or C, and regular viral load and CD4 counts as your care team schedules them. Stopping on your own is risky: people who also have hepatitis B can suffer a severe hepatitis flare and need liver monitoring for at least several months after stopping, and gaps in treatment let the virus become resistant. If a regimen must change, the doctor plans it so hepatitis B stays covered.

Yes, follow-up is essential. Intimo Life provides medicine information and online pharmacist advice, with plain packaging, but does not replace your HIV clinic. Choosing a regimen, blood and kidney tests, viral load checks and dose changes for pregnancy, other conditions or new medicines belong with the care team that knows your history. Before ordering, tell the pharmacist your regimen, latest results, every medicine and herb you take, and any missed doses, so the advice fits you. This page supports decisions made with your care team only.