Human immunodeficiency virus (HIV) infects vital cells within the immune system and leads to the severest form of HIV disease called acquired immunodeficiency syndrome (AIDS). Left untreated, the virus cripples the person’s immune system, making even the most common illnesses potentially life-threatening. HIV infection occurs through the transfer of body fluids, via sexual contact, blood transfusion, sharing of needles or through the placenta from mother to unborn child.
Globally, HIV/AIDS is a pandemic and ranks as one of the largest killers of any infectious disease. More than 36 million people have now died from AIDS and there are 38 million people infected with HIV at the end of 2019.1
Around 28,000 Australians were estimated to be living with HIV, where around 10% were unaware they were HIV positive. Overall the number of new infections in Australia each year is falling; from around 1000 in 2014 to 800 in 2018. Community effort to increase HIV testing, implementing Pre-exposure Prophylaxis (PreP; using HIV medication by people at risk of contracting HIV as a prevention), and HIV treatment all contribute to deceased HIV transmission.2
Although no cure exists for HIV infection, antiretroviral therapy (ART) can dramatically slow the disease’s progress, prevent secondary infections and disease complications. In OECD countries, ART has increased the total life expectancy for people living with HIV (PLWH) to near the general population’s.3 However, PLWH may face challenges due to comorbidities that include, but are not limited to: cardiovascular disease and stroke, chronic neurologic complications, cancers and especially those associated with viruses, osteoporosis and fracture, depression, diabetes mellitus, chronic renal disease and chronic obstructive pulmonary disease. 4
HIV drug-resistance to ART remains a global challenge. Drug-resistance refers to HIV that has mutated and is no longer controlled by a drug. When HIV drug resistance occurs then an alternative ART is required. HIV drug-resistance has been monitored by the WHO, and they report high levels of resistance to commonly used drugs such as nevirapine and efavirenz in some countries.5