HIV 101














An HIV Dictionary

Editor's Note: Every community has its own language, and the HIV community is no exception! If you just tested positive for HIV, you may be bewildered by the dozens of new words you're hearing for the first time. Don't worry! The following dictionary defines and explains some of the words people use most often when they're talking about HIV.

ADAP - the "AIDS Drugs Assistance Program," a federally-funded but state-administered program that helps many people with HIV get the medications they need. The criteria for qualifying for ADAP and the drugs the program covers vary widely from state to state. There is a comprehensive listing of ADAP criteria and formularies on-line at: hivpositivemagazine.com.

Adherence - means consistently taking your HIV medications as prescribed. HIV medications are much easier to take and longer-lasting than they used to be. But adherence is still very important. If you quit taking your medications for a period of time, your HIV can mutate and develop resistance to the drugs you are taking. So, when you go on meds, absolutely commit yourself to taking them - on time, every time, for the rest of your life.

AIDS - "Acquired Immune Deficiency Syndrome." You are considered to have AIDS when your T-cell count drops below 200/mm3 (two hundred cells per cubic millimeter of blood) or you begin to suffer from "opportunistic infections." The fact that you are HIV-positive does NOT mean you have AIDS. The whole purpose of HIV treatment is to keep your HIV infection from ever turning into AIDS.

ASO - "AIDS Support Organization." If you are newly diagnosed, one of the first things you should do is find your local ASO, introduce yourself, and ask for help. A good ASO can hook you up with everything from primary health care and medications to housing, drug and alcohol treatment, transportation, psychological counseling and legal representation. They have answers to questions you don't even know to ask! There's a good listing of local ASOs on-line at: hivpositivemagazine.com.

Atripla - a popular HIV medication that combines three HIV drugs into one. Each Atripla tablet contains 600 mg of Sustiva (efavirenz), 300 mg of Viread (tenofovir) and 200 mg of Emtriva (emtricitabine). The standard dose is one pill, once-a-day, usually taken before bedtime. Atripla is the ultimate combination drug, combining a complete, effective HIV regimen into just one pill, taken just once-a-day. It is the only drug available today that does NOT need to be taken with at least one other HIV medication.

AZT - the very first drug found to be effective against HIV. AZT is also called Retrovir or Zidovudine. In the early days, AZT got a bad reputation because it was often given in excessively high doses and because it didn't work for long by itself. (Nothing does - see "Drug Cocktail.") Now, however, they've got the appropriate dosing figured out, and it is still in use. It is an ingredient of both Combivir and Trizivir.

Combivir - an HIV medication that combines two HIV drugs into one. Each Combivir tablet contains 300 mg of Retrovir (zidovudine, AZT) and 150 mg of Epivir (lamivudine). Recommended dose is one tablet, twice a day.

Drug Cocktail - a combination of at least three medications designed to keep HIV from duplicating. In 1995, doctors found that taking three HIV drugs in combination could stop HIV in its tracks. This combination of three drugs was - and still is - often called a "drug cocktail." Since then, the medicines available to treat HIV have gotten better, more effective, and easier to take. But you still have to take a "drug cocktail" of at least three different medications to control your HIV. Fortunately, today, many people can take a single pill, just once a day, that combines a "cocktail" of three medicines into one.

Emtriva - an HIV medication approved by the FDA in 2003. Also known at Emtricitabine, Emtriva is one of the ingredients of Atripla and Truvada. In addition to being effective against HIV, Emtriva also works against Hepatitis B-- a nice bonus, since many people with HIV also have Hepatitis B.

Epivir - an HIV medication approved by the FDA in 1995. Also called Lamivudine or 3TC. Epivir is an excellent HIV drug, an old reliable workhorse that has saved a lot of lives. However, it is not considered to be quite as good as its newer rivals, Emtriva and Viread. Epivir is one of the ingredients in Epzicom.

Epzicom - an HIV medication that combines two HIV drugs into one. Each Epzicom tablet contains 300 mg of Epivir (lamivudine) and 600 mg of Ziagen (abacavir). Standard dose is one tablet a day.

FDA - the "Food and Drug Administration," an agency of the United States Government charged with responsibility for making sure drugs sold in the U.S. are safe and effective.

GRID - "Gay Related Immune Disorder." The first mention of AIDS in America came on June 5, 1981, in a report from the Centers for Disease Control, which said that a rare parasitic lung disease had been reported in Los Angeles among "5 young men, all active homosexuals." So many of the first victims were gay men that one of the first names given to this new disease was GRID - Gay Related Immune Disorder. It was also called "Gay Cancer." Now, of course, it's clear that HIV is NOT a "gay disease." It doesn't care about your sexual preference. It spreads just as readily through straight sex as it does by gay sex. In Africa, where the rates of HIV infection are far higher than in the United States, the vast majority of infections result from straight sex.

HAART - "Highly Active Anti-Retroviral Therapy." The concept, first developed in late 1995, of combining three or more HIV drugs together to stop HIV from duplicating. HAART was the first successful HIV therapy, and it is still the basis of HIV therapy today. See also "Drug Cocktail."

HIV - a virus that weakens the immune system. The letters stand for "Human Immunodeficiency Virus." HIV attacks and kills important immune cells - cells that help you fight off diseases and infections. The cells HIV attacks are called "CD4+T cells," or "T-cells" for short. By attacking and killing T-cells, HIV causes AIDS. But it takes a long time for that to happen. HIV works very slowly. On average, it takes ten years for HIV to cause AIDS-even without treatment. And the medications available today can keep HIV from progressing to AIDS indefinitely.

Intelence - a relatively new HIV drug, approved by the FDA in January, 2008. Also called Etravirine or TMC125. Intelence is a new option for patients who cannot take Sustiva or any of the other non-nucleoside reverse transcriptase inhibitors because of drug resistance. Usually when you develop resistance to one drug in this class, you are resistant to all of them. Intelence breaks that pattern.

Isentress - a popular, relatively new HIV drug, approved by the FDA in October, 2007. Also called Raltegravir. Isentress is the first of a new class of drugs called "integrase inhibitors," which work by blocking a viral enzyme that helps HIV integrate with healthy cell DNA.

Kaletra - an HIV medication that comes in tablets containing 200 mg lopinavir and 50 mg ritonavir. Recommended dose is four Kaletra tablets a day. Kaletra is a protease inhibitor.

Lexiva - an HIV medication that was approved by the FDA in 2003. It is a "prodrug" of Agenerase (Amprenavir), a protease inhibitor that was approved by the FDA in 1999. Basically, Lexiva turns into Agenerase in your body. The big advantage is in the dosing. The standard dose of Agenerase was 16 huge pills a day, which was just too many. Lexiva's dosing is far more convenient and it causes fewer side effects. Because Lexiva is so much better, the manufacturer has taken Agenerase off the market. Lexiva is also called Fosamprenavir.

Norvir - an HIV medication also known as Ritonavir. Low doses of Norvir (usually one 100 mg capsule twice a day - sometimes more), when taken with other protease inhibitors, boosts the levels of those other PIs in your blood and keeps them active in your blood longer. In some cases, you may be able to lower the amount of the "main" protease inhibitor you're taking when you take Norvir with it. Prescribing Norvir for its "boosting" effect with other protease inhibitors has become standard practice.

Prezista - an HIV medication that was approved by the FDA in 2006. It is a protease inhibitor. The approved dose of Prezista for people just starting treatment is two 400 mg tablets plus one 100 mg Norvir capsule once-a-day. For treatment-experienced patients, it is one 600 mg tablet and one 100 mg Norvir capsule twice-a-day. Prezista is also called Duranavir. Prezista boosted by Norvir (ritonavir) is listed as a "preferred" drug in the latest DHHS guidelines.

Reyataz - an HIV medication approved by the FDA in 2003. It is an azapeptide protease inhibitor. Standard dose is two capsules taken with food once-a-day. Reyataz doesn't seem to raise your cholesterol and triglyceride levels the way some other protease inhibitors do. In fact, one study suggests that Reyataz may actually increase your HDL (good) cholesterol, which helps protect you from heart disease. Reyataz boosted with Norvir (ritonavir) is listed as a "preferred" drug in the current Department of Health and Human Services guidelines.

Selzentry, - a relatively new HIV drug, approved by the FDA in August, 2007. Also called Maraviroc. Selzentry was originally approved only for experienced patients who are resistant to multiple HIV drugs. But the FDA recently expanded its approval to include treatment-naive patients also. Selzentry is the first in a new class of drugs called "entry inhibitors." It stops HIV from entering your cells using the CCR5 receptor. Unfortunately, it does not work against strains of the virus that use another receptor, called CXCR4. You should have a "tropism assay" done before taking Selzentry to see if the drug will work for you.

SIV - "Simian Immunodeficiency Virus," the same virus as HIV, but in monkeys. Scientists believe that HIV spread to humans from monkeys. HIV-1, the strain most common in Central and Southern Africa, the United States and the rest of the world, seems to have come from chimpanzees. HIV-2, the strain found in West Africa, seems to have come from the sooty mangabey monkey.

Sustiva - a popular HIV medication, also known at Efavirenz. A first-class drug, considered the "standard of care" for HIV. Sustiva is one of the ingredients of Atripla.

T-cells - also called "CD4+T cells" or "CD4 cells," T-cells are important immune cells that help you fight off diseases and infections. HIV attacks and kills your T-cells. You want to keep your "T-cell count" as high as possible. When your T-cells decline below 200 (two hundred cells per cubic millimeter of blood), you are considered to have AIDS. Your doctor should measure your T-cell count every three to six months to see how well your medications are working.

Transmission - Passing HIV from one person to another. It's not easy to transmit HIV. If you are HIV-positive, you don't have to worry about giving the disease to your family or friends by sneezing or coughing on them, or by swimming in the same pool. It is not spread by a handshake, or a hug, or even a kiss. People talk about HIV being transmitted by "shared bodily fluids," but there are no known cases of HIV being caused by sweat, saliva or tears. The bodily fluids that CAN spread HIV are: blood, vaginal fluid, semen and breast milk.

Trizivir - an HIV medication that combines three HIV drugs. Each Trizivir tablet contains 300 mg of Retrovir (zidovudine, AZT), 150 mg of Epivir (lamivudine); and 300 mg of Ziagen (abacavir). Trizivir was an early attempt to put a complete, three-drug HIV cocktail into a single pill. It worked for a lot of people, but it is not as good as the more recent version of the same concept: Atripla is simply stronger and more effective than Trizivir. According to the latest DHHS guidelines, Trizivir is "generally not recommended and should only be used when a preferred or an alternative NNRTI-based or PI-based regimen is less desirable because of concerns about toxicities, drug interactions, or regimen complexity."

Truvada - a popular HIV medication that combines two HIV drugs into one. Each Truvada capsule contains 200 mg of Emtriva (emtricitabine), and 300 mg of Viread (tenofovir). Standard dose is one capsule a day.

Viread - a popular HIV drug approved by the FDA in 2001. Also known at Tenofovir. Viread is one of the ingredients in Atripla and Truvada.

Viral Load - a measure of how many copies of the HIV virus are in your body. This is an important measure of your health, and your doctor should test your viral load every three to four months to see how well your medications are working. Your goal should be to keep your viral load "undetectable" - that is, so low that the test cannot detect it. Unfortunately, even when the virus in your body is undetectable, it is still there, and if you quit taking your medications it will come roaring back. But as long as you keep it undetectable, it is very unlikely to hurt you.

Viramume - an HIV medication, also known at Nevirapine.

Ziagen -an HIV medication approved by the FDA in 2000. Also known as Abacavir. Ziagen is one of the ingredients of Trizivir and Epzicom. Ziagen carries with it the risk of a hypersensitivity reaction, which may include fever, rash, fatigue, nausea, vomiting, diarrhea, and abdominal pain. You should quit using Ziagen as soon as a hypersensitivity reaction is suspected, and never try it again --it can be fatal. This hypersensitivity reaction occurs in about 5% to 8% of people who use Ziagen.

Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!