Which HIV Treatment Regimen Should You Start With?

You may be here because you're worried about starting treatment, whether you're feeling overwhelmed with this life-changing event or you're confused about which regimen to choose. We've got your back.

Even though over 30 medications are approved for HIV treatment, the U.S. has official HIV treatment guidelines that narrow the choice down to about six first-line regimens -- meaning regimens for people who have never been on treatment before. They each work really well with few to no side effects in most individuals starting treatment.

What to Start With

The guidelines currently recommend these as first-line regimens:

• Genvoya
• Prezista + Norvir + Truvada (or Descovy)
• Triumeq
• Tivicay + Truvada (or Descovy)
• Stribild
• Isentress + Truvada (or Descovy)

Of note, Descovy is included as a substitute for Truvada because it contains an improved version of the drug tenofovir (one of the components of Truvada), which in study was found to have better bone and kidney safety.

Also of note, Triumeq is recommended only for those who test negative for HLA-B*5701, which is a genetic mutation associated with hypersensitivity to abacavir (one of the components of Triumeq).

When to Start

All five of the major international HIV treatment guidelines recommend starting treatment as soon as possible for all individuals living with HIV. However, before selecting a regimen, your doctor should give you a baseline evaluation to determine a few things, including your CD4 count, viral load and, perhaps more important, your readiness to start treatment.

Factors that can affect your readiness include other high-risk behaviors, substance abuse, social support, mental illness, other chronic diseases, economic factors (such as unstable housing), medical insurance status and other factors that may impair your adherence to treatment and increase the risk of HIV transmission. It is important that you work with your doctor to determine when you're ready.

But, when you are ready, you can learn more about each of the meds that the U.S. guidelines list as potential first-line drugs here.

Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.

Follow Warren on Twitter: @WarrenAtTheBody.