HIV: from lifelong treatment to PrEP prevention
Undetectable viral load = untransmissible
Dr. Sophie Martin
Infectiologist
A chronic controllable infection
HIV attacks the immune system (CD4 lymphocytes). Without treatment, it evolves to AIDS in a few years. With treatment, life expectancy is now almost normal.
Screening
Rapid tests, self-tests, laboratory serology. Test recommended at least once in a lifetime, more regularly in case of exposures.
Treatment
Oral triple therapies in a single pill/day (bictegravir/emtricitabine/tenofovir). Now also long-acting injections (cabotegravir/rilpivirine) every 2 months. Goal: undetectable viral load, which makes the virus untransmissible (U=U).
Prevention: PrEP
Pre-exposure prophylaxis (tenofovir/emtricitabine, or injectable cabotegravir) prevents infection in exposed individuals. Now also lenacapavir as a bi-annual injection (spectacular results in 2024). Condoms remain essential for other STIs.
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