Frequently Asked Questions about HIV

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What is HIV?

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (acquired immunodeficiency syndrome). The most common ways HIV can spread:

  • Contact with HIV-infected blood (for example, sharing drug needles or syringes)
  • Sexual contact with people who are infected with HIV
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What is AIDS?

AIDS (acquired immunodeficiency syndrome) is caused by HIV and refers to the advanced stage of HIV infection. If you develop an AIDS-related illness, including infections called opportunistic infections, you are then diagnosed with AIDS. If you have HIV, but don’t have an illness associated with AIDS, you can still be diagnosed with AIDS based on blood test results (T-cell count or CD4+ <200 cells/mm3).

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How long does it take for AIDS to develop?

There is no set time when HIV can become AIDS. It’s important to talk to your doctor about your treatment options for HIV.

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What are some of the most common symptoms of HIV?

Many people with HIV have no symptoms for years. You must be tested to know if you have HIV for sure.

Possible symptoms of HIV may include:

  • Feeling tired all the time
  • Frequent fevers
  • Diarrhea that lasts for more than a week
  • Swollen glands in your neck, armpits or groin
  • Sweating a lot at night
  • Rapid weight loss without dieting
  • White spots or unusual blemishes on the tongue, in the mouth or in the throat
  • Persistent skin rashes or flaky skin
  • Memory loss, depression and other neurological disorders
  • Persistent or frequent yeast infections (oral or vaginal)

The symptoms of HIV are similar to the symptoms of many other illnesses. If you have any of these symptoms, see your doctor immediately.

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Where can I get tested for HIV?

Many places provide testing for HIV, such as doctor’s offices, local health departments, hospitals, or locations set up specifically for HIV testing. The Centers for Disease Control and Prevention information line (1-800-232-4636) or the National HIV and STD Testing Resources Website (www.hivtest.org) can answer questions about testing and refer you to places near you for testing.

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How might I get HIV?

The most common ways that HIV is passed from one person to another are:

  • Through sexual intercourse (vaginal, anal or oral) with a person who has HIV
  • By sharing drug needles or syringes with someone who has HIV
  • Mothers who have HIV can pass the virus to their babies during pregnancy, birth or breastfeeding after birth
  • HIV can enter through the vagina, penis, mouth, mucous membranes like the eyes, the anus or rectum, a vein (injection/intravenous drug use), or cuts and sores. The virus is found in blood, vaginal fluid, semen, and breast milk
  • Through transfusion of HIV-infected blood or blood components (e.g., plasma, platelets, etc.). However, all donated blood in the United States has been tested for HIV since 1985 and the chances of infection in this way are extremely rare
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Can I get HIV from casual contact like hugging and shaking hands?

No. HIV is not transmitted through day-to-day contact in the workplace, schools, or social settings. HIV is not spread through casual contact such as shaking hands, hugging, or casual kissing. Also, you can’t get HIV from drinking fountains, doorknobs, drinking glasses, dishes, toilet seats, or food.

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What is the connection between HIV and other sexually transmitted diseases?

Having a sexually transmitted disease (STD) like herpes, gonorrhea, syphilis, or chlamydia can increase a person’s risk of becoming infected with HIV, even if the STD does not cause breaks or open sores on the skin. Having an STD can make you more likely to get HIV during sexual contact with someone who has HIV. Also, if someone has HIV and another STD, they are more likely to transmit HIV through sexual contact than someone who just has HIV alone.

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Can I get HIV from body piercing or getting a tattoo?

You can get HIV from body piercing or getting a tattoo if the tools have infected blood on them and have not been sterilized or disinfected. The Centers for Disease Control and Prevention recommends thorough cleaning and sterilization of tools that penetrate skin, including those used during body piercing and tattooing. Or they should be used once and thrown away. If you are thinking about getting a tattoo or a body piercing, be sure to ask the staff about what they do to prevent spreading HIV.

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Can I get HIV from mosquitoes?

No. It is no longer believed that you can get HIV from biting and bloodsucking insects like mosquitoes. Studies have shown no evidence that you can get HIV from mosquitoes or any other insects. Even in areas with many AIDS cases and many mosquitoes, no cases of people getting HIV from insects have been shown. When an insect bites you, it injects its own saliva and not its own blood or blood from another person. Even if a mosquito bites someone who has the virus, the insect doesn’t get HIV and cannot transmit HIV to the next human it bites.

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How safe is the blood supply in the United States?

According to the CDC, the blood supply in the United States is one of the world's safest. Almost every person who got HIV from a blood transfusion got it before 1985, when HIV testing of donated blood began. All donated blood has been screened for HIV-1 since March 1985 and for HIV-2 since June 1992. Blood and blood products that test positive for HIV are not used for transfusions. The chance of HIV infection through a blood transfusion is very low in the United States.

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What are T-cells? Why are T-cells important in HIV?

T-cells, or CD4+ cells, are a kind of white blood cell—and are an important part of the immune system. When HIV infects the body, it attacks these cells, reducing their count as the virus multiplies. Fewer CD4+ cells means a weakened immune system. A person is more likely to get sick with a low CD4+ cell count. HIV therapy can help raise your CD4+ cell count by keeping the virus in check. This allows the T-cells to recover and defend the body against infections.

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What is a viral load test?

A viral load test measures how much HIV is in a sample of your blood. Two important tests are:

  • HIV RNA amplication (RT-PCR) test and
  • Branched chain DNA (bDNA) test

Results from viral load tests are usually reported as copies of HIV per milliliter of blood.

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What is ART?

ART stands for AntiRetroviral Therapy. It is a combination HIV therapy that usually contains at least three drugs from at least two classes.

  • NRTI (nucleoside or nucleotide reverse transcriptase inhibitor) or "nuke"
  • NNRTI (non-nucleoside reverse transcriptase inhibitor) or "non-nuke"
  • PI (protease inhibitor)
  • INSTI (integrase strand transfer inhibitor)
  • Entry inhibitor
  • Fusion inhibitor

ART combinations are effective because they slow HIV from multiplying at different stages in the process. HIV medicines help reduce the amount of HIV-1 in the blood. The amount of HIV in the blood is called viral load. Your doctor will prescribe HIV medicines that help get your viral load as low as possible. This is one of the goals of HIV therapy—keeping HIV under control so that your viral load remains low.

In some cases, your viral load can become so low that the viral load test cannot find HIV in the blood. This is called an undetectable viral load. This is a good sign because it shows that your treatment is working. But remember, an undetectable viral load does not mean that you are cured. The virus still exists at very low levels in your body, and you can still pass HIV on to others.

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When should I start HIV treatment?

Talk to your healthcare provider about when to start HIV treatment. You and your healthcare provider can decide when you should begin taking medications to treat your HIV.

Starting medication can be an important step in beginning to manage your HIV. Some of the things that are considered when deciding to start treatment are T-cell (CD4+ cell) count, viral load, and your readiness to begin treatment.

According to the Department of Health and Human Services (DHHS) Guidelines, HIV-1 treatment should be considered for all adults and adolescents with HIV, including those with CD4+ cell counts above 500 cells/mm3.*

Potential limitations of earlier initiation of treatment include:

  • Risks of side effects and possible problems related to HIV medications
  • Possible inconvenience of taking medication every day
  • Potential to become resistant to medications if you do not take your medications correctly
  • Difficulty sticking to longer-term treatment
  • Cost of medications each year

Ask your healthcare provider about this information and whether it’s time for you to start HIV medicines.

*Adapted from the DHHS Guidelines for the Use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents.
Please see DHHS Guidelines for full consideration.

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Additional IMPORTANT SAFETY INFORMATION for
ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate)

Who should not take ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate)?

You and your healthcare provider should decide if ATRIPLA is right for you. Do not take ATRIPLA if you are allergic to ATRIPLA or any of its ingredients.

What should I tell my healthcare provider before taking
ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate)?

Tell your healthcare provider if you:

  • Are pregnant or planning to become pregnant: Women should not become pregnant while taking ATRIPLA and for 12 weeks after stopping ATRIPLA. Serious birth defects have been seen in children of women treated during pregnancy with one of the medicines in ATRIPLA. Women must use a reliable form of barrier contraception, such as a condom or diaphragm, even if they also use other methods of birth control, while on ATRIPLA and for 12 weeks after stopping ATRIPLA. Women should not rely only on hormone-based birth control, such as pills, injections, or implants, because ATRIPLA may make these contraceptives ineffective.
  • Are breastfeeding: Women with HIV should not breastfeed because they can pass HIV and some of the medicines in ATRIPLA through their milk to the baby. We do not know if ATRIPLA could harm your baby.
  • Have kidney problems or are undergoing kidney dialysis treatment
  • Have bone problems
  • Have liver problems, including hepatitis B or C virus infection. Your healthcare provider may want to do tests to check your liver while you take ATRIPLA or may switch you to another medicine.
  • Have ever had mental illness or are using drugs or alcohol
  • Have ever had seizures or are taking medicine for seizures. Seizures have occurred in patients taking efavirenz, a component of ATRIPLA, generally in those with a history of seizures. If you have ever had seizures, or take medicine for seizures, your healthcare provider may want to switch you to another medicine or monitor you.

What important information should I know about taking other medicines with
ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate)?

ATRIPLA may change the effect of other medicines, including the ones for HIV-1, and may cause serious side effects. Your healthcare provider may change your other medicines or change their doses.

MEDICINES YOU SHOULD NOT TAKE WITH ATRIPLA

  • Do not take ATRIPLA if you are taking the following medicines because serious and life-threatening side effects may occur when taken together: Vascor® (bepridil), Propulsid® (cisapride), Versed® (midazolam), Orap® (pimozide), Halcion® (triazolam), or ergot medications (for example, Wigraine® and Cafergot®).
  • ATRIPLA should not be taken with: Combivir® (lamivudine/zidovudine),
    COMPLERA® (emtricitabine/rilpivirine/tenofovir disoproxil fumarate),
    EMTRIVA® (emtricitabine), Epivir® or Epivir-HBV® (lamivudine),
    Epzicom® (abacavir sulfate/lamivudine),
    STRIBILD® (elvitegravir/cobicistat/emtricitabine/tenofovir DF),
    Trizivir® (abacavir sulfate/lamivudine/zidovudine),
    TRUVADA® (emtricitabine/tenofovir DF), or VIREAD® (tenofovir DF), because they contain the same or similar active ingredients as ATRIPLA. ATRIPLA should not be used with
    SUSTIVA® (efavirenz) unless recommended by your healthcare provider.
  • Vfend® (voriconazole) should not be taken with ATRIPLA since it may lose its effect or may increase the chance of having side effects from ATRIPLA.
  • Do not take St. John’s wort (Hypericum perforatum), or products containing St. John’s wort with ATRIPLA. Taking St. John’s wort may decrease ATRIPLA levels and lead to increased viral load, and possible resistance to ATRIPLA or cross-resistance to other anti-HIV-1 drugs.
  • ATRIPLA should not be used with HEPSERA® (adefovir dipivoxil).

These are not all the medicines that may cause problems if you take ATRIPLA. Tell your healthcare provider about all prescription and nonprescription medicines, vitamins, or herbal supplements you are taking or plan to take.

What are the possible side effects of
ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate)?

ATRIPLA may cause the following additional serious side effects:

  • Serious psychiatric problems. Severe depression, strange thoughts, or angry behavior have been reported by a small number of patients. Some patients have had thoughts of suicide, and a few have actually committed suicide. These problems may occur more often in patients who have had mental illness.
  • Kidney problems (including decline or failure of kidney function). If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider should do regular blood tests. Symptoms that may be related to kidney problems include a high volume of urine, thirst, muscle pain, and muscle weakness.
  • Other serious liver problems. Some patients have experienced serious liver problems, including liver failure resulting in transplantation or death. Most of these serious side effects occurred in patients with a chronic liver disease such as hepatitis infection, but there have also been a few reports in patients without any existing liver disease.
  • Changes in bone mineral density (thinning bones). Lab tests show changes in the bones of patients treated with tenofovir DF, a component of ATRIPLA. Some HIV patients treated with tenofovir DF developed thinning of the bones (osteopenia), which could lead to fractures. Also, bone pain and softening of the bone (which may lead to fractures) may occur as a consequence of kidney problems. If you have had bone problems in the past, your healthcare provider may want to do tests to check your bones or may prescribe medicines to help your bones. Also, bone pain and bone softening may occur because of kidney problems.

Common side effects:

  • Patients may have dizziness, headache, trouble sleeping, drowsiness, trouble concentrating, and/or unusual dreams during treatment with ATRIPLA. These side effects may be reduced if you take ATRIPLA at bedtime on an empty stomach; they tend to go away after taking ATRIPLA for a few weeks. Tell your healthcare provider right away if any of these side effects continue or if they bother you. These symptoms may be more severe if ATRIPLA is used with alcohol and/or mood-altering (street) drugs.
  • If you are dizzy, have trouble concentrating, and/or are drowsy, avoid activities that may be dangerous, such as driving or operating machinery.
  • Rash is a common side effect with ATRIPLA that usually goes away without any change in treatment. Rash may be serious in a small number of patients. Rash occurs more commonly in children and may be a serious problem. If a rash develops, call your healthcare provider right away.
  • Other common side effects include: tiredness, upset stomach, vomiting, gas, and diarrhea.

Other possible side effects:

  • Changes in body fat have been seen in some people taking anti-HIV-1 medicines. Increase of fat in the upper back and neck, breasts, and around the trunk may happen. Loss of fat from the legs, arms, and face may also happen. The cause and long-term health effects of these changes in body fat are not known.
  • Skin discoloration (small spots or freckles) may also happen.
  • In some patients with advanced HIV infection (AIDS), signs and symptoms of inflammation from previous infections may occur soon after anti-HIV treatment is started. If you notice any symptoms of infection, contact your healthcare provider right away.
  • Additional side effects are inflammation of the pancreas, allergic reaction (including swelling of the face, lips, tongue, or throat), shortness of breath, pain, stomach pain, weakness, and indigestion.

This is not a complete list of side effects. Tell your healthcare provider or pharmacist if you notice any side effects while taking ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate).

You should take ATRIPLA once daily on an empty stomach. Taking ATRIPLA at bedtime may make some side effects less bothersome.

Please see Full Prescribing Information, including “What is the most important information I should know about ATRIPLA” in the Patient Information section.

Bristol-Myers Squibb    Gilead

© 2014 Bristol-Myers Squibb Company.

ATRIPLA is a registered trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. SUSTIVA is a registered trademark of Bristol-Myers Squibb Pharma Company. COMPLERA, EMTRIVA, GILEAD, GSI, HEPSERA, STRIBILD, TRUVADA, and VIREAD are trademarks of Gilead Sciences, Inc., or its related companies. All other trademarks referenced herein are the property of their respective owners.

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