HIV treatment

Focus and Purpose of the paper

HIV has become a very contentious and controversial illness for many around the world. HIV has become a societal health concern as it continues to grow as a result of increased sexual activity of individuals around the world. In the United States alone roughly 1.5 million people have HIV. Even more alarming is that roughly 20% of these individuals do not know they have the virus. This partially explains the steady rise in infections rates around the world, as not only are more individuals have unprotected sexual intercourse, many are going undiagnosed due to lack of proper healthcare infrastructure and treatment. In addition, preventative mechanism, used to help mitigate the spread of HIV has been rendered moot due to poor planning and healthcare infrastructure. This only exacerbates the steady growth of HIV that is occurring around the world. Currently, there are 34 million HIV positive people worldwide. Roughly 66% of these individuals or 24 million reside in sub-Sahara Africa. In African alone, roughly 1.2 million individuals die every year due to HIV infections (Hollingsworth, 2018).

HIV is a virus that attacks the immune system of body, rendering it useless against other bacteria and infections. Even more alarming, if HIV is not treated, it can eventually lead to AIDS, which has very severe consequences for the individual. If left untreated, these consequences can include death. Currently there is no effective cure for HIV. Once it is contracted, the individual has it for life. Thankfully, through medication such as Apretude, HIV can be controlled. Those with HIV can not only live healthy lives, they can do so productivity due to advancements in treatment options. The common symptoms of HIV are fever, chills, rash, night sweats, fatigue and mouth ulcers. As noted in the introduction, it is critical for individual to get tested if they contract these symptoms so that they can properly mitigate an HIV diagnosis (HIV and AIDS, 2020).

HIV has three primary stages. Stage 1 is termed Acute HIV infection. Stage 2 is the chronic HIV infection, and Stage 3 is AIDS. A summary of each stage along with common characteristics is found in Table 1 below.

Table 1 – Stages of HIV

Stage

Common Characteristics

States 1 – Acute HIV Infection

· Very high contagion risk

· Flu-like symptoms

· Possible to not experience any symptoms at all

· Testing is very important during this phase.

Stage 2 – Chronic HIV Infection

· Stage is termed asymptomatic HIV infection or clinical latency

· The virus is active but reproduces at a very low level

· Period can last a decade or longer without treatment

· Transmition of the virus is very easy during this phase

· Treatment is very important during this phase to prevent going into stage 3

Stage 3 – AIDS

· Most severe phase of HIV

· Heavily damages immune system

· Higher susceptibility for infection and adverse side effects

· Highly infectious

· Without treatment, people will survive for only three years.

Here, the new drug Apretude, can help significantly alleviate the side effects of HIV. The treatment guidelines for HIV first revolve around testing. It is important for those who are sexually active to conduct regular testing for HIV. Next, it is important to communicate properly with partners in the invent an individual is HIV positive. In addition, it is important to adopt evidence-based prevention strategies based on the latest research available. Finally, it is important to develop community-based resources that can help prevent further spread of the virus to others. This illness can be fully treated through abstinence (Kuhar 2020).

Patient Introduction

The patient will be treated using the new medication noted above. In this circumstance the patient suffers from both Asthma and Hypertension. This has adverse impacts on the individual as it can potentially impact how the drug is administered and the cadence of the treatment. With these conditions that patient will take the oral cabotegravier for four weeks. After the four weeks an assessment will be conducted to determine the bodies response

Introduction of New Medication

The mechanisms of action or indication for usage is a single-does vial containing 600 mg/3 mL (200 mg/mL) of cabotegravir as a white to light pink, free-flowing, extended-release injectable suspension. The kit contains a syringe, vial adapter, and needle for intramuscular injection. As it relates to injection the ventrogluteal is the recommended option. In addition the dorsolateral region is also an acceptable administration approach. Here, it also to account of the individuals weight and BMI when administering the treatment. This is an important consideration as the needle may not be appropriate length for those who are extremely overweight or obese. As a result, longer needles may be required in order to ensure the treatment is administered properly (Imamichi, 2020).

Unfortunately, the drug does have a particularly large amount of side effects that can adversely impact patients during their treatment. Here, the most common side effects are diarrhea, headache, fatigue, sleep disorders, nausea, dizziness, vomiting, and back pain. As it relates to clinic trials, each of these side effects occurred less than 4% of the time. Relative to the condition of HIV, these side effects appear very minor. Although they are numerous, these side effects often pale in comparison to contracting HIV or in extreme cases, dealing with AIDS. Chart 1 below details the side effects related to the treatment.

Chart 1 – Adverse Drug Reactions for Apretude

Tom a patient care and nursing perspective, it is important to provide this critical information to the patient prior to administering treatment. It is also advisable to review the medical history of the patient to ensure that these side effects will not be more pronounce with the patient due to prior adverse circumstances. As a nurse it also important to understand the current drugs the patient may be tacking to ensure that an adverse reaction will not occur with the HIV treatment. For example if the concomitant drag is an Anticonvulsants, it can result in a significant decrease in plasma within the bloodstream. Likewise, the use of an Antimycobacterial can result in higher fatigue levels and other adverse side effects. It is therefore important to recognize how Apretude can interact with other treatment options that the patient is undergoing (Hobbs, 2018).

Analysis of New Medication

The medication does have clear advantages over other treatments. The most important of which is the prevention of HIV. It is the first FDA-Approved drug that can be used to help prevent HIV. This makes in unique relative to other product offerings as it is a much more proactive solution to HIV. Other options are only available after HIV is contracted which, although beneficial, is not ideal. With this FDA approved drug, patients cannot lower the likelihood of contracting HIV thereby lowering the overall prevalence and incidents of the virus around the world.

As it relates to clinical trial result, the treatment performed well. Here, in a sample of 4566 cisgender men and transgender women who are HIV positive and have sex with men, the study found that 69% of the participants where at lower risk of contracting HIV when compared with participants that took other HIV treatment options such as Truvada. Further studies and clinical trials found similar results as Apretude performed material better than competitive products on the market. The treatment must only be prescribed to individuals confirmed to be HIV-negative immediately prior to starting the drug and before each injection to reduce the risk of developing drug resistance. Drug-resistant HIV variants have been identified in people with undiagnosed HIV when they use Apretude for HIV Prep. This has been a significant negative element of the treatment as the body can develop an immunity to the treatment thus rending it less effective as compared to other treatment options on the market (Jean, 2019).

In addition to the patient care issues discussed above, the primary issues related to administering the drug properly, ensuring that it doesn’t interact negative with other drugs, and ensure that side effects are properly communicated on the part of the patient.

Important considerations in prescribing this medication to this particular patient

The important considerations when prescribing the medication were discussed in detail above. Here, the first consideration is the prior medical history of the patient. Here, the prior medical history is important as it details how susceptible the individual will be to current treatment options. As noted above the combination of HIV treatment with other medicines can have adverse consequences for the patient. In addition, as noted in Chart 1 - Adverse Drug Reactions for Apretude, there are numerous minor side effects that can occur simply from taking the drug by itself. Thankfully, many of these side effects are minor as compared to the over benefit of HIV prevention (Cornett, 2019)

Another important consideration when prescribing the drug is that of cost. This element is high contention within the United States. Here, the United States has the highest healthcare costs out of any developed nation in the world. Currently 20% of the nation’s GDP is consumed by healthcare spending. This is an increase of nearly 10% form 2020 level and account for nearly $12,530 per person. These costs are very unsustainable, which makes treatment options difficult for those looking to take advantage of the benefits the drug has to offer. Even more alarming is the fact that healthcare costs continue to increase. By 2030 healthcare costs are expected to be roughly 25% of GDP, further exacerbating the affordability issue of drugs in the United States. This has particularly negative ramifications for the drug and treatment as consumers may be unable to afford the option. With consumer less likely to adopt the treatment option, HIV can continue to spread to at-risk communities such as African and other parts of the United States. Costs also enter into the equation as treatment require multiple doses on a consistent basis. Currently. The treatment option is a single pill that is administered orally or through injection. However, the treatment must occur at least once a month for it to be effective. As a result, clients looking to leverage the drug must do so on a consistent basis to utilize the benefits it provides. This again can adversely impact the overall cost equation as becomes more expensive to engage it preventative HIV treatment (Balter, 2020).

This is an important element when prescribing the drug as set expectations for the client in an honest and ethical manner. When prescribing the drug, even to patients that have insurance, it is important to recognize how treatment may impact their overall financial standing. This allows patients to make better informed decisions while also protecting their health.

Role of APN in providing care for this patient

The role of the APN is critical to providing proper care to the patient. Here, the APN is an important information conduit for the patient. For one, they are going to be interacting with the patient on a much more consistent and intimate basis. They will also be interacting with the patient with administration tasks related to medical records and other sensitive information. As it relates to the rationale for determining if the medication should be part of the therapeutic regimen, the APN should first communicate all of the benefits and negative aspects of the treatment to the patient. These aspects will include cost, side effects, benefits, and overall administration. The patient should then take this information and determine if the treatment is right for them with guidance from qualified medical personnel. In addition, the patient and medical professional must consider their own personal issues relates to hypertension and obesity into account.