TasP (Treatment as Prevention) is recommended as soon as the HIV diagnosis is confirmed, to maintain an undetectable viral load, preserve the immune system and reduce the risk of transmission.
Definition: what is TasP?
TasP is a prevention strategy to reduce HIV transmission, especially in heterosexual couples. “TasP (Treatment as Prevention) or antiretroviral treatment as preventionmeans that an HIV-positive person who has a undetectable viral load for 6 months under effective treatment and who is observant of his treatment and medical follow-up no longer transmits the virus“says Dr. Charlotte Methorst, urologist.”Undetectable HIV = zero transmission“.
What are the indications for TasP?
“Put in early antiretroviral treatment allows a better immune response for the affected personensuring a better quality of life in the long term, continues the specialist. It also represents at the individual and collective level one of the most effective means of prevention“. “Several studies and models claim that if all HIV-positive people were tested and treated, we would see the end of HIV transmission by 2050.“. TasP is not recommended for all people with HIV, but only for those with a certain viral load.
When to take TasP?
It is recommended to start antiretroviral therapy (ART) as soon as the HIV diagnosis is confirmed. “In fact, early treatment can maintain an undetectable viral load, preserve the immune system and reduce the risk of transmission HIV“, underlines the doctor.
What is the difference with PrEP?
PrEP (Pre-Exposure Prophylaxis) is a other HIV prevention strategy which involves giving antiretroviral (ARV) drugs to people who are not infected with HIV to reduce their risk of infection. While TasP is used to reduce the risk of HIV transmission in people who are already infected with HIV. “By eliminating the risk of transmission when HIV-positive people have been on treatment and have had an undetectable viral load for at least six months, ARVs are also becoming an effective means of prevention, assures the urologist. They thus supplement the already existing prevention offer with the risk reduction tools such as condoms, TPE, screening and PrEP“. In 2008, Dr. Bernard Hirschel declared that treated HIV-positive people with an undetectable viral load can no longer transmit the HIV virus. “In 2009, the Lert-Pialloux report underlines the preventive role of antiretroviral treatments. In 2011, the HPTN 052 study demonstrated, in mostly heterosexual serodiscordant couples, a 96% reduction in HIV transmission when the HIV-positive person is on antiretroviral treatment. The Partner 1 (2014) studies of mainly heterosexual and serodiscordant couples, and Partner 2 (2018), confirm an HIV transmission rate equal to zero with the taking of ARVs, in the absence of any other means of prevention (condom, PrEP, TPE)”.
“To be prescribed TasP (Treatment as Prevention), it is recommended to see a doctor who specializes in infectious diseases or HIV, advocates Dr. Methorst. He/she can make a checkup and prescribe antiretroviral therapy (TAR) if necessary”. It is important to note that TasP is not recommended for all people with HIV, but only for those with a certain viral load, some CD4 or risk factors for morbidity or mortality related to HIV. “It is also recommended to undergo regular medical monitoring and do viral load and CD4 checks to ensure that the treatment is effective and to detect any possible development of drug resistance“.
What are the side effects of TasP?
“TasP (Treatment as Prevention) is generally well tolerated, but it can cause some usually minor side effects“, recognizes Dr. Methorst. Among them:
- Nausea, vomiting, diarrhea or abdominal pain
- Headaches, dizziness or vertigo
- sleep disorders or mood
- tiredness or lethargy
- Muscle pain or joints
- Skin rashes or itchy
- weight changes or body fat
The TasP is 100% reimbursed by Social Security
What are the contraindications of TasP?
“There are no absolute contraindications for TasP (Treatment as Prevention), however some people cannot be treated with certain antiretroviral drugs due to other health conditions or drug interactions“, insists our interlocutor. The most common contraindications include:
- The allergies antiretroviral drugs
- Severe liver diseases
- Severe kidney disease
- Pregnancies or breastfeeding women
- Drug interactions with other medicines you are taking
It is important to discuss all health conditions and medications you are taking with your doctor before starting antiretroviral therapy.
What is the price of TasP?
“In France, antiretroviral treatment for people with HIV is 100% covered by health insurance“, confirms the urologist. This means that the treatment is completely free for patients, at no cost to them.
Is it reimbursed?
In France, TasP is 100% reimbursed by Social Security for people with HIV.
Thanks to Dr Charlotte Methorst, urologist at the Intercommunal Hospital Center of the Four Cities of Saint Cloud (92).