Treatment Naive for Illness Therapies

A person is considered to be "treatment-naive" if they have never undergone treatment for a particular illness. In the world of sexually transmitted infections (STIs), the term is most often used to refer to people who are HIV-positive and who have never taken any antiretroviral therapy for their infection.

People who have already taken one or more forms of HIV medication are considered to be "treatment experienced."

Pharmacist consulting with a patient

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Treatment-Naive Patients and Antiretroviral Therapy

In general, treatment-naive patients have more options for antiretroviral therapy than treatment-experienced patients. This is because doctors have little to no concern that they may have developed resistance to one or more drugs or classes of drugs.

However, although most people who are treatment-naive have many treatment options, that's not true for everyone. Sometimes people become infected with strains of HIV that are already resistant to one or more antiviral treatments.

It's also unclear whether being treatment-naive is necessary or whether it's possible for treatment-experienced people to also switch to new drug regimens.

When Is it Better to Be Treatment-Naive?

Although medications are often more effective in treatment-naive patients, that doesn't mean that you necessarily want to postpone treatment to wait for a better option to emerge, particularly when talking about HIV treatment. There is a growing body of research that shows how important early treatment for HIV can be, especially when trying to reduce the long-term consequences of infection.

Earlier in the history of the AIDS epidemic, people were encouraged to wait to begin treatment. However, now, the reasons for that encouragement are no longer valid. Side effects from antiretroviral medications have been greatly reduced, and simplified treatment options make it easier for patients to remain drug compliant. Therefore, treatment is being started earlier in the course of infection, at least for patients who can afford it.

Another reason why early treatment is becoming more common is that doctors now understand that they can use treatment as prevention. Reducing an infected individual's viral load with appropriate treatment turns out to be a great way of reducing the likelihood that they'll pass their infection to others. The likelihood of transmitting HIV is heavily correlated to the amount of virus a person has in their blood.

Treatment-Naive Patients With Hepatitis C

For people with hepatitis C virus (HCV), some may be able to clear the infection without treatment. Their immune systems get rid of the infection on its own. Some people with HCV choose to remain treatment-naive in hopes that they may not need to undergo treatment with pegylated interferon and ribavirin. It is a treatment regimen that can be incredibly unpleasant.

Unlike with HIV, there is not necessarily an advantage in treating hepatitis infections as soon as they are detected. Except on rare occasions where HCV is detected in the acute phases of infection, treatment is often not started until the infection has not only become chronic but when the virus has begun to have noticeable effects on a person's liver.

Until recently, it was not understood how important it is to treat HIV infections early. However, hepatitis infections have been around and recognized for much longer than HIV, and the infections are better understood.

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5 Sources
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  1. U.S. Department of Health and Human Services. Treatment-naive.

  2. Hellmuth J, Slike BM, Sacdalan C, et al. Very early initiation of antiretroviral therapy during acute HIV infection is associated with normalized levels of immune activation markers in cerebrospinal fluid but not in plasma. J Infect Dis. 2019;220(12):1885-1891. doi:10.1093/infdis/jiz030

  3. National Institutes of Health. Benefits of early antiretroviral therapy in HIV infection.

  4. Centers for Disease Control and Prevention. HIV transmission.

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