Today, HIV treatments are more tolerable and more effective than in decades past. While in the early 90s there was only one drug – AZT – for people with HIV, now there are over 20 different HIV medications, prescribed in a variety of combinations, as well as effective treatments for the conditions commonly associated with HIV.
These treatments are not cures for HIV infection, but they have helped countless positive people live long and healthy lives.
The Basics of HIV Treatment
HIV is a retrovirus, and anti-HIV drugs are called antiretrovirals (ARVs). Antiretroviral therapy (ART) works to get the number of copies of HIV in the body – the viral load – so low that HIV can’t be detected in a standard laboratory test.
There are several different classes of antiretroviral drugs, with multiple medications in each class. These classes include:
- nucleoside reverse transcriptase inhibitors (NRTIs)
- non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- protease inhibitors
- integrase inhibitors
- CCR5 antagonists
- fusion inhibitors
Each class interferes with HIV’s replication within the body in a different way.
ART consists of at least two and preferably three drugs from multiple classes of ARVs.
If antiretroviral medications are not taken correctly and consistently, HIV may mutate, changing so that a particular drug or drugs are no longer active against the virus. When drug resistance occurs, healthcare providers do a test to determine which component of the regimen isn’t working, and then construct a new, effective treatment.
When to Start Antiretroviral Treatment
In making the decision about when to start ART, you and your doctor will consider your health, feelings about medication and the risk of the disease progressing.
Your doctor will use established treatment initiation guidelines to decide whether to recommend therapy. Generally, your immune function and the presence of conditions like viral hepatitis and HIV-related kidney disease will be considered.
CD4 cell count is a key marker of immune function. The number of CD4 cells in the body directly correlates to the risk of getting sick from a collapsing immune system, and medication may be advised if that number is low. Even with a high number of CD4 cells, however, symptoms may indicate that ART is a good idea.
Deciding when to start therapy isn’t just about CD4 cell count and HIV-related illness, though. ART requires a commitment to taking medication daily – as instructed, and for life. People who don’t adhere to their drug regimens risk building up resistance without suppressing the virus, so it’s important to assess ability to stay on medication when thinking about starting ART.
The Side Effects Of Antiretroviral Treatment
Antiretrovirals all have potential side effects, although not every effect will be felt by everyone on a given drug. While many of these dissipate as the body adjusts to medication, some require further treatment to manage, or a doctor’s adjustment to the regimen.
Anti-HIV drugs also can interact with each other or with other medications – either by making them less effective (as is the case with some birth control pills), or by harming the body. It’s important to be informed about potential interactions before embarking on any drug plan.