Your HIV specialist doctor will advise you if test results do show that you should consider beginning anti-HIV treatments, sometimes called HAART (Highly Active Anti-Retroviral Therapy) or Combination therapy. The section below explains how these drugs work and how they are used. This section of our website is not intended to advocate any particular treatment, and in considering treatment decisions you should always speak to your HIV consultant.
Starting or changing HIV treatment can be a confusing and complicated time. Remember it is your body and it is your choice. If you are not sure about anything you should always ask your doctor or clinical nurse specialist to explain. You may find it helpful to speak to someone with HIV who has experienced different treatments. This is available through Positive Options at DHIVERSE.
Just because you are HIV-positive does not mean that you will need to take medication. You will probably be advised to consider HIV therapy if your CD4 count begins to drop, or stays below 200 - 300, or if your viral load is very high or if you have developed symptoms. There are some sites on the web that advocate against anti-retroviral treatments, it is however generally accepted by almost every HIV specialist and most people living with the virus that HAART when taken correctly is very effective in delaying the progression of HIV and thus reducing the risk of death from HIV related illnesses. This does not however preclude the fact that many people living with HIV find complementary therapies such as massage, aromatherapy, Indian head massage and acupuncture effective in both improving mental and physical health and managing drug side effects. Complementary therapies are available through Positive Options.
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If your immune system or your CD4 count is very low you may be offered prophylaxis. This is a course of antibiotic treatment to reduce the chance of the development of some of the opportunistic infections linked to a weak immune system.
HIV treatment in the UK is generally given as a three or four drug combination. This maximises the impact of the drugs and therefore reduces the chances of drug-resistant strains of HIV (see below) being produced within your body. Currently HIV treatment is free of charge to UK citizens from any HIV clinic in the UK (click here for a list of clinics).
There are now about 18 anti-HIV drugs (also known as anti-retrovirals) licensed for use. New drugs are being trialled all the time, and every year one or two new treatments usually become available. These drugs are currently not able to kill HIV but to affect how it reproduces, and thus limit the HIV lifecycle, reducing the amount of HIV in the body. HIV reproduces by entering your white blood (CD4) cells, and then using the cell as a 'factory' to reproduce new HIV. This eventually damages and kills the white blood cell.
Different HIV drugs affect this reproduction cycle in different ways. There are essentially two different types of anti-HIV drug:
Other drug treatments such as Fusion Inhibitors or Entry Inhibitors (e.g. T20 - Fuzeon), that prevent HIV binding to the cell are becoming available in some circumstances.
Most people receive treatment with 3 NRTIs, or 2 NRTIs and 1 NNRTI, or 2 NRTIs and 1PI. Entry Inhibitors are a very new type of drug and the only drug in this class is quite difficult to administer and so is currently not widely-used apart from in cases where other drugs have failed.
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Like all medicines, anti-HIV drugs can cause side-effects. Different drugs cause different side effects. Ask your doctor or HIV pharmacist to explain what side-effects you can expect, including mild ones which wear off, and serious ones which you should report to your doctor straight away.
Resistance can develop whenever HIV continues to reproduce whilst anti-HIV drugs are being taken, but can be delayed, perhaps indefinitely, by taking drugs in powerful three or four drug combinations which suppress viral load to very low levels. HIV that is resistant to one anti-HIV drug is likely to still be susceptible to some other anti-HIV drugs. However, if you become resistant to one drug in a class, you may be resistant to other similar drugs and this could limit your future treatment options.
The risk of developing resistance increases if you don't to take your anti-HIV drugs regularly at the right time and in the right way, following any food restrictions and that you get support which enables you to take your treatment over the long-term. Sticking with your treatment regimen in this way is called adherence.
The different drugs have different dosing regimes. Some are easier to take than others. If you are HIV-positive and considering treatment it is important to discuss this with your doctor or HIV nurse to identify which treatments will work for you and your life.
Immune Therapies - Immune therapies are treatments which influence or modify certain components of the immune system. Apart from drugs designed to attack HIV directly, a number of immune therapies are also being investigated for use by people with HIV for the purpose of boosting immunity and to try to correct the abnormalities seen in HIV infection. These drugs include Interleukin-2 (IL-2), which encourages the growth of CD4 T-cells and Remune, a therapeutic vaccine designed to boost immune response to HIV.
If you would like more information about conventional treatments you can contact i-base:
Much of the information in this section is taken from the Factsheets produced by the National AIDS Manual. These and a large body of information about HIV treatment is available online on the National AIDS Manual website.
Decisions relating to your treatment should always be taken in consultation with your doctor. Starting or stopping treatment without expert medical advice is potentially dangerous.
