HIV and Medication

Although there is no cure for HIV, there are many drugs available which are used to control and manage the condition and due to the development of new drugs, there’s now a variety of drugs available to treat HIV. The drugs used to treat HIV are more refined and more effective that they have ever been, they’re much safer and have fewer side effects associated with them. These improvements have dramatically changed the life expectancy of people living with HIV. Medically, HIV can now be classified as a chronic manageable health condition.

If you attend regular check- ups at your sexual health clinic, your HIV team will be able to tell from your blood results when the time is right for you to start taking HIV medication. In the UK, guidelines recommend people start treatment when their CD4 count is below 350. There may also be other factors which influence when to start treatments. These could include:

  • Whether you have a co-infection e.g. Tuberculosis or Hepatitis C
  • Whether you have a negative partner
  • Whether you are pregnant
  • Whether you have a very high viral load

Being told that you have to start HIV treatment can be very difficult. Some people may start treatments as soon as they are diagnosed, other may not start for several months or even years. This differs between individuals; there are no set rules to the length of time somebody will not need treatment. HIV is an individual infection that affects people in a number of different ways. Ultimately, what we know is that the majority of people will have to start treatments at some point in their lives.

Without treatment, HIV will weaken the immune system making people susceptible to a variety of other infections. The aim of HIV treatment is to:

  • Strengthen the immune system: Seen by an increase in the CD4 count/percentage
  • Prevent HIV from replicating: Seen by a decrease in the viral load. Ideally, the viral load should reach undetectable – where there are less than 40/50 copies of HIV per cubic ml of blood.

Adherence

In order for HIV treatments to be most effective, they require a high adherence rate. Adherence means taking the medication regularly every day. HIV tablets require at least a 95% adherence rate in order to work correctly. In reality this means:
If you take your tablets twice a day: You can miss no more than 3 doses in a month.
If you take your tablets once a day: You can only miss one dose in a month.
However, 100% adherence is what you should aim for. This means taking your tablets every day. From time to time you may forget. It’s important to remember the importance of your HIV medication and to develop a strategy for taking them which works for you, for example choosing a time which fits in with the other things in your life like work and socialising.
DHIVERSE can offer you information, support and advice about adherence.

Resistance

Poor adherence may lead to a situation where your tablets are no longer managing your HIV effectively. This is known as resistance. Resistance is more likely to happen if you miss doses of your medication regularly.
If resistance happens, you may have to change the treatment that you’re taking. Although there is a variety of treatments available, resistance ultimately reduces the treatment options that are available to you.

Side effects

Many people living with HIV are concerned about starting treatment because of the potential side effects. Some people may experience side effects while others may not. Everybody responds differently to treatments, and you may experience more or fewer side effects than other people.
At the least you should expect a couple of weeks where you’re feeling slightly nauseous or experiencing mild diarrhoea. Remember that the drugs are strong and that your body will need to adjust to them. You can be prescribed other medication which will counteract these initial side effects.
For most people the side effects will reduce over time. The most important thing is to stay with your medication and get yourself through the first couple of weeks.

If your side effects persist for longer and you feel that you can’t cope with them, then you should talk with your consultant or specialist nurse. Whilst it’s always better to try to stay with your initial combination of drugs for as long as possible, you can ask to change your combination of drugs if the side effects are unmanageable.

Once your side effects have subsided, and you are in a pattern of taking your medication regularly, there is no reason why you cannot carry on with your life doing all the things that you did before. DHIVERSE can help with advice support and information about treatments and side effects.