When to Start Anti-HIV Medications

I just tested HIV positive. When will I start treatment?

Antiretroviral therapy (ART) is recommended for all people infected with HIV. ART involves taking a combination of anti-HIV medications (a regimen) every day. ART is a lifelong treatment.

When to start anti-HIV medications (also called antiretrovirals) is a decision you will make with your health care provider. You and your health care provider will consider the following factors:

• How well your immune system is working (CD4 count)
• The amount of HIV in your blood (viral load)
• Whether you have an HIV-related illness or AIDS
• Whether you're pregnant
• Your ability and willingness to commit to lifelong treatment

Can anti-HIV medications really help?

Yes. Anti-HIV medications can't cure HIV, but treatment can improve your quality of life and help you live longer.

HIV attacks and destroys the infection-fighting CD4 cells of the body's immune system. Loss of CD4 cells makes it hard for the body to fight infection. Anti-HIV medications can prevent HIV from multiplying. This reduces the amount of HIV in the body, giving the immune system a chance to recover and produce more infection-fighting CD4 cells. Once a person starts taking anti-HIV medications, an increase in CD4 cells is a sign that the immune system is recovering.

How long does it take for treatment to work?

Once you start treatment -- and take your anti-HIV medications exactly as directed -- it's possible to have an undetectable viral load within 3 to 6 months. An undetectable viral load means that the level of HIV in your blood is too low to be detected by a viral load test. You aren't cured. There is still some HIV in your body. But an undetectable viral load indicates that your anti-HIV medications are working effectively to keep you healthier and reduce your risk of transmitting HIV.

What treatment is right for me?

The U.S. Department of Health and Human Services (HHS) provides guidelines on using anti-HIV medications to treat HIV infection. The HHS guidelines recommend starting treatment with a regimen of three or more anti-HIV medications from at least two different drug classes. (See the "FDA-Approved Anti-HIV Medications" fact sheet.) The HHS guidelines list preferred ART regimens. (See the "Recommended HIV Treatment Regimens" fact sheet.) Because people's needs vary, the preferred regimens may not be right for everyone. You and your health care provider will consider your individual needs to select the most effective regimen for you.

For More Information

Contact an AIDSinfo health information specialist at 1-800-448-0440 or visit http://aidsinfo.nih.gov. See your health care provider for medical advice.

This information is based on the U.S. Department of Health and Human Services' Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents.