Considering HIV Treatment

Table of Contents

• Are You Ready?
• The Right Health Care Provider
• Knowledge About HIV
• A Positive Attitude

Are You Ready?

Treatment with HIV drugs can improve quality of life and help people living with HIV (HIV-positive people) stay healthier longer. But starting treatment is a big decision. In order to get the most benefit from HIV drugs, they must be used just the way they are prescribed. Taking your treatment correctly is as important as which drugs you and your health care provider choose. So before you get started, make sure you are ready to commit to taking your HIV drugs the right way, every day for your own health! This takes a combination of the right health care provider, enough knowledge about HIV, and a positive attitude.

The Right Health Care Provider

You and your health care provider are a team working together to make the best treatment decisions for you. Ask yourself a few questions: Do I have confidence in my provider? Can I be totally honest with him or her? Is he or she available when I have questions? Does he or she take my concerns seriously? If so, great!

If not, try to make changes. Write down the questions you would like to ask your health care provider before you go to visits. It is important to answer your provider's questions with the truth, not with what you think she or he wants to hear. If that still does not work, it may be time to look for another provider.

It is also wise to have a health care provider who is an HIV specialist. Health care providers who devote most of their time to HIV are best able to manage this complicated condition. Helpful suggestions for HIV specialists near you can come from friends, ASOs (AIDS Service Organizations), or by checking with the American Academy of HIV Medicine (AAHIVM). To find an ASO in your area, click here or look at the AAHIVM's Referral Link.

Knowledge About HIV

The Basics

HIV is a virus that infects and destroys CD4 cells. CD4 cells are part of the body's immune system. The immune system protects the body from germs. When the immune system loses too many CD4 cells, it becomes weak and is unable to fight off germs. At this point, HIV+ people are at risk of getting opportunistic infections (OIs) that can cause serious illness or death.

HIV Treatments

Scientists have developed drugs that stop HIV from making copies of itself (multiplying). These drugs are grouped into classes. Each class of drugs works to stop HIV at a certain point in its life cycle. So far there are five classes of drugs:

• Entry inhibitors (includes fusion inhibitors and CCR5 antagonists)
• Integrase inhibitors
• Nucleoside/nucleotide reverse transcriptase inhibitors ("nukes" or NRTIs)
• Non-nucleoside reverse transcriptase inhibitors ("non-nukes" or NNRTIs)
• Protease inhibitors (PIs)

HIV drugs are always used in combination to attack the virus at different points in its life cycle. This usually means using drugs from at least two different classes. Combining HIV drugs is the best way to reduce the amount of HIV in your blood (viral load).

Baseline Blood Tests

Before you start HIV treatment, your health care provider should have you take a number of blood tests. These are your original, or baseline tests. Future test results will be compared to your baseline results to see how you are doing and how well your treatment is working.

1. CD4 cell (T-cell) count: The CD4 count checks the strength of your immune system. After you start HIV treatment, you should see your CD4 count go up. Your CD4 count should be checked every 3-4 months, if possible.
2. Viral load test: The viral load test measures the amount of HIV in your blood. After you start HIV treatment, you should see your viral load go down. Your viral load should be checked about a month after you start or change HIV drugs. After that, it should be checked every 3-4 months.
3. Resistance test: The resistance test helps determine which drugs are likely to work against the strain of HIV you have. Experts recommend that everyone get a resistance test before starting or changing HIV treatments, even if you do not plan to start HIV treatment for a while.
4. Other tests to check your overall health: These include complete blood count (CBC), chemistry screen, lipid profile, liver tests, and glucose (blood sugar). Your health care provider should talk with you about how often these tests need to be done.

Treatment Goals

• To get your viral load as low as possible for as long as possible
• To preserve or improve the health of your immune system by increasing your CD4 cells
• To improve your quality of life and reduce illness