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HIV Treatments And 10 Good Reasons To Think About Taking Them

Medications used to treat HIV have traditionally been called ‘treatments’. They can also be called medication, medicine, meds, HAART, ART, cART, combination, combo, Antivirals, Antiretrovirals, Antirets, therapy or whatever you like to call it.

People worry about taking HIV treatments because they are concerned about the side effects. Most stories and fears about side effects relate to information about old treatments that are no longer used. In the early days of HIV treatment, people with HIV and their doctors used to wait as long as they could before starting treatments so as to avoid side effects.

Among people that have been living with HIV for a long time, doctors and researchers are seeing the development of health issues a lot earlier in comparison to people who don’t have HIV. Doctors have also noticed that HIV treatment can reduce the risk of people developing these health issues by reducing the amount of HIV in the body.

New treatments are being developed all the time and these new treatments can work more effectively against HIV, often with fewer side effects. These days side effects are usually only experienced at the beginning of treatment, don’t last for very long and are easily managed therefore people are starting treatments much earlier than was previously the case.

Starting treatment at the right time can reduce the risk of long term side effects as well as reducing the risk of developing HIV related health issues. The benefits of taking HIV treatment include:

1. Living longer
People who take treatments live longer and healthier lives than people who don’t. Treatments stop HIV from replicating or multiplying, reducing the level of HIV in our blood to ‘undetectable’. An undetectable viral load allows our immune system to work better. A healthy immune system helps us fight infection and other health issues, so we don’t get sick as often and are less likely to get an AIDS defining illness.

2. A healthy heart

The HIV virus can cause damage to our heart and blood vessels, increasing the risk of high blood pressure, hardening of the blood vessels, stroke (CVA) and other problems relating to circulation. This is because HIV signals the immune system to send out cells that cause inflammation to fight HIV. As well as fighting HIV, these cells cause damage to the heart and blood vessels. People who take HIV treatment have a lower risk of health issues relating to the heart and blood vessels.

A word of caution though. Some older treatments can also cause heart problems by increasing the amount of fats in your blood, like cholesterol and triglycerides. You should ask your doctor about the level of these fats in your blood results. If they are high ask your doctor about diet, exercise and other strategies to bring these levels down. Sometimes switching to HIV treatments will help.

3. HIV and the Brain

As well as being detectable in our blood, HIV is detectable in our brain, cum and other parts of the body. The longer you live with HIV, the longer your brain is exposed to HIV, putting you as risk of certain HIV related brain issues. Having HIV in the brain can cause tiredness, depression, a quick temper and other problems.

You might find you have difficulty concentrating or are more forgetful. HIV treatments can reduce the amount of HIV in the brain and reduce the risk of these health problems. Many of these health issues are reversible if treated in time.

NB: Not all HIV treatments get into the brain as well as others, and one medication, Efavirenz (Stoctrin) can cause side effects like drowsiness. This is usually temporary so talk to your doctor if this side effect continues.

4. Energy

The immune systems of people with HIV are constantly fighting HIV and consequently burn up a lot of energy. This can leave people feeling tired and flat, not feeling motivated to exercise thus tending to put on weight. Some people with HIV feel so tired they say they feel like they have the flu.

Treatments take care of fighting HIV which means that your body doesn’t need to use up extra energy to fight the virus. Most people find that they have far more energy when they start taking HIV treatments.

When starting HIV treatment for the first time some people can feel tired during the first week while their immune system is getting stronger. This is perfectly normal, so people are encouraged to commence their treatment on days when they don’t have any plans or commitments.

5. HIV and Inflammation

HIV causes chronic inflammation. When we have an infection our immune systems release specialised cells that cause inflammation in order to help fight the infection. This is why our noses get blocked and red when we get a cold or our skin becomes red or bruised if we bump or scratch it. When you recover from a cold, or when your bruise heals, your immune system stops releasing these ‘pro inflammatory’ cells, and things tend to go back to normal.

With HIV however the immune system recognises the virus as a chronic, or ongoing, infection requiring these ‘pro inflammatory cells to be constantly released. In the short term, as with a cold, these cells are helpful. Over a long period of time, as with HIV, these cells can cause damage to our heart, kidneys, liver, brain, bones, cause fatigue and problems with digestion, and a range of other health issues. Taking treatments reduces chronic inflammation and the related health issues.

6. Cancer

As well as fighting infection, our immune system also fights some cancers. People with HIV are at higher risk of developing some cancers including Kaposi’s sarcoma, colorectal cancer, cervical cancer, prostate cancer and melanoma. HIV treatments improve immune function and reduce the rate of these cancers.

7. Diabetes and insulin resistance

Certain HIV treatments can increase the risk of insulin resistance in people with HIV. This group of drugs is called Protease Inhibitors (PI’s). Insulin resistance is a condition whereby our bodies have difficulty using insulin to convert sugar into energy. Insulin resistance increases our risk of developing diabetes and diabetes increases the risk of developing heart and kidney related health complications.

If you have a family history of diabetes you should discuss with your doctor whether you should avoid this group of HIV treatments when choosing your combination.

8. Digestion and gut health

The gut is one of the most important parts of our immune system. Our gut is full of lymph glands and the gut is where most anti microbial activity occurs, including anti HIV activity. HIV can irritate the digestive tract causing a range of symptoms and sometimes preventing the gut from absorbing all the nutrients from the food we eat. Even with treatment, HIV remains detectable in the gut.

Some researchers think that starting treatment sooner could prevent these symptoms and reduce the amount of HIV in the gut.

9. Sexual transmission

HIV is located in our genital fluids as well as in our blood. Scientists believe that people who are on treatments, have no other STI’s and an undectable viral load in their blood for at least six months have a reduced risk of passing on HIV to other people during sex.

This is not a reason to stop using condoms, but HIV treatments certainly lower the risk of passing on HIV to other people during sex. This might be something for HIV positive people who have a HIV negative partner to consider when thinking about starting HIV treatments. HIV treatments used in combination with other protective factors will definitely lower the risk of passing on HIV.

10. Hope for the future

Researchers are constantly developing new treatments, new ways of treating HIV and maybe one day they may even find a cure. New therapies and treatments for HIV may be more successful in people who have better health. Taking HIV treatments, as well as a healthy diet, exercise and not smoking may allow people with HIV to take better advantage of new developments in HIV treatment and care

When should you make the call?

HIV treatment has come a long way in recent years. Combinations are less toxic, require fewer pills and have more simple dosing. Side effects are less common and much less severe, and, in most cases, are comprable to the side effects of antibiotics. As we learn more about HIV and treatments, and as those treatments become easier to manage, guidelines as to when to commence treatment can change.

Signs to start

There are no hard and fast rules but in Australia current recommendations are that treatment should be commenced when:

Your CD4 cell count is 350 or below

and/or

You have symptoms of an AIDS defining illness

If you have less than 350 CD4 cells and/or a viral load above 100,000, it's time to seriously consider commencing treatment if you haven’t already begun. It's equally important for you to be 'ready' and in the right frame of mind to commence treatment. If you have concerns about starting, discuss all the pros and cons with your doctor, nurse or treatments oficer. Once you've taken your first few doses, the whole idea becomes far less worrying.

If your doctor recommends treatment but you decide not to commence just yet, it’s highly advisable to have regular check-ups, including blood tests, at least every month.

Staying alert for the signs

If you’re feeling well, with a CD4 cell count above 350 and CD4 percentage above 17%, you should have regular check-ups and blood tests to monitor your health every 1 to 3 months.