HIV is typically treated with antiretrovirals. The Department of Infectious Diseases at Singapore General Hospital (SGH) discusses the side effects of HIV treatment.
While HIV cannot be cured, treatment can help to lower the risk of HIV-related infections
HIV infection cannot be cured. Treatment aims to suppress replication of the virus, restoring the damaged immune system and lowering your risk of HIV-related infections. When HIV treatment is stopped, the human immunodeficiency virus replication rebounds and the immune system weakens quickly.
Infections that tend to affect HIV-positive individuals are called opportunistic infections because they take advantage of their weakened immune system. Common opportunistic infections and cancers associated with HIV/AIDS include the following:
- Candidiasis (thrush): A fungal infection which causes inflammation and a thick white coating on the tongue and mucous membranes of the mouth.
- Cryptococcal meningitis: A fungal infection of the brain and spinal cord.
- Pneumonia: Lung inflammation which can be recurrent in HIV/AIDS patients.
- Tuberculosis: This bacterial disease is the most common opportunistic infection associated with HIV/AIDS and a leading cause of death.
- Lymphoma, Kaposi’s sarcoma and invasive cervical cancer, which are cancers commonly associated with AIDS.
HIV treatment options
How is HIV diagnosed?
HIV is diagnosed with the help of blood tests. An HIV diagnosis is made on the basis of positive results from two different HIV tests. If you are diagnosed with HIV, you may be required to have a physical exam and undergo additional medical tests to assess your CD4 white blood cells count and your viral load. Your viral load is the amount of HIV in your blood.
Your doctor will also assess your medical history and check if you are resistant to any drugs before recommending HIV treatment.
ART Therapy
HIV is typically treated with anti-HIV drugs called antiretrovirals. The treatment is known as antiretroviral therapy or ART, and this is a lifelong treatment.
ART is recommended for all HIV-infected individuals to reduce the risk of disease progression and transmission. The urgency for HIV treatment varies according to pre-treatment CD4 count. The lower the CD4 count, the more advanced the disease, the more important to start HIV treatment early to restore the immune system for the prevention of life-threatening opportunistic infections.
The willingness to commit to treatment and follow-up is key to HIV care. It is important to discuss your condition with your healthcare providers and to clarify your concerns. Your doctor will go through the benefits and risks of the ART recommended. ART is best started after your doctor has reviewed your medical issues and addressed your concerns, so that you are fully ready to receive and commit to treatment.
There are six different types of antiretrovirals and your doctor will probably recommend that you take three different medicines from two of these categories. Some of these anti-HIV drugs are combined in one pill. A combination of antiretrovirals is the most effective way to treat HIV. The best combination for you will depend on your health and other factors.
It is important to carefully follow your doctor’s instructions regarding the timing and dosage of your HIV drugs for them to be effective. Skipping doses may cause the virus to multiply and lead to drug resistance. HIV treatment also needs to be supported by a healthy diet and healthy lifestyle.
Side effects of HIV treatment
Anti-HIV drugs can have side effects, which may vary from patient to patient. Some common side effects of anti-HIV drugs are:
- Anaemia
- Nausea and vomiting
- Diarrhoea
- Fatigue
- Dizziness
- Headaches
- Skin rash
- Sleep problems
- Pain and tingling
These are short-term side effects, which may appear at the start of HIV treatment and disappear when you adjust to the drug regimen.
Side effects of a more serious nature such as a decrease in bone density and insulin resistance will require medical treatment. This again highlights the importance of regular follow-up with your doctor while you are undergoing treatment. If you develop serious side effects which prevent you from taking your anti-HIV medication, your doctor may have to change your treatment plan.
With advances in treatment, a person infected with HIV can now live a long and productive life.
Ref: Q15