The Basics: Starting Anti-HIV Medications

I am HIV positive. Do I need to take anti-HIV medications?

You do not necessarily need to take anti-HIV (also called antiretroviral) medications just because you are HIV positive. You and your doctor will determine the best time to start treatment. When to take anti-HIV medications depends on your overall health, the amount of virus in your blood (viral load), and how well your immune system is working.

How will I know when to start anti-HIV medications?

You should start treatment if:
• you are experiencing severe symptoms of HIV infection or have been diagnosed with AIDS
• your CD4 count is 350 cells/mm³ or less (especially if 200 cells/mm³ or less)
• you are pregnant
• you have HIV-related kidney disease
• you are being treated for hepatitis B

If anti-HIV medications can help me stay healthy, why wait to start treatment?
Once you begin treatment, you may need to continue taking anti-HIV medications for the rest of your life.

Although newer anti-HIV medications are easier to take, starting treatment usually means a significant adjustment in your lifestyle. Some anti-HIV medications need to be taken several times a day at specific times and may require a change in the foods you eat, when you eat meals, and when you take other medications.

In addition to their desired effects, anti-HIV medications may have negative side effects, some of which are serious. If the virus is not suppressed completely, drug
resistance can develop. Side effects and drug resistance may limit your future treatment options.

What treatment is right for me?

The U.S. Department of Health and Human Services (HHS) provides HIV treatment guidelines to doctors and patients. These guidelines recommend that you take a
combination of three or more medications from different classes (see Approved Medications to Treat HIV Infection Fact Sheet) in a regimen called Highly Active Antiretroviral Therapy (HAART). The guidelines list "preferred" HAART regimens. However, your regimen should be tailored to your needs. Factors to consider in selecting a treatment regimen include:

• your drug resistance testing results
• number of pills
• how often the pills must be taken
• if pills can be taken with or without food
• how the medications interact with one another
• other medications you take
• other diseases or conditions
• pregnancy

For more information:

Contact your doctor or an AIDSinfo Health Information Specialist at 1–800–448–0440 or http://aidsinfo.nih.gov.

Terms Used in This Fact Sheet:

AIDS: Acquired Immune Deficiency Syndrome. AIDS is the most severe form of HIV infection. HIV infected patients are diagnosed with AIDS when their CD4 count falls below 200 cells/mm3 or if they develop an AIDS-defining illness (an illness that is very unusual in someone who is not HIV positive).

Antiretroviral: a medication that interferes with replication of retroviruses. HIV is a retrovirus. CD4 count: CD4 cells, also called T cells or CD4⁺ T cells, are white blood cells that fight infection. HIV destroys CD4 cells, making it harder for your body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood.

Drug resistance testing: A laboratory test to determine if an individual's HIV strain is resistant to any anti-HIV medications. HIV can mutate (change form), resulting in HIV that cannot be controlled with certain medications.

Viral load: the amount of HIV in a sample of blood.

A Service of the U.S. Department of Health and Human Services. 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 (available at http://aidsinfo.nih.gov).