Do you know what your CD4 count and viral load are? If not, it’s time to find out, because the lower a CD4 count is or the higher a viral load is, the greater chance there is of getting sick with other infections or diseases. HIV medicines are recommended for all people with HIV and may help raise CD4 counts and decrease viral load.
Although HIV medicines are now recommended for all people with HIV, the decision to start treatment is a difficult one that can be overwhelming. It is also a very personal decision, one that you should discuss thoroughly with your healthcare provider. (Don’t have one? Find one in your area now.)
There are a number of things you will want to discuss with your HIV healthcare provider to best evaluate when is the right time for YOU to begin treatment.
- How healthy you are
- How healthy you feel
- How much HIV is in your blood (your viral load)
- How strong your immune system is, as measured by your CD4 count)
- Your ability and willingness to commit to a lifelong treatment plan
- Medical, social, and emotional factors that might impact how well you will be able to stick to your treatment plan
Guidelines for starting HIV treatment
The latest HIV treatment guidelines from the US Department of Health and Human Services (DHHS) state that starting HIV medicines is now recommended for everyone with HIV.
- HIV medicines are recommended for all people with HIV, no matter what their CD4 counts are
- Several conditions increase the urgency for starting HIV medicines in patients who:
- Have symptomatic HIV disease
- Have had an AIDS-defining illness
- Have HIV-1 RNA greater than100,000 copies/mL
- Have had a rapid decline of CD4 cells greater than 100 cells/mm3 per year
- Have active or are at a high risk for heart disease
- Have symptomatic primary HIV infection
- Have a high risk of spreading HIV to their HIV-negative partner
- Are older than 60
- Are pregnant
- Have HIV-related kidney disease
- Have active hepatitis B or C virus
There are benefits and some potential limitations to starting HIV medicines.
Benefits of starting HIV treatment
HIV treatment can:
- Help preserve your immune system by keeping your CD4 count up
- Lower your viral load and keep it low to the point that it is undetectable
- Reduce inflammation, which can harm vital organs
- Help you live longer
- Reduce the risk of HIV-related illnesses, including heart disease, liver disease, kidney disease, certain cancers, and conditions that affect the brain
- Reduce the risk of the onset of AIDS
- Prevent the spread of HIV between sexual partners
- Prevent the spread of HIV from mother to child
There are also potential limitations of early HIV treatment, including:
- The risk of short- and long-term side effects and unknown problems related to HIV treatment, especially if you have no HIV signs or symptoms
- The risk that your medicines may no longer work as well if you do not take them correctly, because the virus could adapt
- Difficulty staying on lifelong treatment
- Yearly cost of treatment
Current HIV medicines do not cure HIV infection or prevent its spread.