How to choose a treatment for HIV

Human immunodeficiency virus (HIV) is a virus that infects white blood cells called T-helper cells, or CD4 cells, which are vital to the proper functioning of the immune system. If left untreated, HIV weakens the immune system, leaving the body unable to fight off infections and illnesses. Over time, this can progress into acquired immunodeficiency syndrome (AIDS).

However, there are effective treatments for HIV, which enable people with the virus to live long, fulfilling lives. Many healthcare providers (HCPs) view managing HIV in a similar way to managing high blood pressure or cholesterol—it’s a chronic condition that requires medication and monitoring, but with treatment, the impact on a person’s life and health can be minimal.

Monitoring HIV

You’ll often hear two numbers mentioned in regard to monitoring an HIV infection—viral load and T-cell count (or CD4 cell count). Viral load is the amount of virus present in the body. T-cell count is the number of healthy T-helper cells. If left untreated, the viral load goes up and the T-cell count goes down. With treatment, the viral load should reach undetectable levels, and the T-helper cells should increase. These numbers will be tested and monitored at various times to ensure that a treatment is working effectively.

Treatment for HIV

The standard treatment for HIV is called “antiretroviral therapy” or ART. This approach uses medications that disrupt the lifecycle of HIV. This stops the virus from replicating itself, allows the T-cell count to improve and prevents the virus from spreading to others. ART medications are taken as pills or via regular injection.

Treating HIV with ART is a lifelong commitment—once a person starts treatment for HIV, it will continue for life. Skipping doses or going off medication can lead to drug resistance, where certain medications will no longer be effective at treating the virus. Discontinuing treatment will lead to an increased viral load as well as a decreased T-cell count.

Choosing a treatment

Some people may take a combination of several ART pills, which is called a regimen. There are a number of different drugs and combinations that can be used, and it is important to work with an HCP on determining what would work best for you.

Aside from that, some of the factors that should be considered when choosing an HIV treatment include the following.

The cost of treatment

Treating HIV can be expensive. Because of the risks of pausing or stopping treatment, and the fact that treatment will continue for the rest of a person’s life, it is important to have a plan for paying for treatment. You’ll need to find out what insurance will cover and what programs are available to help pay for the cost of treatment.

Side effects and drug interactions

Some people may experience side effects with certain medications. It’s important to know what side effects to watch for, and to inform your HCPs of any side effects you experience. It is also important to inform your HCPs about other medications and supplements you may be taking for other health conditions, as drug interactions are possible.

Other health conditions or illnesses

It is important for your HCPs to know about any other health conditions you have, as this may guide treatment decisions.

If you are pregnant or intend to become pregnant

In utero transmission can be avoided in treated patients, and it is urgent that pregnant people with HIV begin treatment as soon as possible to prevent transmission to the baby. However, some HIV medications can affect developing fetuses, and alternatives may be needed in people who are pregnant or planning on becoming pregnant.