Why Sticking With HIV Treatment is Essential
HIV, or human immunodeficiency virus, is the name of the virus that weakens the immune system by killing the Cluster of Differentiation 4 (CD4) T cells, making you more susceptible to infections and certain cancers. If untreated, HIV can eventually turn into acquired immune deficiency syndrome or AIDS, which is the end-stage, clinical syndrome of the HIV infection.
HIV is transmitted through any bodily fluid like blood, semen or saliva and here’s what’s scary: an estimated one million people in the United States are infected with the disease, and one in five people infected do not know it. That’s why the Centers for Disease Control (CDC) recommends that every adult between the ages of thirteen and sixty-four in the U.S. be tested for HIV. HIV is tested through a blood test, which looks for a specific antibody, or protein, that your body produces to fight HIV. The test also looks of an HIV antigen, or a piece of the virus. The antibody usually takes at least two to four weeks after exposure to show up in your blood, the antigen can show up after days.
Ideally, once you’re HIV is positively confirmed, we’ll start you on an antiretroviral regimen right away. However, before starting treatment, we have to make sure you’re ready and willing to take your medication every day for the rest of your life. Why? Because if you miss a day, the virus can become resistant to that treatment and you may have to switch to a different medication. And once your virus becomes resistant to one medication, that medication will never work again to keep your virus from replicating. And though there are a more treatment options for HIV than when the virus was discovered in the 80s, the choices are not endless. If you keep stopping and starting medications, eventually I’m going to run out of treatment options for you.
Bottom line? The goal of HIV treatment is to keep the virus from reproducing. When the virus is not fully controlled by medication, for whatever reason, whether it’s negatively interacting with a medication you’re taking for another condition, the side effects are bothersome to you or you’ve been sporadic with taking it, the HIV replicates extremely rapidly. During replication, new forms or “mutations” of the virus are created and these mutations may not respond to the antiretroviral regimen you’re currently on. And that means your virus will become resistant to the treatment and begin freely replicating in your blood.
When I first began my career in 1998, there were far fewer treatment options for HIV, with far more serious side effects. In 1996, when the FDA approved protease inhibitors, it allowed for combination therapy, which meant we could give HIV patients three medications from at least two classes of antiretroviral drugs. That’s when the face of HIV treatment radically changed.
Today, the vast majority of patients will take one of the first-line regimens and do very well with minimal side effects--as long as they take that medication every day. As I always tell my patients, it’s better to take nothing at all, than to take it poorly.
THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
Stacey Rizza, MD, is Chair of the Mayo HIV
Clinic, and Associate Professor of Internal Medicine at the Mayo Medical
School. She has been treating HIV patients since 1998.
View her Healthgrades profile >