6 Signs It's Time to Try a New HIV Treatment
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Sarah Lewis, PharmD on October 25, 2021
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Why change an HIV regimen?Many people stay on an HIV treatment regimen for years. And research suggests people have the greatest long-term success with their first HIV regimen. So why think about changing? There are some situations when changing your treatment may be in your best interest.
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1. Your HIV virus has developed drug resistance.Drug resistance occurs when the HIV virus mutates—or changes itself—and becomes stronger than the drug treating it. When this happens, your current drug regimen can no longer suppress the virus and the virus starts replicating faster despite the presence of the drug. An increasing viral load can be a sign drug resistance is developing, but the only way to tell for sure is to have drug resistance testing. It’s a blood test your doctor can order if he or she suspects drug resistance.
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2. You’re having problematic side effects.Every medication has the potential to cause side effects. Medicines to treat HIV are no exception. Many side effects—such as nausea and fatigue—are often mild and temporary. They don’t require a change in your treatment, just patience to see if they eventually pass. But sometimes, side effects start to affect your quality of life. There are also some serious side effects that can pose threats to your health. In either case, changing your regimen may be the solution.
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3. Your medicines are causing a drug interaction.HIV medicines can interact with each other. And other medicines, like prescription drugs, non-prescription medicines, supplements, and herbal products can affect the drugs in your HIV regimen. Some of these drug interactions can increase the risk of side effects or decrease your HIV regimen’s effectiveness. Make sure all your providers know about all of your medicines whenever you start a new drug. It’s possible you may need to change your HIV regimen to avoid a drug interaction.
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4. You’re having trouble sticking with your regimen.Medication adherence means taking all of your medicines correctly—every dose, every day. Poor medication adherence is the main cause of drug resistance. HIV medicines slow viral replication, but can’t stop it completely. Skipping doses gives the virus a chance to multiply faster. This increases the chance of the virus mutating and developing drug resistance. If your regimen isn’t working for your lifestyle and habits, talk with your doctor about changing it. Effective solutions exist. Trying to stick with your current prescriptions may do more harm than good.
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5. Your regimen is failing.Your regimen can start to fail even with good medication adherence. Other things can contribute, including your overall health and poor absorption of the drugs. A rising viral load, falling CD4 count, and increasing symptoms are signs your regimen is no longer controlling HIV infection. You and your doctor should explore the reasons your treatment is failing. Be honest if you’ve struggled with taking your medicines correctly. Your doctor can help you design a new regimen that fits your life better.
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6. You discover you’re pregnant.Women with HIV can pass the virus to their babies during pregnancy, delivery, or breastfeeding. It’s the most common way children develop HIV infection. The good news is HIV medicines decrease the risk of passing the virus to your baby; but some medications are better to take during pregnancy than others. Even if you’re already taking an HIV regimen when you become pregnant, contact your doctor as soon as possible. Your doctor can help you find the best regimen for both you and your baby.
6 Signs It's Time to Try a New HIV Treatment