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3 Myths About Switching HIV Treatment

By

Dan Brubaker

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The goal of treatment for Human Immunodeficiency Virus (HIV) is to suppress your viral load—how much HIV is in your body. Despite efforts by researchers to develop and refine HIV medication, treatment can be challenging. Many patients struggle to stick to their treatment regimens in the face of debilitating side effects and demanding dosing schedules.

Unfortunately, each time you miss a dose, you give HIV the opportunity to develop resistance to the drugs you’re taking. And so over time, not taking your medication can negatively affect your treatment’s ability to suppress your HIV.

Even for people with strict adherence, the effectiveness of a given treatment can diminish after a while. Luckily, over 30 HIV drugs have received approval from the Food and Drug Administration (FDA). These drugs fall into five classes, allowing your doctor to prescribe them in a variety of combinations.

Thanks to years of research and discoveries, we know a lot more about HIV than we did decades ago. Keep yourself safe and healthy by knowing the facts about HIV.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Oct 23, 2015

If your current treatment fails to suppress your viral load, your doctor may talk to you about switching regimens. But if you’re thinking about changing your HIV treatment, it’s important to know what you’re getting into. Here are three myths about switching regimens.

1. Myth: It’s easier to stick with a simpler medication regimen.

Regimens that can greatly simplify your dosing schedule are now available. And often, a decrease to twice or once daily oral dosing can promote greater adherence. But it’s important to recognize the dosing schedule alone doesn’t always make sticking to a regimen easier.

What remains unknown with a treatment change is how you will respond to any new drugs. You may experience worse side effects. The simpler regimen may increase your chances of developing conditions like high cholesterol or diabetes.

Are you adhering to a more complex regimen with ease? Is it suppressing your HIV as intended? If you answered yes to both questions, consider sticking with your current treatment for now.

2. Myth: Drug-resistance test results are a guarantee.

Your HIV may have developed resistance to any HIV medications you’ve taken in the past. Drug-resistance testing can identify if drugs will still work against the variations of the virus within your body. If test results show signs of resistance to certain drugs, your doctor will look into other options.

But drug-resistance testing isn’t foolproof. If test results don’t suggest any drug-resistance, it could be a false negative. Tests may overlook drug-resistant viruses in your body. These false negatives occur when resistant HIV makes up only a small percentage of all the HIV in your bloodstream. So don’t forget about the possibility of a false negative. The drug in question may have worked well for you in the past. But you and your doctor should still interpret negative test results with caution.

3. Myth: A new regimen will always be available.

While there are many approved HIV drugs on the market, the options aren’t endless. With each regimen switch you increase the odds that your HIV will develop resistance to a new treatment. Cycle through treatments too quickly and you can exhaust all your options.

A conservative approach is to only switch regimens when your current treatment stops working. If you want to change treatment because of side effects you’re experiencing, talk with your doctor. Sometimes you can swap out drugs that are causing problems without completely switching your regimen. This solution can address your intolerability while still conserving future options.

Find you’ve run out of alternatives? Research suggests that partial suppression of HIV trumps no treatment at all. You can also ask your doctor about enrolling in a clinical trial, where you would test out a new treatment that hasn’t yet received FDA approval.

Remember, there are options. Weigh the risks and benefits of switching your HIV treatment with your doctor before you make a change.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Oct 25, 2016

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Medical References

  1. Adverse Effects of Antiretroviral Agents. Adult and Adolescent ARV Guidelines. Guidelines. National Institutes of Health. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/31/adverse-effects-of-arv
  2. Chesney M. Adherence to HAART Regimens. AIDS Patient Care and STDs. 2003;17(4):169-177. https://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?sid=47c6b9da-34a8-425e-8bbb-2ec29de94fbd%40sessionmgr4008&vid=0&hid=4105
  3. Guidelines for Using Antiretroviral Agents Among HIV-Infected Adults and Adolescents. Recommendations of the Panel on Clinical Practices for Treatment of HIV. Recommendations and Reports. Centers for Disease Control and Prevention. https://www.cdc.gov/MMWR/preview/MMWRhtml/rr5107a1.htm
  4. Harrison P. Switching Antiretrovirals May Not Enhance HIV Treatment. August 8, 2014. Medscape. http://www.medscape.com/viewarticle/829651
  5. HIV/AIDS Treatment. HIV/AIDS. Diseases and Conditions. National Institute of Allergy and Infectious Diseases. National Institutes of Health. https://www.niaid.nih.gov/diseases-conditions/hiv-treatment
  6. Regimen Switching in the Setting of Virologic Suppression. Adult and Adolescent ARV Guidelines. Guidelines. National Institutes of Health. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/16/regimen-switching-in-the-setting-of-virologic-suppression

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