When you’re first diagnosed with HIV, your doctor will look at how healthy your immune system is, in order to decide on a treatment strategy. Your CD4 count and the amount of HIV in your blood (your viral load) are indicators of your immune system’s health.
If you have HIV, you should begin treatment with antiretroviral therapy (ART) when you are diagnosed, even if your immune system is relatively strong. National recommendations call for taking at least three medications from at least two different classes of antiretroviral drugs. This combination approach should keep your HIV under control by halting viral replication. Factors that will affect treatment decisions include whether you’re pregnant, have AIDS, or have any other chronic health problems.
Many people find that, over time, their first treatment recommendations have to be changed to adjust to a change in the virus or their response to the medications. The best treatment plan is the one that you can stick with. If there are issues that keep you from staying on your medication plan, your doctor might recommend a change.
You may need a change in medications if, for example:
You can’t afford the medications. If you aren’t able to afford the drugs first recommended, your doctor may switch you to more affordable ones.
Side effects are intolerable. All medications have side effects, and some are relatively mild and go away over time. Some of the more challenging side effects of HIV medications include fatigue, nausea, rashes, fever, changes in vision, and changes in your ability to think clearly. If they become so unpleasant that you don’t want to take your medications, you may be able to try other drugs.
Your health status has changed. For example, if you become pregnant, you might need different medications until your baby is born.
Your medications aren’t working or aren't working well enough. One or more of your HIV drugs might not work for you, or might not be effective against the type of HIV that you have. This is called drug resistance. This can also happen if you skip doses.
You have difficulty taking the medications. For example, swallowing pills is difficult for some people.
Pros and Cons of Changing Your HIV Treatment
If you’re switching medications because your current regimen isn’t working well, you might feel apprehensive. But keep in mind there can be benefits to switching:
You might be better able to afford the new drugs.
You might be more likely to take them.
You might not have the same side effects.
You might have better success controlling HIV.
As is the case when you change any medication, there is a possibility of new or different side effects and interactions with other medications you’re taking for other conditions.
The most important part of HIV treatment is sticking to your regimen. It is critical for you to let your doctor know if you have new problems that could keep you from taking your medications as prescribed. Never stop taking any of your HIV medications on your own.
