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About HIV Treatments
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The following is a list of questions to ask your doctor About HIV Treatments  as well as tips for preparing for these conversations.

What are the treatments for HIV?

Although there is no cure for HIV there are antiretroviral medications that can lower the amount of the HIV virus in your body, sometimes to very low levels. Your doctor will recommend starting these treatments based on many different factors including:
  • The stage of your disease
  • Symptoms
  • The level of HIV virus in your blood (viral load)
  • The level of CD4 T-cells in your blood (T-cells)
  • Your willingness to begin therapy
Antiretroviral medications for HIV are divided into three main classes: nucleoside/nucleotide reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and protease inhibitors (PI). A new class of antiretrovirals, fusion inhibitors, was approved by the Food and Drug Administration (FDA) in March 2003.

In addition to antiretroviral medications, you may receive medications to help treat complications of the disease and opportunistic infections that may occur. These medicines don't have any direct effect on the HIV virus.

How you can prepare for this discussion

  • Keep a record of any laboratory test and procedure results performed in the past
  • Record the dosages and schedules of all the prescription, over-the-counter medications and dietary supplements you are taking
  • Record all side effects you have experienced in the past
  • Keep a health history containing details of any illnesses and health conditions

Should I begin therapy right away?

The decision to begin HIV therapy must be made carefully in consultation with your doctor. Once you begin therapy you may need to stay on it for the rest of your life. There are benefits and risks to both beginning therapy early and delaying therapy. You should ask your doctor about how the medicines will help your immune system, the potential side effects of the medications, and if the drugs will interact with other medications that you are taking (drug-drug interactions). You may also want to know if there are ways to maintain a good quality of life while taking your medications and about future medication options. Using all of this information will enable you to make a more informed decision about whether or not to start therapy.

How you can prepare for this discussion

  • Make a list of all prescription, over-the-counter medications and dietary supplements you are taking now or in the past
  • List any drug allergies
  • Examine your lifestyle to identify potential issues with starting treatment <
  • Note the date of your HIV diagnosis

What type of therapy is right for me?

HIV is a difficult virus to control and research has shown that a combination of mediations offers the best result. HIV drugs work by interfering with the life cycle of the virus and its ability to reproduce. Currently, the best way to treat HIV disease is to attack the virus at different stages in its life cycle using a combination of drugs. This type of combination therapy increases the chances of killing the virus.

The currently recommended treatment for HIV is also known as HAART therapy-Highly, Active, AntiRetroviral, Therapy. It combines three or more HIV drugs from the different classes available and is sometimes referred to as "cocktail therapy". Current regimens use a combination of two (or more) medicines from the NRTI class and add to them medicines from the NNRTI or PI class. As newer antiretroviral medicines are developed and approved, they may be incorporated into different regimens.

Some regimens require taking many pills on a strict schedule. Other regimens require fewer pills to be taken less frequently. Whatever regimen you are taking, make sure that you take the medications exactly as prescribed. Without doing so, the medications may not continue to be effective. A commitment to adherence is crucial, so let your doctor know if you have had any problems taking other drug regimens in the past. In some cases, certain combinations may be chosen over others that may better fit into your lifestyle.

How you can prepare for this discussion

  • Tell your doctor if you have any issues obtaining or paying for medication
  • Tell your doctor if you have had any problems in the past remembering to take medications
  • Make a list of any dietary habits and restrictions you may have
  • Keep a record of your personal lifestyle habits and regular activities that may be affected by complicated drug regimens
  • Let your doctor know about your support networ
  • Learn the names of HIV drugs and how they work

How will I know if my medicines are working?

The goal of taking antiretroviral therapy is to achieve the following:
  • Decrease your viral load (which means there is less virus detectable in your blood)
  • Increase your T-cell number (which means that your immune system will be better functioning)
  • Prolong life
Your doctor will monitor the medicines' effectiveness by doing physical examinations and by taking blood tests to measure your T-cell count and viral load. Other blood tests will be done to see if you are developing any side effects from the medications.

The viral load and T-cell levels can be affected by many factors such as the number of medicine doses that you don't take on time or you miss taking, the T-cell level that you had prior to starting therapy, how long you've had HIV, your prior experience with HIV therapy, and other related health issues.

If your T-cell or viral load levels do not respond well, or if you are experiencing side effects from the medicines, your doctor may change the medications or add additional drugs to your regimen.

How you can prepare for this discussion

  • Keep a log of all test and procedure results
  • Note all past and current medical problems
  • Ask your doctor about the common and uncommon side effects of all the medicines you are taking
  • Keep a diary indicating how you feel when beginning a new medication <
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