Treating HIV

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

Emergency HIV drugs

If you think you have been exposed to the virus within the last 72 hours (three days), anti-HIV medication may stop you becoming infected.

For it to be effective, the medication, called post-exposure prophylaxis or PEP, must be started within 72 hours of coming into contact with the virus. It is only recommended following higher risk exposure, particularly where the sexual partner is known to be positive.

The quicker PEP is started the better, ideally within hours of coming into contact with HIV. The longer the wait, the less chance of it being effective.

PEP has been misleadingly popularised as a morning-after pill for HIV a reference to the emergency pill women can take to prevent getting pregnant after having unprotected sex.

But the description is not accurate. PEP is a month-long treatment, whichmay haveserious side effects and is not guaranteed to work. The treatment involves taking the same drugs prescribed topeople who have tested positive for HIV.

You should be able to get PEP from:

• sexual health clinics, or genitourinary medicine (GUM) clinics
• hospitals usually accidentand emergency (A&E) departments

If you already have HIV, try your HIV clinic if the PEP is for someone youve had sex with.

Want to know more?

• Terrence Higgins Trust: post-exposure prophylaxis (PEP)

If you test positive

If you are diagnosed with HIV, you will have regular blood tests to monitor the progress of the HIV infection before starting treatment.

This involves monitoring the amount of virus in your blood (viral blood test) and the effect HIV is having on your immune system. This is determined by measuring your levels of CD4+ve lymphocyte cells in your blood.These cells are important for fighting infection.

Treatment is usually recommended to begin when your CD4 cell count falls towards 350 or below, whether or not you have any symptoms.In some people with other medical conditions, treatment may be started at higher CD4 cell counts. When to start treatment should be discussed with your doctor.

The aim of the treatment is to reduce the level of HIV in the blood, allow the immune system to repair itselfand prevent any HIV-related illnesses.

If you are on HIV treatment, the level of the virus in your blood is generally very low and it is unlikely that you will pass HIV on to someone else.

Want to know more?

• namlife (aidsmap.com): Why monitor CD4 and viral load?
• namlife (aidsmap.com): When to start treatment?

If you have another condition

If you have also been diagnosed with Hepatitis B or hepatitis C , it is recommended thatyou start treatment when your CD4 count falls below 500.

Treatment is recommended to begin at any CD4 count if you are on radiotherapy or chemotherapy that will suppress your immune system, or if you have been diagnosed with certain other illnesses, including:

• tuberculosis
• HIV-related nephropathy ( kidney disease )
• HIV-related neurocognitive (brain) illnesses

Want to know more?

• nam (aidsmap.com): Starting treatment if you have another condition

Antiretroviral drugs

HIV is treated with antiretrovirals (ARVs), these work by stopping the virus replicating in the body, allowing the immune system to repair itself and preventing further damage.

A combination of ARVs is used because HIV can quickly adapt and become resistant to one single ARV.

Patients tend to take three or more types of ARV medication. This isknown as combination therapy or antiretroviral therapy (ART).

Some antiretroviral drugs have been combined into one pill, known as a "fixed dose combination". This means that the most common treatments for people just diagnosed with HIV involve taking just one or two pills a day.

Different combinations of ARVs work for different people so the medicine you take will be individual to you.

Once HIV treatment is started, you will probably need to take the medication for the rest of your life. For the treatment to be continuously effective,it will need to be taken regularly every day. Not taking ARVs regularly may cause the treatment to fail.

Many of the medicines used to treat HIV can interact with other medications prescribed by your GP or bought over-the-counter. These include herbal remedies such as St John's Wort, as well as recreational drugs.

Always check with your HIVclinic staff or your GP before taking any other medicines.

Want to know more?

• nam: Anti-HIV drugs (PDF, 1.37Mb)
• Terrence Higgins Trust: Treatment for HIV
• HIV i-Base: Introduction to combination therapy

Pregnancy

ARV treatment is available to prevent a pregnant woman from passing HIV to her child.

Without treatment, there is a one in four chance your baby willbecome infected withHIV. With treatment, the risk is less than one in 100.

Advances in treatment mean there is no increased risk of passing the virus to your baby with a normal delivery. However, for some women, a caesarean section may still be recommended.

If you have HIV, do not breastfeed your baby because the virus can be transmitted through breast milk.

If you or your partner has HIV,speak to an HIV doctor as there are options for safely conceiving a child withoutputting either of you at risk of infection.

Missing a dose

HIV treatment only works if you take your pills regularly every day. Missing even a few doses will increase the risk of your treatment not working.

You will need to develop a daily routine to fit your treatment plan around your lifestyle.

Want to know more?

• nam: Adherence & resistance (PDF, 1Mb)

Side effects

HIV treatment can have side effects. If you get serious side effects (which is uncommon) you may need to try a different combination of ARVs.

Common side effects include:

• nausea
• diarrhoea
• skin rashes
• sleep difficulties

Want to know more?

• nam: Side effects (PDF, 1.36Mb)

People with HIV get treatment at a specialist HIV clinic which is usually part of a sexual health or infectious diseases clinic at your local hospital.

Services, including support organisations, may work together to provide specialist care and emotional support.

Find out more about living with HIV .