HIV & AIDS – What treatment is there for HIV?

Is there a cure for HIV/AIDS?

Currently, there is no cure for HIV/AIDS. However, there are many anti-HIV/AIDS treatment options available to help manage the disease. Also, there are ongoing research efforts to identify a cure or vaccine for HIV/AIDS. With the available treatment options, many HIV-positive individuals can lead long, healthy lives. Immediate treatment is critical for new patients. Each patient’s disease will be different so it is important to talk to your health care provider to determine the best treatment options, some of which are described below.

Antiretroviral therapy (ART) for HIV/AIDS

Antiretroviral (ARV) drugs are a successful treatment for reducing the amount of virus in the bloodstream, improving patient health, reducing mortality rates, preventing AIDS, and reducing rates of HIV transmission. ARVs work by preventing the HIV virus from getting its genetic information to human cells. Different ARVs work in different ways but they all result in blocking the virus from replicating itself to produce more virus and infect more human cells. ART effectively lowers viral counts and increases CD4+ T cell counts, thereby preventing progression to AIDS. Antiretroviral therapy typically consists of a combination of three or more ARV drugs. Combination treatment is sometimes called highly active antiretroviral therapy (HAART) or a coctail. Some combinations of ARVs are available in a single pill, enhancing the ease of drug administration. Your doctor will determine the best combination of ARVs for you based on your HIV status, your viral load, CD4 count, lifestyle, other disease conditions, other medications you are currently taking  and possible drug resistance. Now that there are multiple new ARV drugs which are highly effective in combination, many people who were previously considered un-treatable can now receive effective anti-HIV treatment. A list of approved ARVs is available here.

For patients receiving ART, it is extremely important to follow the treatment schedule and protocol given by your doctor, to prevent the virus from becoming resistant to the drugs. The human immunodeficiency virus can mutate its DNA at a very high rate. This allows different strains of the virus to emerge continually. If ARV drugs are not taken consistently, a treatment-resistant strain of the virus could form and spread. This is a huge detriment to the patient’s health and ongoing treatment efforts.

Treatment for HIV-positive pregnant women

Pregnant women who are living with HIV can also receive ART. ART is successful for reducing the risk of perinatal transmission to the baby. However, some ARVs are toxic to the fetus or can have negative effects on development, so a change in the type of ARV drugs may be required. Women who are HIV-positive and who may become pregnant should also talk with their health care providers about the best treatments to optimize their health and the health of the baby. HIV-positive women who are pregnant should receive counseling from an HIV-experienced obstetrician about the available HIV/AIDS treatments and associated risks, in order to make informed decisions about their health and the health of their child. During pregnancy, special cautions have to be taken to prevent, avoid, and monitor opportunistic infections.

Prevention and treatment of opportunistic infections

Opportunistic infections (OIs) are infections that do not usually affect healthy individuals. However, because HIV kills CD4+ immune cells, the immune system of HIV-positive individuals is weakened which gives certain infections the opportunity to infect them. A key way to avoid opportunistic infections is by getting up-to-date vaccinations.  In order to avoid sexually-transmitted diseases, always practice safe sex. In addition, eating healthy and staying well-rested can help give your immune system the energy it needs to prevent opportunistic infections from taking hold. Quitting smoking, drinking, and other drugs will also help your immune system. If you need help with lifestyle changes, talk to your doctor about resources geared toward people living with HIV/AIDS.

One of the most common OIs for HIV-positive people is pneumocystis pneumonia (PCP). PCP is treated with antibiotics. If your CD4 count is especially low, your doctor may recommend that you start taking antibiotics as a preventative measure to avoid PCP infection. Other OIs include thrush, meningitis and herpes. Keep close tabs on your health, it is important to carefully track all of your symptoms in order to communicate them clearly to your doctor. OIs should not go untreated, as they can allow HIV to replicate faster.

Palliative care for HIV and AIDS

Palliative care relieves the pain, discomfort and stress of having HIV/AIDS. Side effects from opportunistic infections or anti-HIV/AIDS drugs may cause pain and stress in HIV-positive individuals. Palliative treatment emphasizes a holistic approach to treat the person and not just the disease. Symptoms such as weight loss, nausea, fever and diarrhea can be alleviated with palliative treatment.  Keep in mind health is not restricted to the body, and many HIV-positive individuals experience depression or other mental problems. Mental health is a serious concern, but one that can also be addressed by palliative care. Anti-depressants and/or counseling are options for people with HIV/AIDS suffering from depression.

Alternative medicine for HIV/AIDS

There are other treatment options for HIV/AIDS that can be added to anti-retroviral therapy or used alone. Keep in mind that although they may help improve patient health, these alternative treatments are not approved by the Food and Drug Administration (FDA) . Nevertheless, 70% of HIV-positive people have used alternative medicine. One such alternative is homeopathic medicine, which uses small doses of natural products like minerals, vitamins and herbs to stimulate the immune system. Homeopathy is based on the idea that substances which cause disease-like symptoms when taken in high doses, can actually fight the disease in low doses. Homeopathic medicines are prepared for each individual person by a homeopath. In addition, dietary supplements are often used to try to boost the immune system. Certain dietary supplements like fish oil and whey protein may help fight against HIV.  Yoga, meditation, acupuncture and massage therapy can help improve mental health and relieve pain and stress. There are however, some supplements and treatments which can actually interfere with traditional HIV medications such as St. John’s wort and garlic. If you are interested in using alternative medicine for HIV/AIDS, always consult your doctor before starting any treatments.

What to expect when getting treatment for HIV/AIDS

While receiving anti-HIV/AIDS treatment, you can expect that your doctor will do a viral load test every 3 – 4 months to make sure the drugs are working effectively.  This test involves taking a blood sample, which is then sent to a lab to determine how much virus is contained per volume (mL) of blood.  Because the lab tests are not sensitive enough to detect  less than 50 virus copies, HIV can sometimes become undetectable, which is the goal for HIV treatment. However, while this means that the treatment is working very well, it does not mean that you are cured. Only 5% of the total HIV in the body is contained in the blood.

Your health care provider will also track your CD4+ T cell count, which is also measured by a blood test every 3 – 6 months. CD4+ cells are important immune cells which are targeted by the HIV virus. A healthy individual will have between 500-1000 CD4+ cells per cubic mm of blood. A person with less than 200 CD4+ cells per cubic mm is at high risk for getting other infections. The US Department of Health recommends considering anti-HIV/AIDS treatment when your CD4+ count is below 350.

Although new HIV/AIDS treatments have fewer side effects compared to those in the past, some side effects are still possible even with the newest drugs. Since every patient is likely to be on a different treatment regimen, each patient will experience different side effects. It is important to talk to your health care provider to ask what side effects you can expect. Some side effects include dry mouth, fatigue, anemia, diarrhea, headaches, insomnia, weight loss and vivid dreams. These side effects usually lessen over time, and can also be ameliorated with medications. Always talk to your doctor about any side effects you experience and what can be done to reduce or eliminate them.