HIV and AIDS - Treatment 

What are the treatment options? 

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.

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.

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

You should be able to get PEP from:

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

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

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If you test positive

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

You will not normally need to start treatment until the virus has begun weakening your immune system.

This is determined mainly by measuring your levels of CD4, which are infection-fighting cells, in your blood.

Treatment is usually recommended to begin when your CD4 count falls to 350 or below, whether or not you have any symptoms. Treatment is also recommended to as soon as possible if your CD4 count is getting close to 350.

The aim of the treatment is to reduce the level of HIV in the blood and prevent or delay 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.

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If you have another condition

If you have also been diagnosed with hepatitis B or hepatitis C, it is recommended that you 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:

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Antiretroviral drugs

HIV is treated with antiretrovirals (ARVs), which work against the HIV infection by slowing down the spread of the virus in the body.

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 is known 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 effective, it will need to be taken on time, every time.

Many of the medicines used to treat HIV can react in unpredictable ways if you take them with other types of medicines.

These include herbal remedies such as St John's Wort, recreational drugs such as cocaine, and some over-the-counter medicines. Always check with clinic staff or your GP before taking any other medicines.

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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 that your baby will develop HIV. With treatment, the risk is less than one in a hundred.

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 without putting either of you at risk of infection.

Missing a dose

HIV treatment only works if you take your pills on time, every time. 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.

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Side effects

HIV treatment can have unpleasant 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
  • tiredness
  • diarrhoea
  • skin rashes
  • mood changes
  • gaining fat on one part of your body while losing it on another

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People with HIV can get treated by their own doctor or by a specialist at an HIV clinic or a GUM clinic.

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

Find out more about living with HIV.

Page last reviewed: 28/08/2012

Next review due: 28/08/2014

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