HIV diagnoses are not all the same. Some people find out early on and others discover their status years down the road after infection. HIV can progress very slowly. It can take 10-years or more, depending on the individual and other factors, for HIV to progress to AIDS without treatment. But you don't want it to get to that point. Allowing your HIV to progress to AIDS or get closer to that point, can do damage to your body that you can prevent by monitoring and starting treatment before it gets to that point.
Here in the United States we have become very aggressive with treat ment. In fact, the current Department of Health and Human Services (DHHS) Guidelines states, "Antiretroviral therapy (ART) is recommended for all HIV-infected individuals, regardless of CD4 T lymphocyte cell count, to reduce the morbidity and mortality associated with HIV infection." The CD4 T-cell count used to be a major determining factor in when someone would start treatment (we'll discuss this later in the article).
The most important thing you can do after you receive an HIV diagnosis is to begin seeing a doctor. Make sure the doctor you choose is an HIV specialist so they are current on all of the new treatments and trends. This is very important because there have been so many improvements and conveniences to medications over the past several years. Your HIV specialist can begin monitoring your body and your HIV. Seeing a doctor regularly will help assure you’ll start treatment, get it right and stick with it.
Your First Doctor Visit
It is extremely important that you are completely honest with your doctor and staff members. If you think a question might be a little too personal or intrusive, just ask why the question is important and listen to the answer rather than being evasive. Things you think are minor or have no significance can actually be very important to your treatment.
Your doctor will review your tests and information then work with you on an individualized regimen that will be based on many of the following factors:
- Pre-existing physical conditions, ailments and diseases
It's Recommended To Start Treatment Immediately.
The CD4 test measures your CD4 T-cells or just “T-cells.” Your T-cells play an important part in the immune system and HIV, as time goes on, destroys them. The average person without HIV has between 500 and 1200 T-cells (which are measured within a cubic millimeter of blood). When your T-cells drop below 200 or when you have an opportunistic infection, you are considered to have AIDS.
The World Health Organization (WHO) guidelines earlier (2006) gave the 200 T-cell mark as the point to start treatment. This is still a starting point in some developing countries. Until the recent guidelines change for the U.S., most physicians would start patients on therapy between the 350 and 500 T-cell mark. Many physicians who recommend starting sooner did so to make sure there is no damage at all to the immune system.
Now however, findings from two large trials that addressed the optimal time to initiate ART - START (Strategic Timing of Antiretroviral Therapy) and TEMPRANO—have led the guidelines panel to recommend immediate treatment, for all patients, regardless of CD4 cell count. Both studies demonstrated about a 50% reduction in morbidity and mortality among HIV-infected individuals with CD4 counts greater than 500 to receive ART immediately versus delaying initiation of ART. Prompt initiation of ART is particularly important for patients with certain clinical conditions which are the following:
The decision to initiate treatment will also include consideration of a patient’s comorbid conditions (additional diseases or disorders) and his or her willingness and readiness to initiate therapy. On a case-by-case basis, ART may be delayed because of clinical and/or psychosocial factors however, therapy should be initiated as soon as possible.
Your First HIV Treatment Regimen
This used to be tricky and there were terrible side-effects but that was then, back in the early days of the disease, and this is now. Today’s drugs are numerous, tremendous, easy to take, easy to tolerate, easy to adhere to and most of all highly effective.
There are many, highly tested and FDA approved drugs for HIV treatment, including multi-class combination drugs and Single Tablet Regimens (STRs). The combination drugs (some of which have been around for years while a few are relatively new) are tremendous because they combine everything you need in just one or two pills that you take just once-a-day.
More information about the newest and preferred HIV drugs, preferred treatment regimens and current guidelines can be found in the 17th Annual HIV Positive! magazine Treatment Guide being published in April or you can go to the U.S. Department of Health and Human Services website at www.hhs.gov, the U.S. Food and Drug Administration website at www.fda.gov and our website at www.hivpositivemagazine.com.
Visit Your Local ASO
Addiction And Depression
Paying For Your Meds
If you are eligible for an AIDS Drug Assistance Program (ADAP) in your state and the medication(s) you will be taking are covered but think you may be moving to another state in the future, make sure the medication is covered and you are eligible for ADAP in the state you might be moving to. ADAP can vary greatly from state-to-state, especially with regard to qualifying incomes.
Copyright 2018, Positive Health Publications, Inc.
This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!