Although HIV can't be cured, it can be treated. Modern HIV treatment means that many people with HIV are living long, healthy lives. People who are diagnosed in good time nowadays, and who receive the right treatment and care, are likely to have the same life expectancy as someone without HIV.1
HIV treatment, also called antiretroviral therapy or ART, works by suppressing the levels of virus in the blood.
What does HIV treatment involve?
Current HIV treatment involves taking a combination of anti-HIV drugs. This has been shown to prevent the weakening of the immune system by HIV.
There are now more than 20 drugs licensed for the treatment of HIV. Each one belongs to one of six ‘classes’ of anti-HIV drug. The classes vary in how they work against HIV.
Most people on treatment will be prescribed a combination of drugs from more than one class – usually three drugs from two or three classes. This allows the treatment to target HIV in different ways at the same time, making treatment more effective and reducing the possibility of becoming resistant to any one drug class.
You can find out more about the types of anti-HIV drugs, and how they work, in NAM’s (National AIDS Manual Charity) information booklet Anti-HIV drugs.
To make taking HIV treatment easier, there are ‘fixed-dose’ pills that combine two or three anti-HIV drugs into one tablet. These can reduce the number of pills people need to take.
How does HIV treatment work?
HIV treatment works by reducing the level of HIV in the blood to very low levels. While you are not cured of HIV, HIV treatment allows the immune system to recover and stay strong. The amount of virus in the blood is often called ‘viral load’.
The goal of HIV treatment is to achieve and maintain an ‘undetectable’ viral load. This means HIV cannot be detected by the tests most often used to monitor viral load. An undetectable viral load is the aim of HIV treatment for everyone, whether you're taking your first combination of anti-HIV drugs or have considerable experience of HIV treatment.
For HIV treatment to be effective, it is important that you take it as prescribed, every day. This is often referred to as ‘adherence’. Missing just a few doses a month can mean that your treatment doesn’t work properly, and your HIV may become resistant to the drugs that you are taking. If you are having problems adhering to your HIV treatment, talk to someone where you receive your HIV care.
At present, once you have started HIV treatment, you are likely to be on it for the rest of your life. It is particularly important that you do not stop treatment without discussing this with your doctor.
How should my health be monitored if I have HIV?
Regular health monitoring is very important when you have HIV.
Doctors use two key laboratory tests to see how active HIV is and what impact it is having on the immune system. These tests are:
- a CD4 cell count, which gives an indication of the strength of the immune system, and
- an HIV viral load test, which shows how much HIV is in the body.
The results of these will help indicate when you need to start HIV treatment and how well any treatment you are on is working. Your healthcare team can look at your test results and then discuss with you the need to start or change HIV treatment.
Other tests will monitor the health of organs such as your liver, kidneys, heart and bones, and look at levels of blood fats (lipids, or cholesterol) and sugars. You will have some of these tests regularly, and others only if you are showing symptoms or at certain times. These tests and examinations are important in identifying the effects of HIV infection, side-effects of HIV treatment, or the development of other conditions common in people with HIV.
You may have some tests more frequently because of your particular circumstances, such as the type of HIV treatment you are on, because of your family history of certain illnesses, or because you have another condition as well as HIV.
- Rodger AJ, Lodwick R, Schechter M, et al. Mortality in well controlled HIV in the continuous antiretroviral therapy arms of the SMART and ESPRIT trials compared with the general population. AIDS. 2013;27(6):973-979.