There is life with HIV

HIV Treatment and Viral Load- When to Start?

… And viral load are some of these tests. You need to know a few things about your body! Medicine is not an exact science. If no…

Tratamento Contra o HIVYou see. In the previous text I said, and said it several times, that it is proven that the best time to start your antiretroviral therapy is now, when you have finished the result. So science proved, with studies, studies and studies. Despite this truth, no one is forced to start treatment now, tomorrow or whenever. I have a friend, Violeta, who, at least until the last time we spoke, was firm in her decision not to be treated.

So there is more, around whether or not to start treatment, not just science. It revolves its intimate forum, its way of seeing life, its way of living, with this text, I try to work a little, and sideways, this aspect

 

Deciding to start HIV treatment - and finding out which medications to start with - can be a difficult decision to make. Learning all you can about the pros and cons of your various treatment options is your best weapon in the fight against HIV. The following information will help you communicate effectively with your doctor when discussing your treatment options.

Why is treatment necessary?

If HIV can reproduce, or "duplicate", in the body, it will damage the immune system. Ultimately, the immune system becomes so weak that the body becomes vulnerable to other diseases. This is the point at which a person is usually diagnosed with AIDS, and the other illnesses that he contracts can cause death. 

For adults living in wealthy nations - such as the United States - the average time between HIV infection and the development of AIDS is 10 years.

 

However, this does not include people taking HIV medications. Clinical trials have repeatedly shown that antiretrovirals can keep people with HIV alive and healthy for longer. In fact, research shows that people who start HIV treatment early have a normal life expectancy.

What can bring good treatment?

People living with the virus should seriously consider starting treatment as soon as they are diagnosed. 

Immediate treatment for HIV not only helps to keep viral load low and CD4 counts high - thus minimizing the risk of immunosuppression and AIDS-related health complications - but it can minimize the risks of certain unrelated diseases AIDS that are more common in people living with HIV. These include cardiovascular disease, kidney disease, liver disease and certain categories of cancer.

HIV treatment is now recommended for everyone living with HIV in the United States.

When should treatment be started?

The United States Department of Health and Human Services (DHHS) - the federal agency responsible for setting health-related policies in the United States - regularly updates and publishes HIV treatment guidelines to help people living with HIV and their providers. determine when antiretroviral therapy should be started. Here's what the guidelines, last updated in December 2019, recommend:

  • Antiretroviral therapy is recommended for all people living with HIV to reduce the risk of AIDS-related and non-AIDS-related illnesses and to prevent the transmission of HIV to others.
  • Antiretroviral therapy should be started immediately (or as soon as possible) after a person is diagnosed to increase the link to treatment results and to reduce the amount of time people spend with a detectable viral load, which improves their own health and reduces the risk of HIV transmission. 
  • It is important that all individuals diagnosed with HIV are informed about the benefits and risks related to antiretroviral therapy and address strategies to optimize adherence (for example, taking medication every day, exactly as prescribed). 

Here is a look at some benefits of starting treatment early, along with the possible risks of starting late:

Potential benefits of starting early
  • Keep your CD4 count high and possibly avoid irreversible damage to your immune system.
  • Decrease the risk of certain HIV-related health problems that can sometimes occur in people with low CD4 counts, including TB, non-Hodgkin lymphoma, Kaposi's sarcoma, peripheral neuropathy, cancers and pre-cancers caused by human papillomavirus (HPV) and mental deficits seen in some people with HIV, such as difficulty thinking and reasoning (neuro-cognitive problems).
  • Decrease the risk of serious health problems that occur more frequently in people living with HIV, such as CVD, kidney, hepatic, neurological complications and several categories of cancer and infections unrelated to AIDS.
  • Reduce or eliminate the risk of transmitting HIV to others - several studies have confirmed that having an undetectable viral load reduces the risk of transmitting the virus to zero, especially during sexual activity and pregnancy. 
Potential Risks of Not Treating
  • Risk of severely weakened immune system, which can be difficult to restore. 
  • Risk of developing AIDS-related illnesses.
  • Risk of passing HIV to others, including sexual partners and your child, if you become pregnant
What if I'm pregnant?

It is recommended that all pregnant women take HIV medications to protect their own health and also prevent the transmission of HIV from mother to child. Click here for detailed information on pregnancy and HIV.

How can I tell if my treatment is working?

When antiretroviral treatment is started, the level of HIV should start to drop dramatically. This is where the viral load test comes in. During the first two months of therapy, a person's viral load should drop by at least 90%. In other words, someone who starts treatment with a viral load count of 100.000 should drop to 10.000 or less in two months. Within 4 to 6 months of starting therapy, the viral load must have dropped much more, hopefully below the sensitivity level of the viral load test ("undetectable"). Most tests used today can detect only 20.

And My CD4 Cell Count? What to expect?

As for the CD4 cell count, you will likely see an increase of between 100 and 200 cells in the first 12 to 18 months, and it may gradually rise from there, as long as the viral load remains undetectable. Some people who start HIV treatment for the first time have a low CD4 response, despite reaching and maintaining an undetectable viral load. The researchers refer to individuals in this situation as "dissenting respondents". Most discordant respondents waited to start treatment until their CD4 counts were well below 200. This is one of the reasons why the guidelines recommend starting ARVs immediately after diagnosis.

 

You and your doctor should continue to monitor your viral load regularly to make sure that your HIV medications are working properly and that the amount of virus in your blood remains below or as low as possible.

 

If your viral load increases while you are taking HIV medications, it may mean that drug resistance has occurred. Click here to learn more about drug resistance.

After Starting Treatment What should I do?

You should also have your CD4 cell count checked regularly, at least once a year. Additional tests that your doctor should monitor to ensure that you are not experiencing certain side effects include proteins associated with liver and kidney health, your cholesterol and blood sugar. (Diabetes or Peripheral Resistance to Sugar)

And be sure to discuss any problems you are having with your treatment regimen with your doctor without delay. If you find yourself missing doses or experiencing side effects, you may be able to change your current regimen to one that is easier to take or associated with fewer side effects. But it is crucial that you do this sooner or later.

Translated by Original Claudio Souza in treatment against HIV.

 

Ten Further Reading Suggestions

  1.  HIV or what to do?
  2. HIV / AIDS well explained
  3. Opportunistic Infections “IO”. It is Important to Know What They Are and How to Prevent
  4. CD4 cells The evolution of HIV infection to AIDS
  5. HIV and lymph nodes and lymph nodes and HIV
  6. Blood Tests Before Starting Or Changing HIV Treatment
  7. HIV Positive Blog
  8. COVID-19 attacks the entire body!
  9. What is HIV? What is AIDS
  10. CD4 and CD4 T Cells Clarifying the difference!


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