HIV: Taking antiretroviral medicines

Highly active antiretroviral therapy (HAART) is the use of 3 or more antiretroviral drugs. It is the standard treatment for HIV infection. Antiretroviral drugs attack the virus at different stages in its life cycle. HAART helps prevent HIV from multiplying and helps the immune system stay healthy.

Treatment with antiretroviral drugs is usually offered when:

• HIV-related infections, such as pneumonia, or certain cancers develop.
• Mild "non-AIDS" symptoms of HIV develop.
• CD4+ cell count drops below 350 cells per microliter (mcL). Some experts may wait for a lower CD4+ count before recommending treatment.
• You are willing and able to take your medicine as prescribed.

You should not start antiretroviral therapy until you have considered the benefits and risks of treatment and discussed all the issues with your doctor.

Test Your Knowledge

1. Highly active antiretroviral therapy (HAART) is the use of 3 or more antiretroviral drugs to treat the HIV infection.

   1. True

      This answer is correct.

      In the treatment of HIV, highly active antiretroviral therapy (HAART) involves the use of 3 or more antiretroviral drugs. HAART is considered the standard of care for treating HIV infection.

   2. False

      This answer is incorrect.

      In the treatment of HIV, highly active antiretroviral therapy (HAART) involves the use of 3 or more antiretroviral drugs. HAART is considered the standard of care for treating HIV infection.

2. There are several factors to consider when deciding to start antiretroviral therapy.

   1. True

      This answer is correct.

      You and your doctor will consider many factors when deciding whether you should start antiretroviral therapy. Some of these factors are:

      • Whether you want to start antiretroviral therapy now.
      • How badly impaired your immune system is and how rapidly it is declining.
      • How likely it is that your infection will progress to AIDS.
      • Your thoughts about the possible benefits and risks of antiretroviral therapy.
   2. False

      This answer is incorrect.

      You and your doctor will consider many factors when deciding whether you should start antiretroviral therapy. Some of these factors are:

      • Whether you want to start antiretroviral therapy now.
      • How badly impaired your immune system is and how rapidly it is declining.
      • How likely it is that your infection will progress to AIDS.
      • Your thoughts about the possible benefits and risks of antiretroviral therapy.

3. My willingness and ability to take my medicine as prescribed is not a factor in making the decision to start antiretroviral therapy.

   1. True

      This answer is incorrect.

      Your willingness and ability to follow take your medicine as prescribed is an important factor in determining whether you should start antiretroviral therapy. It is also essential for successful treatment of your HIV infection. Some people find that taking their medicine as prescribed by their doctor is challenging. Not following your prescribed HIV therapy may cause treatment to fail because drug-resistant strains of HIV will produce higher viral loads and the disease will progress.

   2. False

      This answer is correct.

      Your willingness and ability to follow take your medicine as prescribed is an important factor in determining whether you should start antiretroviral therapy. It is also essential for successful treatment of your HIV infection. Some people find that taking their medicine as prescribed by their doctor is challenging. Not following your prescribed HIV therapy may cause treatment to fail because drug-resistant strains of HIV will produce higher viral loads and the disease will progress.

Complications may develop if you do not take your antiretroviral therapy drugs exactly as prescribed.

• The antiretroviral therapy drugs will not control the virus replication as effectively or protect the immune system.
• Drug resistance is more likely to occur. The virus that causes HIV can become resistant to antiretroviral drugs used to treat the infection.

Test Your Knowledge

1. Drug resistance is more likely to occur if I do not take my drugs exactly as prescribed.

   1. True

      This answer is correct.

      Not following your prescribed antiretroviral therapy may cause drug resistance. When this happens, the drug no longer effectively controls virus replication or protects the immune system.

   2. False

      This answer is incorrect.

      Not following your prescribed antiretroviral therapy may cause drug resistance. When this happens, the drug no longer effectively controls virus replication or protects the immune system.

2. Not taking my antiretroviral drugs exactly as prescribed will not change the effectiveness of the antiretroviral drug.

   1. True

      This answer is incorrect.

      When antiretroviral drugs are not taken exactly as prescribed, the effectiveness of the drug is decreased and drug resistance is more likely to occur.

   2. False

      This answer is correct.

      When antiretroviral drugs are not taken exactly as prescribed, the effectiveness of the drug is decreased and drug resistance is more likely to occur.

In the past, a person had to take many pills several times a day, which was difficult for some people. But over the past few years this routine has become much simpler, and many people take their medicine only once or twice a day. With the right knowledge and tools, you can successfully take your medicine as prescribed.

Work with your doctor when starting HAART.

• Know the names of all of your drugs.
  • Get a clear explanation of the actions and purpose of each of your drugs. If you understand what you are taking and how it is helping you, it may be easier to stick to your schedule.
  • Write down both the prescription and generic names for your drugs. Have your doctor check the list.
• Know your when to take your medicine. Write down when to take your medicine, and have your doctor check it. Get pictures of all of your drugs so you are sure you are taking the right drug and the right dose at the right time. Be sure you understand how much of each drug to take and when to take each one.
• Know how to handle missed doses. Talk with your doctor about what you should do if you accidentally miss a dose of a drug. Discuss what to do for each drug-it may be different for each one.
• Learn what drugs to avoid. Some drugs can cause a bad reaction or a decrease in effectiveness if they are taken with antiretroviral drugs.

Keep the following in mind:

• Store drugs properly. Keeping drugs in a location that is too hot or too cold may decrease their effectiveness. Find out from your doctor or pharmacist how to properly store your drugs. Always store drugs out of the reach of children.
• Watch for side effects. Ask your doctor or pharmacist what to expect. Notify your doctor immediately if you have any serious side effects.
• Avoid other drugs. Post your drugs-to-avoid list in a place where you can refer to it whenever you need to. Always check with your doctor before taking any additional drugs, prescription or nonprescription. This includes any herbal or "natural" supplements.
• Review your drug list. Review your list and bring it with you each time you visit with your doctor. Tell your doctor about any side effects you are having.
• Communicate with your doctor. Notify your doctor immediately if you have any serious side effects. Let your doctor know if you have any changes in your health that might affect your condition, such as weight loss or another medical condition.

You may be able to reduce the costs of your antiretroviral drugs and other drugs.

• Compare prices among several drugstores.
• Consider using a mail-order or online drugstore.

Test Your Knowledge

1. I need to develop a drug plan with my doctor that includes a list of all my drugs and their names, dosages, and when to take them.

   1. True

      This answer is correct.

      You need to develop a drug plan with your doctor that includes a list of all your drugs and their names, dosages, and schedules. You and your doctor can establish what drugs you need to take, their dosages, and when to take them. You will also need to know what other drugs to avoid.

   2. False

      This answer is incorrect.

      You do need to develop a drug plan with your doctor that includes a list of all your drugs and their names, dosages, and schedules. You and your doctor can establish what drugs you need to take, their dosages, and when to take them. You will also need to know what other drugs to avoid.

Now that you have more knowledge about your antiretroviral drugs and some tools to help you take them, you are ready to develop your system for taking your drugs correctly.

Work in partnership with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of the pages where you have questions.

Also be sure to discuss any questions you have about your antiretroviral therapy schedule or if you are having difficulty following your drug schedule.