Are the drugs a cure? and other questions

The current drugs are a treatment but they are not a cure. They stop the progression of HIV. They let your immune system start to repair itself. But, you will still be HIV-positive.

Even people taking combination therapy for many years, with a viral load below 50 copies/mL, still have very small amounts of HIV. This HIV is in cells that are 'resting' or 'sleeping' and is not reached by current drugs.

These sleeping cells are one of the reasons that it is very difficult to find a cure for HIV. Some of these cells can sleep for 70 years.

You may need medication for a long time, but newer drugs may be easier to take and more effective.

This means you may still get to die of old age rather than from HIV.

It may also mean that you are still alive when we find a cure – and this is something good to aim for.

Why do treatments not always work?

Guide to changing treatment: second-line therapy and drug resistancewww.i-base.info/guides/changing

For some people the treatments will not work as well.

The combination may not be potent enough.
You may already be resistant to one or more of the drugs in your combination.
Missed or late doses can lead to resistance (even if you are only missing one dose a week).
One or more of the drugs may not be absorbed properly. There can be big variations between people and tests can check for this.
Side effects may be too difficult to tolerate.

Trial results never show a 100% success rate. BUT if you have a good doctor, and you follow your regimen carefully, anyone starting treatment for the first time should be able to get an undetectable viral load.

Success rates for people on their second or third therapy are usually lower than for those starting treatments for the first time.

This is often because people continue to make the same mistakes and move to a new combination without understanding why the original one failed.
If you need new drugs in order to put together a new combination, then make sure you and your doctor keep up-to-date on the latest research.

Recreational drugs and complementary therapy

Some HIV drugs interact with recreational drugs, street drugs, methadone and complementary therapies.

The interactions can be complicated and involve both higher and lower levels of HIV or other drugs.

It is therefore very important that your HIV doctor and pharmacist know about any other drugs or supplements that you use. Even if you use them rarely. Your doctor will treat this information in confidence.

Alcohol does not interact with HIV medications. However, heavy alcohol use, as with recreational drug use, may reduce adherence. It would help if your healthcare workers know about this.

What else do I need to know?

Ask questions about anything you don't understand. You can then take responsibility for whatever you decide.

Ongoing research means that ideas about how to use anti-HIV drugs are changing. The treatment your doctor will advise today may be different from 12 months ago.

This isn't just because there are newer drugs available. It is to do with understanding how the drugs work, why they sometimes stop working, and especially increasing knowledge about resistance.

This is why it is important to make sure your information is up-to-date.

Don't look at the drugs you start with now as a treatment that you will be taking forever

Look at them as something you have to be really committed to for the next couple of years. Take this new aspect of your life more seriously than anything else until you get it right.