Antiretroviral therapy, or ART, is a safe and proven way to treat HIV. Your doctor will want you to start right away – usually the same day you’re diagnosed. This is called Rapid Start ART. Early and effective treatment can help you live a normal life. It can also reduce the chance of passing the virus on to someone else.
The sooner you start ART, the better. This is true even when you feel good.
“There’s nothing to expect,” says Shannon Galvin, MD, associate professor of medicine and infectious disease at Northwestern Medicine. “Everyone who has HIV will benefit from treatment regardless of T-cell count.”
Effective ART can lower your viral load so much that blood tests won’t be able to find it. It not only supports health. This means that there is virtually no chance that you will pass the virus on to someone else sexually. This is called “indiscernible equals incommunicable”. If you achieve this state quickly, you can feel more in control and hopeful about your condition, says Gregory Hoon, MD, assistant professor of medicine and infectious diseases at Rush University Medical Center.
ART can help you stay healthy. But it is not a cure for HIV. You will need to take medicine every day. If you have any questions about treatment, consult your doctor before starting. They can help you find a plan that’s right for you.
How does ART treat HIV?
This combination of drugs can lower the amount of HIV in the blood, called the viral load. This keeps your CD4 count up. The higher the number, the more T cells you have and the better you are immune system is working ART also reduces your HIV-related immune activation. This inflammation which can harm you heart, the brainbones and other organs.
Basically, ART makes it less likely that you will get HIV. And it helps to live longer.
“If you take a 20-year-old with a CD4 count above 500 who starts ART immediately after diagnosis – and he doesn’t have hepatitis BC or other co-morbidities – their life expectancy is about the same as someone without HIV, Hoon says.
Who should start ART immediately?
In the past, doctors started ART quickly in people with very low CD4 counts. But now anyone who has HIV can get it. “We have clear data showing that everyone (with HIV) lives longer and healthier lives when they take antiretroviral drugs,” says Galvin.
ART is even more important to some groups. This includes people who:
- There is pregnant. You are less likely to pass HIV to your baby if you have an undetectable viral load. If you are already taking ART, continue taking the medicine. But if it’s not, talk to your doctor about how you can start treatment right away.
- Have low CD4 levels. People with a CD4 count of less than 200 are at high risk of getting sick. In fact, a CD4 level this low means you have AIDS.
- There is a condition that defines AIDS. These are infections and cancers that are particularly serious for people with HIV.
Should someone delay ART?
Hoon says there are very few people who should wait to start ART. But sometimes some infections may need treatment.
Your doctor may delay ART if you have:
Your doctor may also want to treat any serious mental illness first, says Hoon. Untreated psychological or substance abuse problems can make treatment difficult for you.
What if you’re not ready?
It is normal that it will take you some time to diagnose. It is still considered rapid initiation if you start ART within 7 days. The most important thing is that you are ready to continue treatment once you start. “There are a few people who need to think about it, and they need to be given that opportunity,” says Galvin. “We just want to make sure we start what we plan to continue.”