Disease Information > Treatment of HIV

HIV TREATMENT


HIV is a retrovirus, thus the treatment available to control it is called antiretroviral or ARV in short. ARVs are taken in combination to lower the level of HIV in the body. This allows the immune system to partially recover and prevent further damage to the body.

 

ARVs are not a cure for HIV and AIDS. They help to treat HIV so you may live a longer and healthier life. The drugs attack the virus, interfering with the way the virus tries to reproduce itself inside the human cells. The treatment is lifelong.

 

As HIV progresses and the immune system becomes weaker, you may develop opportunistic infections. There is treatment available to prevent some of these infections. ARVs help your body to fight off and prevent opportunistic infections such as pneumonia, tuberculosis (TB) and diarrhoea.

 

What antiretroviral medication will I need to take?

  • There are many different ARVs, but none work well on their own.
  • They work well in a combination (usually three ARVs taken together).
  • The combination you are given will control the amount of HIV in your body and prevent it from increasing.
  • New information about HIV is continuously becoming available and new medication is being developed by scientists.

 

Why do ARVs have different names?
ARVs are sometimes called by their generic name, their labelled name (this is the name appearing on the box) or by their abbreviated name.

 

How will I know if ARVs are working for me?
Healthcare workers will conduct the following tests to check whether the ARVs are effective:

 

  • CD4 count

This test checks the number of CD4 cells. If ARVs are working, the number of CD4 cells you have will increase. This is a sign that your immune system is getting stronger. If your CD4 count was very low (<50), it may not increase very much in the beginning, but you will feel better.

 

  • Viral load test
This measures the amount of HIV in your blood. It checks if it is going down until there is so little HIV in your blood that the test cannot find any virus. If ARVs are working well, this can happen in about 12 weeks. Remember: ARVs cannot cure or remove HIV completely from the body. If you stop taking the medication, the virus will start increasing in your blood.

 

  • An examination
A healthcare worker will examine you to check your weight and to look for any changes in your body and health.

 

If the ARVs are working:
1. You will feel better.
2. You will be stronger and have more energy.
3. Your immune system will be stronger.
4. The HIV in your body will stop multiplying and growing.
5. Your viral load will drop.
6. Your CD4 count will go up.
7. You won't get sick as often as before you started taking ARVs.
8. You will recover from diarrhoea, oral thrush, cough, etc.
9. If you lost weight before, you will start to gain weight.
10. If your appetite was poor before, it will improve.

 

Where can I obtain ARVs?
The public sector has specific ARV clinics. Your healthcare worker can assist you and direct you to these clinics. To be eligible, it must be established that you meet certain clinical, immunological and social criteria.

 

You may also call the AIDS helpline on 0800 012 0322.

 

What happens at my visits to the clinic?
First visit

  • The doctor will confirm your CD4 count and make sure you are tested for TB and pregnancy.
  • Opportunistic infections will be treated.
  • You will meet all healthcare workers involved in your care.
  • The counsellor will discuss your treatment.
  • You will receive a four-week supply of Co-trimoxazole.
  • A follow-up date will be given.

 

The treatment counsellor will visit you at home to:

  • check your home circumstances
  • verify your contact details
  • check your support structures such as your family/partner
  • check your drug storage facilities.

 

Second visit

  • clinical assessment
  • information and treatment education session
  • pill count (Co-trimoxazole) to check your adherence
  • adherence counselling
       
Subsequent visit
  • your readiness to start ARVs will be assessed.
  • Co-trimoxazole pill count
  • detailed description of ARV drugs
  • further discussion of treatment information and adherence issues with your counsellor
  • dosage details will be explained to you.

 

What treatment do I need?
Guidelines have been developed in South Africa to help doctors, nurses and healthcare workers in treating patients with HIV. There are different HIV drugs and the guidelines outlines what combinations of ARVs are recommended to start with.

 

There are two combinations in South African healthcare facilities:

  • First-line therapy:Stavudine (d4T) + Lamivudine (3TC) + Nevirapine (NVP) or Efavirenz If you develop side effects or if your medication is no longer working, your doctor will change your medication.
  • Second-line therapy: Zidovudine (AZT) + Didanosine (ddI) + combination of Lopinavir and Ritonavir

 

How will I take my ARVs?
Once you start taking ARVs you may not stop - it is a lifetime commitment. If you take the medication as prescribed, at the right time, it should stop the virus from spreading. This is called adherence and can be very difficult.

 

Your legal and human rights
You have a right to healthcare and medical treatment. The South African Constitution gives every person the right to access healthcare services, sufficient food and water, and emergency medical treatment
(Section 27).

 

According to the Health Professions Council of South Africa (HPCSA) guidelines, no healthcare worker can:

  • refuse to treat someone because they have HIV
  • treat HIV-positive people differently to other patients

 

An HIV-positive person who is refused treatment by a public hospital or clinic can report this to the South African National Department of Health or the Public Prosecutor, or take their case to the High Court.

 

Reference
METROPOLITAN FOUNDATION. 2009. B the Future cellbook. South Africa.