This guide includes information about the most important aspects of HIV treatment. It is written and reviewed by HIV-positive people and it uses everyday language to explain medical terms.

Introduction

First questions

• What is combination therapy?
• Do the drugs really work?
• Does everyone need treatment?
• CD4 and viral load: two essential blood tests
• Your CD4 count and the risk of becoming ill
• How do the drugs work?
• How long will the drugs work?
• Can I take a break in my treatment?
• Does treatment always work?
• Can I change treatments?
• Should I enter a study?
• What about alcohol and recreational drugs?
• What is ‘treatment-naive’?
• What else do I need to know?
• Are the drugs a cure?

Age, heart disease, gender and pregnancy

• Is age an important factor in adults?
• Age, HIV drugs and heart disease
• Are recommendations the same for men and women?
• What about treatment in pregnancy?
• How do children use HIV treatment?

Deciding when to start treatment

• When should I start treatment?
• CD4 count and guidelines
• Early diagnosis and primary infection
• Using treatment at higher CD4 counts: the START trial
• Average CD4 increases by starting CD4 count
• Late diagnosis and low CD4s

Why are treatment guidelines different?

Treatment as Prevention (TasP)

Side effects

• What about side effects?
• The most common side effects
• Lipodystrophy and metabolic changes
• Other side effects

You and your doctor

Adherence

• Adherence and why it is so important
• Adherence tips
• What if I forget to take my pills?
• Adherence diary

Resistance

• What is resistance?
• How do I avoid resistance?
• A missed or late dose increases the risk of resistance

Which drugs, which combination?

• What is the best combination?
• Main types of HIV drugs
• HIV lifecycle – how drugs work in different ways
• First combination
• The two nukes…
• Choice of the third drug
• Efavirenz – an NNRTI
• Boosted PIs: atazanavir or darunavir
• Integrase inhibitors
• Alternative first-line options
• Non-standard approaches
• Other meds that are sometimes used
• Antiretroviral drugs: illustrated pill chart

HIV in the UK: NHS changes and new generic drugs

Your personal treatment history

Glossary

Further information

Tables and diagrams

References

PDF downloads

Feedback

Written and compiled by Simon Collins for HIV i-Base with thanks to an extended advisory group of HIV-positive people and community advocates.

Design by No Days Off. Funding thanks to The Monument Trust.

Not-for-profit copying is encouraged or call for additional free copies.

1 April 2013