Q and A

Question

Will I get any symptoms if I do not take my med regularly?

What symptoms do I have if I do not take my medication on a regular basis?

Answer

Firstly can I ask the reasons to why you are having problems taking your meds?

If it is due to side effects, you could probably use other drugs. If it is due to other reasons, your clinic could support you with ideas to help adherence.

The answer will also depend on how often you are missing doses. Is this several times a week, or once a month. Does this happen on odd days or for many days in a row?

Your doctor needs to know how things really are. If you are missing more than 20% of doses (one in five) it may be better to stop treatment for a short time until you get the support for adherence to be better. This would be unusual, but some doctors might consider this to reduce your risk of resistance. Of tyhey might recommend switching to drugs wehre resistance is less likely.

Not taking meds regularly can lead to drug resistance. This would stop the meds from working and stop you using similar drugs in the future. Second-line treatments involve more people, more doses and in some countries are difficult to get because they are much more expensive.  If you have no active drugs because of drug resistance, the HIV would progress and your CD4 count would eventually drop so you become ill.

Sometimes people do forget to take their medication, as long as it does not happen on a regular basis then it is ok.  There is usually a window period of about 1 or 2 hour that is still okay and all combination drugs are flexible enough to allow this widow period. The odd occasion of missing or being late with a dose (say once a month) may not make very much difference but do make sure it does not become too regular.

‘Adherence’ is taking your medication every time, on time and to follow any diet restriction (for example with or without food).

Take a look at this link for information on adherence.

HIV medication works by stopping the virus from reproducing but the drugs needs to stay at good levels to work.  If the levels of the medication drops below the minimal level then the treatment can stop working and you can develop resistance.  If this were to happen then you would need to change your drugs.  This means that you cannot take the same class of drugs which you are taking presently.  You would need to use a different class of drugs and this will limit you to a fewer class of drugs that are available.

Resistance also cause your CD4 to go down and your viral load to go up.  You do not develop symptoms at this stage but you are much more prone to other opportunistic illnesses (OIs) due to low CD4 count.

Take a look at this link for information on drug resistance.

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