Introduction to ART
This guide includes information about the most important aspects of HIV antiretroviral treatment (ART).
It is written and reviewed by HIV positive people and it uses everyday language to explain medical terms. October 2019.
Introduction
First questions: what, when, why?
- What is ART and what are ARVs?
- Does ART really work?
- Does everyone need ART?
- How soon do I need to start?
- What about side effects?
- CD4 and viral load: two essential blood tests
- Your CD4 count and the risk of becoming ill
- How does ART work?
- How long will ART work for?
- Can I change drugs?
- Can I stop ART?
- What if I have been doing well without ART?
- What if I am a slow progressor?
- Does ART always work?
- Finding out you are positive
- Review your ART every year
- Should I enter a study?
- What about alcohol and recreational drugs?
- What about a cure?
Age, heart disease, gender and pregnancy
- How do children use HIV treatment?
- Is age an important factor in adults?
- Age, HIV drugs and heart disease
- What about treatment in pregnancy?
- Does gender affect ART?
- Trans* people and HIV treatment
Deciding when to start treatment
- Is starting easy?
- How soon do I need to start?
- Early diagnosis and primary infection
- Late diagnosis and low CD4s
- Average CD4 count increases on ART – based on count when you start
U=U and Treatment as Prevention (TasP)
Side effects
- What is the risk of side effects?
- Common side effects
- Metabolic changes: how your body processes fat and sugar
- Other side effects
You and your doctor: your rights as a patient and things you can do to help
Adherence
Drug resistance
- What is resistance?
- How do I avoid resistance?
- How a missed or late dose increases the risk of resistance
Which drugs, which combination?
- Main types of HIV drugs
- What is the best combination?
- HIV life cycle – how drugs work in different ways
- First combination meds
- The two nukes
- Choice of integrase inhibitor
- Alternative third drugs
- Boosted PIs (PI/b): darunavir or atazanavir
- NNRTIs: rilpivirine and efavirenz
- Non-standard combinations: dolutegravir/rilpivirine (Juluca)
- Other meds that are sometimes used
- Future drugs
- Antiretroviral drugs: illustrated pill chart
Generic HIV drugs and HIV care in the UK
Continued use of efavirenz
Your personal treatment history
Glossary
Further information
Tables and diagrams
References
PDFs and downloads
Feedback
Quotes
Credits
Written and compiled by Simon Collins for HIV i-Base with thanks to an extended advisory group of HIV positive people and community advocates for comments. Additional thanks to Dr Laura Waters, Dr Tristan Barber and to Neal Marshall at the HIV Pharmacist Group for medical review and comments. Thanks also to Hosanna, Lenny, Matt, Memory, Mike, Nathan, Paul, Polly, Simon, Vladimir, Winnie and Xavi for permission to include quotes from their experience. Design by No Days Off. Funding thanks to The Monument Trust. Not-for-profit copying is encouraged or call for additional free copies.
About our guides
Information about how we produced this guide and the importance of using language that is direct and easy to understand. This includes information on how to write non technical medical information that may be useful as a resource for other organisations.
Last updated: 1 October 2019.
