What are the long term effects of HIV treatment?
I am scared about the long term effects of living with HIV and being on treatment. I am 22.
I’m not yet on treatment (CD4 701/CD4% 19/VL 3000). I understand ART can keep me well for a long time and side effects are milder than before.
However, I keep reading that the long-term effects of being on medication and HIV itself are still quite harmful for kidney function, cardiovascular function, bone density and cognitive function. Plus there is the issue with immune inflammation and reconstitution.
I just can’t help but feel hopeless about the future even if short-term I’ll be fine, knowing that I am at such higher risk of so many non-AIDS related problems.
Thank-you for your question.
You didn’t say when you were diagnosed but as you are still very young it is understandable that you think about your long term health.
Firstly, with current HIV drugs, your outlook is really good. Several studies report average life expectancy of another 50 years taking you well into your 70s.
Your high CD4 count also means you have time to learn about treatment and to decide which is the best treatment for you.
Current drugs have a low risk of side effects, and these are usually mild if they do occur. Many of the concerns you listed are more relating to HIV than to treatment. It might be that in reading about HIV you are picking the negative worries rather than the positive things – and that some of the articles you are reading are not up-todate.
The risk of problems related to kidney, liver and heart disease are higher from not being on ART. The risk of most HIV-related infections are much lower if someone is on ART. So is the risk of non-HIV complications.
Bone health is slightly more complicated. This is becasue ART does reduce bone density. But the reductions from ART are not likely to be clinically significant unless your bone densitiy is already very low.
As with most complications, routine monitoing should highlight any problems early on. You could then change treatment if this was needed.
The information in this previous question which is from someone worrying about the risk of cancer discusses similar long-term worries. See: I’m worrying about reports of higher risk of HIV and cancer…
Do you know anyone else who is positive? HIV is pretty rough to handle by yourself. Talking to other people – either online or at a support group – might help. Given how good your CD4 count is, you could also try doing things you really enjoy and not worry so much about HIV for a few weeks.
Although I believe that being informed is a great way to understand the impact HIV has on your life, sometimes we get questions from people who are reading so much that this is just causing them to worry.
Further information about healthy living and ageing with HIV can be found in our guide to HIV and your quality of life.
Here is a recent question from someone about life expectancy, but there are many more.
Please have a read through these links, and let me know if you have any questions.
This answer was updated in January 2016 from an original question on 22 August 2012.