Question
What are the long term effects of HIV treatment?
4 January 2016. Related: All topics, Living with HIV long-term, Side effects, Starting 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.
Answer
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.
Hi Lebo,
The time that you take your meds is up to you. Nausea can be a side effect. How long have you been on meds for? What are you taking? How are you taking them?
Will changing times have a negative impact? And why is one always having nausea when on treatment, is this normal?
Hi Emmanuel,
What is your sister taking? How long has she been taking ARVs for? Do you know what her CD4 count is? And her viral load? How much weight has she lost, and over what time frame.
If you can get back to me, I’ll be able to help you.
My sister is hiv positive and she was adviced to start taking the retrovital drugs.. But anytime she takes it she urinates frequently. At the moment she getting tinny, weak,lost of appetite and last nite was a serious stomach ache that almost killed her. Pls sir, are there other drugs she can take that help to help her situation. Pls help me! She is all i gat!!!
Hi,
Please see here for an answer to a similar question:
http://i-base.info/qa/9002
Is TRIBUSS & Odimune is the same tablet?I am taking TRIBUSS and today they gave me Odimune and told me its the same thing,2nd is’t possible to have side effects each time they change the tablets?am so worried bcz the 1st week of taking Tribuss I had itchy rash all over my body now they are giving me this Odimune am so stressed of having that itchy rash back again so plz help me with more info on what to expect this time as I am not happy with the change of TRIBUSS
As a general rule it is important to take treatment as close to the same time as possible everyday.
The extent to which this is the case varies depending what treatment you are on. With some it is really important to take it at the same time. With others half an hour either way probably won’t make much of a difference.
The risk of taking it at different times is that you will develop resistance to the meds. This means they won’t work effectively. it is important for it to continue working properly that you take your treatment everyday and as close to the same time as possible. This is called adherence.
You can find more information on adherence and resistance here:
http://i-base.info/guides/changing/how-do-missed-doses-lead-to-resistance
Just recently started the treatment and was told to take it at night. Just I need to take the pills at the same time everyday? Will changing times have a negative impact?
Hi Jonathan, thanks for your comment. I’m glad to hear you have had a good experience with treatment. Unfortunately there is very little research looking at whether viral replication in non-progressors is harmful or not. It’s therefore up to each individual in this situation, together with advice from their doctor, to decide what is best for them. I wish you the best of luck in the future!
I have been a long term non- progressor re HIV, I am now in my 50s.
I decided to go on meds with a CD4 of 720, It was not easy to make the decision but overalI I’m glad I did. Having any VL other than undetectable is going to be a constant strain on the body. I have now been on the meds for two years, Since starting taking them I have noticed a dramatic increase in energy levels. Hope this info helps.!!