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.
Dear Naomi, Modern HIV treatment (ART) is safe and effective. It’s also easier to take than some early HIV meds. If you are well and without other infections you have time to think about starting. Can you talk to the doctor and discuss which ARVs will suit you best? But studies show that it’s a good idea to start ART sooner rather than later. Many people on ART can have a life expectancy similar to being HIV negative.
I was diagnosed with HIV this year, do I av to start arvs immediately? Will they affect me after taking for long?
Hi Anonymous,
Even if you’re feeling well, if you want to control your HIV, you’ll need to be on meds. For what will happen if you don’t please see Q7 here:
http://i-base.info/qa/what-are-the-most-asked-questions
If the side effects with your previous meds were bad, you could ask to try something else.
I’m a 20 year old lady and was diagnosed with HIV when I was 18. I stop taking ARVs because of the side effects. And after I stopped takin them I feel fine and I don’t feel like I’m loosing my mind anymore. Does this mean that the treatment was not treating me or what? And I’m scared of going back to the treatment again because of the long term side effects
Hi Justus,
If you take ARVs on an irregular basis you could become resistant to your meds. Your CD4 count could also drop, and your viral load will increase. If you want to control your HIV, you need to take your meds as prescribed.
What Hapens When I Take Arv’s On An Irregular Basis?
Hi Thobeka,
What ARVs are you taking? Have you discussed this with your doctor?
Beginning of the year I was diagnosed I since started taking my Arv and I also have high blood pressure, my memory is not so good now. I’m kind of worried because I am going back to school next year?
Hi Benge,
The ARVs won’t be causing him to think he’s bewitched. If he is having mental health problems he’ll need to see a doctor about this. If he isn’t using ARVs his health is at risk.
My brother is on ARV for 5years now.Recently he has been using traditional medication and i doubt that he is taking his ARV.He now has this exaggerated thoughts of being bewitched. I wanted to find out if the ARV can cause mental dysfunction. He is 53yrs. Thank you