If you have tested positive for HIV, you will be advised to undergo treatment immediately. There is currently no cure for HIV, so the treatment works to manage the virus.

The purpose of HIV treatment is to create an undetectable viral load. This means that the level of HIV in your blood is so low, it will be undetectable when tests are carried out. This generally runs at below 20 copies/ml, although this can vary by clinic.

How HIV treatment works

Even though you would still have HIV, when you have an undetectable viral load and remain on effective treatment, it would not be possible to pass the virus on or for HIV to cause any damage to your immune system.

There will be several treatment options that your health care provider will look to explore. Finding the right drug combination can take some time, and you may have to switch treatments if the medications you are taking are not effective or have too many side effects.

When you should start HIV treatment

Starting HIV treatment as soon as possible is important, and arrangements will be put in place as soon as you are diagnosed. Your doctor will refer you for treatment to a specialist team who will inform you of the next steps that will need to be taken.

Without taking HIV treatment, the virus will attack and weaken your immune system. By weakening your natural defence against infections, it makes you more susceptible to infections your body would usually be able to fight off.

Starting your treatment later puts you at far greater risk. Figures have shown that when your CD4 count (this measures your immune system strength) is above 500, you cut the risk of serious illness or death by over 50%.

• Benefits of starting your HIV treatment as early as possible include;
• Reducing or removing the risk that you could transmit the virus to partners.
• Reduction of illness caused by HIV
• Treatment will stop HIV from reproducing in your body
• It will strengthen your immune system

What are antiretroviral drugs?

The medicine used by doctors to treat HIV is called antiretroviral therapy (ART). Antiretroviral therapy (ART) is a treatment that suppresses a retrovirus such as the human immunodeficiency virus (HIV) that can cause AIDS if left untreated.

Regularly taking your anti-HIV drugs when scheduled is important in tackling resistance. If your strain develops resistance, it can impact similar drugs and mean you need to take a more complicated combination of drugs that may have side effects.

HIV Medications

HIV medications are designed to control the growth of the virus, improve your immune system, slow or stop the symptoms and prevent the transmission of HIV to others. Some commonly used HIV medications include;

• Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs) - These make the HIV use faulty building blocks meaning infected cells can't produce more HIV.
• Protease Inhibitors (PIs) - PIs block the protein needed for infected cells to create new HIV particles.
• Integrase Inhibitors - Also known as integrase strand transfer inhibitors (INSTIs), prohibit HIV from infecting healthy DNA by blocking a key protein.
• Fusion Inhibitors - Fusion Inhibitors block HIV from getting into healthy cells.
• gp120 Attachment Inhibitor - This is a new drug used by patients that are resistant to other medications. It stops the virus from attaching to CD$ T-cells by targetting the glycoprotein 120.
• CCR5 Antagonist - This blocks a hook on certain HIV cells, stopping them from getting into healthy cells.
• Post-Attachment Inhibitor or Monoclonal Antibody - Another drug used by patients showing resistance to other medications. This stops HIV cells from spreading the virus to healthy cells.

Side effects of HIV Treatments

It is not guaranteed that you will suffer from side effects from your HIV treatment. Depending on the side effects that you suffer, one course of action could be to change treatments. Here are some of the side effects you could experience from HIV treatment;

• Headaches
• Tiredness
• Rashes
• Nausea
• Vomiting
• Diarrhoea

While changing treatments is an option, it would not normally be necessary as side effects caused by anti-HIV drugs are usually mild and go away in time. You must inform your doctor if any side effects persist or cause you considerable discomfort.

Generic HIV treatments

When a pharmaceutical company develops a new drug, it will be under a patent that can last up to 20 years. Only this pharmaceutical company will be able to produce this drug during this time. At the end of that 20-year term, other drug companies can make their own versions of the medication.

As effective HIV treatments in the UK have been on the market for over 20 years, many of these drugs are coming off patent, meaning different versions are available. These are known as 'generic'.

Because of this, the NHS can purchase the same high-quality HIV drugs for a much lower price. This cost-cutting tactic frees up money for other treatments.

Though a generic drug may look slightly different in shape or colour, it will be the same drug. Much like paracetamol is available on the high street by different brands, generic HIV drugs work the same way.

Your health care provider will be able to explain any changes to generic HIV treatments fully. Small differences like the amount of medication you take can change, but this should not change how it works.

HIV treatment resistance

Resistance to your anti-HIV medication can happen. If it does, you may need to change treatments. Your health care provider will monitor the effectiveness of your medication and advise you of any changes that need to be made.

A change of medication may be necessary if;

• Your viral load does not stay low
• Your virus is resistant
• You struggle to manage the side effects
• The schedule your drugs need to be taken does not suit
• You are on other medication that does not interact with your anti-HIV medication

HIV cells can mutate, normally these differences would not make a difference, but sometimes they can develop a resistance to the medication you are taking.

This can occur when you do not adhere to your HIV treatment timetable. This allows the virus to develop drug resistance and mutate. Nucleoside reverse transcriptase inhibitors NNRTIs and nucleoside reverse transcriptase inhibitors NRTIs are used to stop the virus from making copies of itself and replicating.

The strain you contracted may already have resistance against some anti-HIV drugs, so there may be a period of testing what works when you first start your treatment.

According to the BHIVA (British HIV Association), you should be tested for resistance when you are initially diagnosed, when you are ready to start your treatment, or if you are going to change treatment.

Developments on HIV treatments are regularly being made, and there are many anti-HIV drugs now on the market that can treat strains of the virus that are resistant to other drugs.

Clinical trials

During clinical trials, new drugs or treatments are tested on patients and assessed. The aim is to discover whether a proposed treatment is;

• Safe to use
• Free from side effects
• More effective than existing HIV treatments

Clinical trials can take place in many settings depending on who is developing the drug, including;

• NHS hospitals or clinics
• Universities
• Research institutes
• Social care services
• Private sector drug companies

Trials need to be reviewed by the MHRA (Medicines and Healthcare products Regulatory Agency) and local ethics committees.

Pros for joining a clinical trial

Some of the main reasons someone might want to take part in a clinical trial include;

• Access to new drugs and treatments that may prove more effective than current options
• Regular monitoring and advanced testing opportunities
• To benefit future treatments of HIV and help other people with the virus
• Incentives such as being paid can occur, although it is not common.

Cons for joining a clinical trial

There may be some reasons you shouldn't take part in a clinical trial, such as;

• Outcomes and effectiveness are unproven and unknown
• You may already be on a treatment that is having good results
• Sometimes a placebo is used as a control
• It can be time-consuming and involve many hospital trips and appointments
• The treatment timetable may be unmanageable
• There is a risk of unpredictable side effects

Is HIV Curable?

HIV is not curable, but the virus can be managed if caught in time. Ensuring you are tested if you recognise any of the symptoms and adhering to your treatment plan will mean you will have the best chance of avoiding complications such as HIV infection developing into AIDs.

You can either visit your doctor to get tested or perform an at-home test - the results will be available to you within 2-5 working days.

People living with HIV can now expect to live a long, healthy life by taking their HIV medicines.

FAQs

What are the symptoms of HIV?

Understanding the symptoms of HIV can help an early diagnosis. HIV (human immunodeficiency virus) symptoms would come in three different stages.

Stage 1: Acute HIV Infection

• Symptoms
• Fever
• Chills
• Rash
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Mouth ulcers

Stage 2: Clinical Latency

Though this stage can be symptomless, HIV will still be present in your system. You will have to manage the virus with regular treatment, or it can develop to stage 3.

Stage 3: HIV/AIDS

If treatment for HIV is not administered, you will eventually progress to AIDS (acquired immunodeficiency syndrome) when your bodies immune system has been sufficiently weakened. The symptoms of HIV AIDS include;

• Rapid unexplained weight loss
• Regular fever or night sweats
• Extreme tiredness and fatigue
• Swelling of the lymph glands in the armpits, groin, or neck
• Continuous diarrhoea that can last for more than a week
• Sores around the mouth, anus, or genitals
• Pneumonia
• Skin lesions that are red, brown, pink, or purplish. They can also appear inside the mouth, nose, or eyelids.
• Neurologic disorders such as memory loss or depression

How do I get an HIV test?

If you recognise any of the symptoms of HIV or have recently had unprotected sex, it is worth ordering an at-home STI testing kit for HIV and other STIs. You can also take a HIV test discreetly in the comfort of your own home with iPlaySafe. Order through our website and you'll receive your kit within 2-5 working days.

If you want to take a HIV test in-person, HIV testing locations include:

• Sexual health clinics
• Genitourinary medicine (GUM) clinics
• Clinics run by charities
• GP surgeries
• Contraception and young people's clinics
• Drug dependency services.
• Antenatal clinics

Taking an HIV test will always be nerve-wracking and worrying for anyone, but you mustn't delay testing. Treatment for HIV and AIDS has a much better success rate when people start their treatment during the early stages of HIV.