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I am HIV positive. Do I need to start anti-HIV medications?
Even though you are HIV positive, you may not need to start treatment right away. When to start anti-HIV (also called antiretroviral) medications depends on:
• your overall health
• how well your immune system is working (CD4 count)
• the amount of virus in your blood (viral load)
You and your doctor will determine the best time to start treatment.
How will I know when to start anti-HIV medications?
It’s time to start treatment if:
• you have severe symptoms of HIV infection or are diagnosed with AIDS
• your CD4 count is below 500 cells/mm3 (especially below
350 cells/mm3)
• you are pregnant
• you have HIV-related kidney disease
• you are being treated for hepatitis B
Some research suggests that it may be helpful to start treatment early (when CD4 count is above 500 cells/mm3). You may want to discuss the risks and benefits of starting treatment early with your doctor.
If anti-HIV medications can help me stay healthy, why wait to start treatment?
If you and your doctor feel that you are committed to lifelong treatment and prepared to take medications exactly as directed, you may begin treatment at any time. However, if you feel you aren’t ready, you may decide to delay treatment. Delaying treatment will give you and your doctor time to work on a plan to handle issues that can affect treatment.
HIV treatment may affect your lifestyle. Some anti-HIV medications must be taken several times a day at specific times. When you start anti-HIV medications you may need to change what and when you eat. You may need to change the time you take other medications.
Taking your medications according to your doctor’s directions (treatment adherence) is very important. Skipping doses or easier for HIV to multiply. Your HIV can become resistant to the anti-HIV medications you take (drug resistance). Drug resistance may limit your treatment choices in the future. (See fact sheets on What Is Treatment Adherence? and Adhering to My HIV Treatment Regimen.)
What treatment is right for me?
The U.S. Department of Health and Human Services (HHS) provides guidelines on using anti-HIV medications to treat HIV infection. The HHS guidelines recommend starting treatment with a combination (called a regimen) of three anti-HIV medications from at least two different classes. (See fact sheet on Approved Medications to Treat HIV Infection.) This is called Highly Active Antiretroviral Therapy (HAART). The guidelines list recommended HAART regimens. However, the recommended regimens may not be exactly right for everyone. You and your doctor will need to consider your individual needs when choosing a regimen. Factors to consider in selecting a treatment regimen include:
• your drug resistance testing results
• results of other laboratory tests
• how many pills you will need to take and how often you will need to take them
• if you will need to take pills with food or on an empty stomach
• how medications in your regimen affect one another
• other medications you take
• other diseases or conditions you may have
• if you are pregnant or expect to become pregnant soon