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Initial antiretroviral therapy for HIV

Related Terms

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Background

  • There is debate among researchers and healthcare professionals over when anti-HIV medications (antiretrovirals) should be started in patients with the human immunodeficiency virus (HIV). Although these medications have been shown to effectively suppress the virus from replicating inside the body, they can also cause severe side effects, including liver damage and neuropathy (nerve damage). Therefore, when patients are diagnosed with HIV, they should discuss the risks and benefits of all treatment options with their healthcare providers.
  • Before beginning treatment, patients must be prepared to follow treatment plans. Some patients may need to take several different pills each day. If drugs are not taken exactly as prescribed on a regular basis, the patient may become resistant to the medication. When this happens, the medication does not effectively suppress the virus. Once a patient is resistant to a drug, the patient can no longer take the drug in the future because it is ineffective. As a result, the patient has fewer treatment options for HIV.
  • In general, most guidelines recommend that antiretroviral therapy (ART) is started when the patient's CD4 cell count is between 200-350 cells per microliter of blood. HIV primarily infects the CD4 cells, which are white blood cells that help coordinate the immune system's response to infections and diseases. Healthy individuals have a CD4 cell count between 600 and 1,200 cells per microliter of blood. The lower the CD4 count, the higher the risk of infection. Patients progress to AIDS (acquired immune deficiency syndrome) when their CD4 cell counts drops below 200 cells per microliter of blood. AIDS patients have the greatest risk of developing life-threatening infections because their immune systems are severely weakened.
  • The results of viral load tests are also taken into consideration. These tests measure the amount of viral particles inside the patient's blood. According to treatment guidelines in the United States, anyone who has a viral load higher than 100,000 copies per milliliter of blood should be offered treatment.
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When To Start Treatment

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Treatment Regimens

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Pregnancy

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Children

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Adhering To Treatment

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Integrative Therapies

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.