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HAART

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We will always hold out hope for a cure for HIV or at least an effective treatment that creates a long term remission of HIV production after treatment has stopped. Currently there is medicine that can control the production of HIV within the human body whilst you are taking it.

HIV treatment is considered to be most effective when it is started before your immune system has been severely damaged by the virus AND the treatment is taken properly with few side effects.

So….HIV can be treated quite effectively. The treatment may cause side effects (which are discussed on the side effects page of this section) and not everyone needs it.

 

What is the treatment for HIV?

The treatment for HIV is anti-HIV drugs (Highly Active Anti Retro-viral Therapy – HAART). It can reduce the amount of virus in your blood stream (viral load) so it becomes a safer amount (undetectable).

HIV spends all its time trying to reproduce itself (HIV lifecycle). HAART is usually a combination of three different types of anti-HIV drugs that attack HIV in different ways as it is trying to reproduce itself within our body.

 

How does HAART work?

There are 4 types of anti-HIV drugs and each one works at a specific point in the HIV lifecycle as it tries to infect cells within our body.

Stage 1:

HIV tries to attach itself to one of our CD4 cells (immune system cells/ white blood cells)

– Drugs that are called “ENTRY INHIBITORS” try to stop the entry of HIV into our CD4 cell

Stage 2:

Once inside our CD4 cells HIV changes its structure

– Drugs called “NUKES” and “NON-NUKES” try to stop this from happening by making the cell too unstable for HIV

Stage 3:

HIV buries itself deeper within our CD4 cell

– Drugs called “INTEGRASE INHIBITORS” try to stop this by preventing HIV from integrating itself into our CD4 cell

Stage 4:

HIV uses the now converted CD4 cell to create more HIV

– Drugs called “PROTEASE INHIBITORS” try to stop this from happening by making the cell too unstable for HIV to reproduce

Stage 5:

The newly created HIV leaves the now infected CD4 cell and looks for another CD4 cell to infect

– There are currently no drugs that can stop HIV from moving out from an infected CD4 cell

 

So basically the HAART will try to stop HIV from entering, messing about with, changing and copying itself within our immune system. This means that more of our immune system cells are free to fight off other infections such as cold and the flu, or attack HIV itself. The aim of the treatment is to have as little HIV in your body as possible.

When HAART is working well it is possible to have an undetectable HIV viral load and a normal CD4 count. If this can be maintained, you can consider yourself to have a long and healthy life ahead of you.

 

Why wouldn’t HAART work?

The main reason that HAART does not reduce your viral load to undetectable is that the medication is not taken correctly – as with all medications you must take them in the way they are meant to be taken or they might not work properly. This is particularly true of HAART.

HAART takes some time to build up to effective levels within your body. Once it is up to a good level each time you take the medication it will work for several hours. Every combination must be taken before the last tablet is out of your system to stop HIV from infecting your cells.

Sometimes you can build up a resistance – If you have taken breaks from your medication or have not taken it on time, then it is possible for HIV to adapt to the medication.

Just like every other virus, HIV changes and mutates. Once it has mutated the drug you are taking will no longer be effective and you will be prescribed a different combination of HAART.

You will have a blood test every three months to ensure that your medication is still effective.

 

How often will I have to take it?

It depends on which combination of HAART you are given. Some are taken once a day, some three times a day and some four times a day. Once a treatment has been started it is recommended to continue with the treatment for as long as it continues to work for you.

If it stops working for you then your consultant will recommend that you take a different combination of HAART.