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Published Sunday June 22, 2008
BRIDGETOWN, Barbados
By Body Health Resources Foundation
STEP 4: Learning About HIV Treatment
When is it Time to Start Taking HIV Medications?
Your HIV-positive test result *won't* tell you the answer. All it tells you
is that you've been infected with HIV. Some people can live many years with
HIV before they need to take medications to control it.
However, every person who tests HIV positive should immediately have two
additional tests: a CD4 count and a viral load test. These tests are the
critical measuring tools you and your doctor will use to see what the virus
is doing in (and to) your body.
The CD4 Count Test
This test, also known as a "T-cell count," gives an indication of the number
of CD4 cells in your bloodstream. The more CD4 cells you have, the stronger
your immune system is. After living with HIV for a while (if you don't take
medications), the number of CD4 cells you have will usually fall. This is a
sign that your immune system is being weakened. A normal CD4 count for
someone without HIV is usually between 500 and 1,600. Experts generally
agree that when your CD4 count goes below 200, you're at a high risk for
developing potentially dangerous illnesses, so you should begin taking HIV
medications *before* your CD4 count hits 200.
The Viral Load Test
Viral load tests provide an estimate of how much HIV is circulating in your
blood. Generally speaking, your viral load is *not* considered as critical
as your CD4 count in determining the health of your immune system. However,
once you begin HIV treatment, it is a good measure of how well your HIV
medications are working.
A viral load test measures the amount of HIV in a small amount (milliliter
or mL) of your blood. Current viral load tests can detect as few as 50
copies of HIV per milliliter of blood. When your viral load test indicates
that you have fewer than 50 copies/mL of HIV, your health care provider will
tell you that your viral load is "below the limit of detection," or
"undetectable. " This does *not* mean that you no longer have HIV in your
body. Even someone who has an "undetectable" viral load can transmit HIV to
someone else. However, an "undetectable" viral load means that your
medications are doing an excellent job of keeping HIV in check.
Do HIV Meds Work Differently in blacks?
Generally, whether a person is black or white, HIV meds appear to work the
same way. The real problem, experts say, may be that blacks are already at a
higher risk for some health problems that HIV meds can cause or worsen.
These Health Problems Include:
High blood pressure (also called hypertension)
High cholesterol
Anemia (a low blood count, which can make you feel tired)
Diabetes
Hepatitis C (which, over time, can cause liver damage)
Kidney disease
Dealing With HIV and Other Illnesses?
Be sure to stay on top of HIV as well as any other infections or illnesses.
If you are infected, for example, with HIV and hepatitis B or C, your
physician may refer you to a liver specialist who also specializes in HIV.
If you are seeing other health care providers, besides your HIV specialist,
be sure that they are all in contact.
STEP 5: Preparing to Start HIV Treatment
*Once your health care provider recommends that you begin treatment, it's
important to consider how treatment will change your life. Are you ready
mentally, as well as physically, to take medications every day? Remember:
Most HIV specialists say that you have to take your medications as
prescribed, at least 95 percent of the time, to keep HIV under control and
prevent it from becoming "resistant." HIV that is resistant can make your
medications less effective.
This means you have to be certain that taking your medications will become a
central part of your daily life. Be honest with your HIV specialist about
anything that may make it more difficult for you to take all of your
medications on time. If you have a case manager or a counselor, talk with
them about this important issue as well.
Without a doubt, the commitment to taking HIV medications will be
challenging. However, you have a good chance of keeping HIV under control
with the very first combination of medications that works for you. If this
combination successfully controls your HIV, and if you take each and every
pill prescribed, you may not have to change medications for a long time.
What if you aren't always able to take all your medications on time?
This may cause your first combination of medications to fail. If this
happens, it can get harder and harder to keep HIV under control with each
new drug combination.
So it's crucial to identify a combination you can stick to, *before* you
start treatment. Here are some things to consider:
Your Medication Schedule Shouldn't Be too Complex
One thing is certain: Taking medications daily will change your life.
Suddenly, you'll have new responsibilities. You'll always have to be aware
of the time, your schedule and changes in your routine. In some cases, you
may have to schedule taking your HIV medicine around meals or take it with
or without certain foods. You'll have to remember to take your pills with
you when you go on vacation, go away for the weekend or go out at night.
Even if you are depressed or busy, you will still have to take your
medications as prescribed every single day. So, before you begin HIV
treatment, you must ask yourself: "Am I really ready?
Plan How You Will Deal With Side Effects if They Occur.
All medications can have potential side effects -- even aspirin. Not
everyone experiences side effects from HIV medications, which can range from
mild to severe. Because you really want to give this first combination your
best shot, talk to your doctor and read about the possible side effects of
the medications you are thinking of taking. This can help you not only plan
how to manage side effects if they arise, but to choose medications whose
possible side effects you can manage.
Your Surroundings and Your Mental Health Are Critical
If you are feeling depressed, using recreational drugs or living on a
friend's couch, it may be unrealistic to assume you'll be able to take all
your medications all the time. It's also a good idea to get some support.
This way it will be easier for you to follow a strict treatment plan. It
helps a lot to have friends, family, a support group or a therapist you can
rely on while you are on a treatment regimen -- especially at the beginning
when you are still adjusting. |
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