Is there a cure for HIV?
There is no cure for HIV. There has been, and continues to be, lots of research into possible cures. But treatment with anti-HIV drugs means that many people with HIV are living long and healthy lives.
How is HIV treated?
Treatment for HIV involves taking a combination of anti-HIV drugs. HIV treatment works better if people start treatment before they become ill because of HIV.
This treatment has a very powerful anti-HIV effect and stops the virus from reproducing. This allows the immune system to strengthen and to fight infections effectively.
The goal of HIV treatment is an undetectable viral load. This means that no HIV can be found in your blood by a viral load test.
What does HIV treatment involve?
HIV treatment involves taking anti-HIV drugs every day. These cannot cure HIV. However, they can stop HIV from reproducing. This allows the immune system to stay strong.
There are now more than 20 of these drugs, although they are not all available everywhere in the world. HIV is normally treated with a combination of three different drugs. Most HIV treatment combinations are taken once or twice daily. This treatment has a very powerful anti-HIV effect. Thanks to HIV treatment, many people with the virus can hope to live a long and healthy life.
You should aim to take all the doses of your treatment, following the instructions of your HIV doctor. This is often called ‘adherence’.
Missing just a few doses a month can mean that your treatment doesn’t work properly, and your HIV may become resistant to the drugs that you are taking.
Anti-HIV drugs can interact with other some other prescribed drugs, medications you would buy from a pharmacy, herbal remedies, and illegal or ‘recreational’ drugs. To reduce the risk of interactions, it’s important to tell your HIV doctor or pharmacist about any other medicines and drugs you are taking.
You’ll be monitored regularly to see if your treatment is working. If you do encounter a problem with your treatment, it should be possible to do something about it.
Where do I go for treatment and care?
In the UK, nearly all HIV treatment and care is provided by specialist hospital clinics. These are provided by the National Health Service (NHS).
If you are entitled to free NHS care, then all the treatment and care provided by these clinics will be free. You can choose where you receive your HIV care – you don’t have to go to your nearest hospital.
Clinics will usually provide a range of services. You may see other healthcare workers, such as nurses, dietitians or pharmacists, as part of your HIV care.
Even though you receive your HIV care from a specialist HIV clinic, it is still important to have a general practitioner (GP) or family doctor for health needs that aren’t related to HIV.
Telling your GP that you are HIV-positive will help them have a full picture of your health to ensure you get the best possible care.
Many GPs also offer services which may not be available at your HIV clinic, but which you may need from time to time, such as health visiting for women who have recently had a baby; support if you need nursing at home; counselling; physiotherapy; and chiropody.
In other parts of the world, medical care for HIV happens in a wide range of hospital and other medical settings. In many parts of the world, most of the care given to people with HIV happens at home. It is provided by family and friends, perhaps with some help from an organisation that provides home-based care.
When will I need to start taking my HIV treatment?
There is no definite ‘right’ time to start HIV treatment.
There are different views on the benefits of starting treatment earlier and later. Guidelines on when people should start HIV treatment vary in different countries.
You will need to talk to your healthcare team and weigh up the benefits and risks of starting treatment. HIV treatment is lifelong and starting treatment is a big commitment. If you feel comfortable about starting treatment and understand what is involved, you may be more likely to be able to take your treatment properly.
However, it is recommended that you should start taking HIV treatment if you are ill because of HIV.
Where it’s available, testing for the strength of your immune system (called a CD4 count ) should help determine whether you need to start treatment. It’s recommended that people whose CD4 cell count is around 350 should start taking HIV treatment.
Starting treatment at this time reduces your risk of becoming ill because of HIV, and also reduces the risk of heart, liver and kidney disease as well as some cancers.
For this reason, patients with risk factors for these illnesses are especially encouraged to start treatment when their CD4 cell count is around 350.
How do I get the treatment and care that I need?
If you don’t understand anything, or if you want to know more about any subject, ask your doctor! Or there may be another member of your healthcare team who can help with a particular issue.
You should feel able to ask questions or tell your doctor, or another healthcare worker, about things that are bothering you. This will be important in staying as well as possible and increasing the chances of any treatment being successful.
Does HIV treatment have side-effects?
All medicines can cause side-effects, and this includes those used to treat HIV. But it’s good to know that many people find modern HIV treatment easy to take.
Anti-HIV drugs can cause both short-term and long-term side-effects.
Common side-effects you might have when you first start a treatment are diarrhoea, feeling or being sick, and headache. Some drugs can also cause problems sleeping, including vivid dreams, a feeling of being ‘spaced out’ or depression.
Most people find that these side-effects lessen or go away completely after a couple of weeks.
A few anti-HIV drugs can cause an allergic reaction. You should be screened for risk factors before taking any of these drugs, and then warned about possible symptoms. If you do then have any of those symptoms, you should seek medical advice immediately.
Longer-term side-effects can involve increased levels in blood fats and sugars, changes in kidney or liver function, or thinning of the bones. You’ll be monitored to see if you develop any of these side-effects.
It’s worth remembering that you don’t always have to put up with side-effects. Mention them to a member of your healthcare team as it may be possible to do something about them.
What happens if I am not a UK national?
Most NHS treatment is not automatically free of charge to people from other countries. The rules about who is entitled to free HIV care are complicated and sometimes change.
However, certain NHS treatment is free to everyone. This includes testing and counselling for HIV or sexually transmitted infections at a sexual health clinic, but does not include any further treatment for HIV. It also includes treatment for tuberculosis (TB).
Urgent and immediately necessary treatment is always free. This includes post-exposure prophylaxis (PEP).
Some people who are not UK nationals can get free treatment. These are:
- people who have been lawfully living in the UK for the previous twelve months
- anyone in legal employment in the UK
- anyone taking up permanent residence in the UK (although those applying for permanent residence will be charged until this is granted)
- refugees and asylum seekers
- prisoners and immigration detainees
- full-time students
- people whose home countries have a reciprocal health agreement with the UK (NAM’s website has more information).
Nobody should be refused NHS treatment if they have a life-threatening condition. This means that people with HIV should be able to access NHS care, even if they are unable to pay for it. It is up to your doctor to decide if you can have free treatment.
It is important that your healthcare team knows what your real financial situation is. Hospitals can write off the costs of treatment if it is clear that a person cannot pay.
Anyone living with HIV who is having difficulty getting free HIV treatment should seek advice and support from local or national HIV support organisations or from your healthcare team.
What regular health monitoring might I have?
To make sure you receive the best treatment and care it is very important that you go to your HIV clinic for regular check-ups.
There are a number of types of tests that you might have. The most common are:
- Physical examinations – your doctor will look at your body and examine it to look for any unusual signs or symptoms.
- Blood tests – samples of blood will be taken and these will be examined in a laboratory. These tests are used to assess how HIV is affecting you, how well any treatment is working and to check your general health. Often your doctor will order several different blood tests. It may look like you’re having a lot of blood taken, but only about a teaspoon of blood is taken in each test tube.
- X-rays, scans, ultrasounds – if you have some specific symptoms, then you may need to have tests such as X-rays, scans or ultrasounds that allow your doctor to see inside your body.
- Small surgical procedures – very occasionally it may be necessary to remove a small sample of body tissue for examination in a laboratory. This is called a biopsy and it’s normal to have this done using a local anaesthetic.
If you are entitled to national health service (NHS)care, then all the treatment and care you receive from your NHS HIV clinic will be free.