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FAQ's
Literacy
Everyone who tests positive for HIV, should be initiated on treatment as soon as possible regardless of CD4 Count.
Yes, ART does have side effects. And they vary depending on which regimen you are on. They range from mirror to severe. The current first line regimen TLD i.e. Tenofovir, Lamivudine and Dolutegravir have been proven to have less severe side effects, but some people can experience nausea, vomiting, dizziness and headaches. These do clear after a few days. One common side effect that tends to last longer with this regimen is insomnia, which can be resolved by taking your treatment in the morning. There are also cases of weight gain with this regimen.
You must make sure that your take your treatment at the same time daily in order to maintain your drug levels and prevent the virus from becoming detectable. If you forget to take them at the right time, do take them as soon as possible. Try not to make it a habit, and don’t skip does.
Your viral load will rebound quickly (maybe within a week). Your CD4 is likely to drop, though this takes a little longer to change. The viral rebound will usually be to the level your viral load was at before you started HIV treatment.
Yes, it is safe to switch from TLE to TLD. Many countries are starting to adopt TLD as first line as it is better tolerated than with fewer side effects. Talk to your healthcare provider bout this.
One of the side effects that people experience with TLD is insomnia, switching the time of your medication will not be a problem. It is important that you find a time that works best for you.
No, you need a valid prescription in order to be able to buy ARVs, a registered medical practitioner with training in treating HIV, can give you a prescription that is valid and renewable every six months.
The main difference between generics and brand-name drugs is just the cost. Generic drugs cost much less than brand-name counterparts. The active ingredients for the generic and brand versions are both the same. Generic drugs might be a different shape, size or colour but they have the same active ingredients. They are just as effective and also have the same risk of side effects.
TB & HIV
Everyone starting ART will be tested for TB. Your doctor will advise you sputum, X-ray chest and other investigations for the diagnosis, as per their suspicion.
TB preventive therapy is done with a drug called isoniazid (INH), taken once a day for 6 months. You will also be given pyridoxine (vitamin B6) to help prevent peripheral neuropathy (nerve damage). TPT and ART will help to stop you getting TB.
Coughing of any duration in HIV positive person, Coughing up blood, Evening rise of Fever, Weight loss, Night Sweats.
If you have these symptoms, then immediately consult your doctor.
If you test positive for active TB and it is drug sensitive* you will start treatment with a combination of four anti-TB drugs: rifampicin, isoniazid, pyrazinamide and ethambutol.
Few ARTs have drug interaction with the TB Treatment. Your doctor will select and modify your treatment for better outcomes.
If you are on dolutegravir-based ART you will need a double dose of dolutegravir to overcome the interaction with rifampicin. If you are on TLD FDC, you will need to add a dolutegravir 50mg dose 12 hours after taking TLD. So if you take your TLD in the morning, you will need to take your extra dolutegravir in the evening.
Yes you can take both ARVs and TB treatment. If newly diagnosed, you must be on TB treatment for two weeks before starting ARVs. An additional 50mg of Dolutegravir is added if you are on TB treatment and TLD.
Myths
No, ART is a combination of drugs which suppress the virus, it does not cure HIV. A person must take ART for the rest of their life as we don’t have an HIV cure yet.
It is not recommended because it is unknown which interactions “Ayurvedic/Homeopathy” has with ARVs, there might be a risk of the “Ayurvedic/Homeopathy” reducing your drug levels and this can lead to resistance. It is better to take only medicines prescribed to you at the health facility.
There is no such thing as an Immune Booster. Even though companies might claim this in advertising, they just want your money. None of these products have any evidence that they boost your immune system. There is no evidence they help for HIV or any other illness. If your viral load is still high and detectable after a year, you are likely to have drug resistance. Using new HIV drugs is the only thing that will help.
The only thing that can help a person improve their CD4 count is ARVs. If you’re on meds, you’re already doing the best thing possible.
The only way to increase your CD4 is to use HIV treatment (ART). Nothing else, including multi vitamins, supplements or herbal remedies can increase your CD4 count.
Pregnancy and HIV
As with everything to do with your pregnancy, please ask your doctor or clinic about everything. Many vitamins of supplements especially those that you get from your healthcare provider will be fine. Some, like folic acid, are recommended.
It is advisable for pregnant women to be on ARVs in order to protect the baby from getting infected.
Yes, it is safe and recommended for all mothers to breastfeed regardless of their HIV status.
Yes you can! you need to get a proper advise from expert/doctor.
ART protects your baby from HIV during pregnancy, birth and breastfeeding. Talk to your doctor about it.
Absolutely yes. There a few extra things for women to consider when starting or taking ART.
There is a slightly higher rate of neural tube defects than normal in babies whose mothers become pregnant on dolutegravir.
But starting dolutegravir after six weeks or more of pregnancy does not have this risk.
The neural tube in a developing baby is what becomes the brain, spinal cord, skull and spine.
The neural tube closes in the first 28 days of pregnancy – that is before most women know they are pregnant.
If it does not fully close for some reason, the baby is said to have a neural tube defect.
Neural tube defects vary, from very minor ones that are easily fixed, to ones that give severe disability and even death.
So, the risk is taken very seriously by the department of health, health workers and patients.
If you are already pregnant and taking dolutegravir-based ART, you will be recommended to continue on it.
If you are concerned about it, then please contact your doctor and discuss about it.
If you do not wish to become pregnant, and you are using effective contraception, you will be recommended the dolutegravir-based combination. Effective contraception means a modern method: condoms, oral contraceptives, injectable, implant and IUCD.
Your own health and your own HIV treatment are the most important things to consider for ensuring a healthy baby.
PrEP (Pre Exposure Prophylaxis)
PrEP stands for Pre-exposure prophylaxis. It is a combination of two ARVs, used to protect HIV negative people from HIV.
When taken every day, PrEP, stops HIV from being able to multiply and take hold within the body.
It is advisable that, as long as a person is at risk of acquiring HIV, one should take PrEP
PEP (Post Exposure Prophylaxis)
PEP stands for post-exposure prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. PEP means taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV to prevent HIV infection.
PEP should be used only in emergency situations.
PEP may be prescribed for people who are HIV negative or do not know their HIV status, and who in the last 72 hours:
May have been exposed to HIV during sex Shared needles or other equipment (works) to inject drugs Were sexually assaulted May have been exposed to HIV at work If you think you were recently exposed to HIV, talk to your health care provider or an emergency room doctor about PEP right away.
PEP is effective in preventing HIV infection when it is taken correctly, but it is not 100% effective. The sooner PEP is started after a possible HIV exposure, the better. Every hour counts.
The HIV medicines used for PEP may cause side effects in some people. The side effects can be treated and are not life threatening. If you are taking PEP, talk to your health care provider if you have any side effect that bothers you