Current treatments available for the human immunodeficiency virus (HIV) are very effective, allowing people with the virus to live long and relatively healthy lives. However, sometimes your specific treatment can start to fail, which can raise your viral load and trigger symptoms. It’s important to know the signs of treatment failure and what you can do to help prevent it.
Routine Blood Testing for Effective HIV Treatment
The answers you need to keep your HIV treatment on track come from the results of a blood test that measures your viral load. Your treatment regimen is considered effective if it’s able to control HIV to the point that the virus is virtually undetectable in your body. The virus is still present, but the viral load level is low enough that HIV is considered controlled.
When an HIV treatment regimen fails, the virus begins to multiply and mutate, or change, which can lead to disease progression and eventually AIDS.
For this reason, routine blood testing is extremely important. Symptoms that indicate HIV treatment failure don’t show up until several months after a treatment stops working, says Laura Guderian, MD, primary care physician at One Medical Group in New York City. But your doctor can determine if your regimen is working much sooner using blood tests to monitor your viral load and CD4 count, two important measurements that indicate whether your medication is doing its job.
Viral load is the best indicator of how effective your treatment is, says Dr. Guderian. “An increase in viral load level is the first sign of possible treatment failure.” The higher the viral load level, the more active the virus is in your system.
CD4 cells are the cells in your body that help fight infection. HIV destroys these cells when it attacks your immune system. A goal of antiretroviral therapy as treatment for HIV is to keep your immune system healthy. A low CD4 count alerts your doctor that your medication isn’t working as it should.
Reasons for HIV Treatment Failure
There are a number of possible causes of HIV treatment failure. Skipping medications or not following your regimen as directed can be to blame, so be sure to stick to your treatment plan faithfully.
But some causes of HIV treatment failure may be out of your control. HIV medications may interact with other medications or supplements, making them less effective. Unmanageable side effects from HIV medications can cause treatment interference. In some instances, people don’t get the full dose of medication because their bodies aren’t able to absorb the HIV medication properly.
HIV Drug Resistance
It’s also possible that your type of HIV has developed a resistance to one or more of the HIV drugs in your regimen. This is called drug resistance, and it occurs when the virus mutates in your body and the new form of the virus doesn’t respond to the medication anymore.
“These virus mutations are archived over time, making them a permanent part of the HIV circulating in your body,” says Guderian. “Once the drug-resistant virus develops, it’s always there. This is an irreversible process, making that drug — or sometimes even entire classes of HIV drugs — no longer effective at any point in the future,” she says. However, there’s a wide range of treatment options available when it comes to antiretroviral therapies for HIV, so if this occurs, your doctor should be able to formulate an effective new treatment regimen for you.
Steps to Take to Help Prevent HIV Treatment Failure
You can help avoid HIV drug resistance by taking these steps to prevent it from occurring:
- Take your medication every day. This helps block HIV replication, says Guderian. Use an alarm on your phone, watch, or another device to make sure you follow your prescribed dosing schedule. Fill prescriptions early, so you don’t risk running out of medication.
- Take your medication as directed. Some HIV medications must be taken with food to ensure that the drug is properly absorbed into the body. Be sure you know how your medication should be taken.
- Let your doctor know about side effects or other treatment challenges. It’s essential that you tell your doctor if any side effects — such as nausea, diarrhea, depressed mood, or poor appetite — are making it difficult for you to stick to your HIV treatment regimen. These side effects can usually be managed, and if not, your doctor may prescribe different combinations of medicines for you.
- Ask your doctor about testing for HIV drug resistance. This type of testing looks for drug-resistant mutations in your specific strain of HIV and is usually done when you’re first diagnosed. This helps determine the medication that will be most effective for you. Testing for drug resistance should be performed again anytime your HIV viral load increases to make sure new drug-resistant mutations haven’t developed.