HIV is a virus that causes the immune system to not function properly.Patients with HIV are at risk of several infections. RISK FACTORS FOR HIV INFECTION Nearly all HIV infections are acquired through sexual contact or exposure to contaminated needles. You are at risk for getting HIV from sex if you have:

  • Had a sexually transmitted disease

  • Had a sexual partner infected with HIV

  • Been a victim of sexual assault

  • Had unprotected sex with multiple partners

  • Exchanged sex for money or drugs or have sex partners who do

You are at risk for exposure to HIV through contaminated needles if you have:

  • Injected drugs with shared needles or "works"

  • Been accidently stuck with a needle or sharp in a healthcare facility

Who should be tested for HIV The Centers for Disease Control and Prevention recommend HIV testing for everyone between age 13 and 64 years.

  • The treatment of HIV is highly effective. People with HIV can live a nearly normal lifetime with currently available drugs. This treatment is most effective when it is started early in the course of the disease,before symptoms develop.

  • Treating HIV can help prevent the spread of infection to others.

Current treatment regimens have significantly improved the possibility of living with HIV. In fact, living with HIV is similar to living with other chronic diseases,such as diabetes or high blood pressure; when HIV is closely monitored and treated, it may be possible to control the disease for a lifetime.

WHEN TO START HIV TREATMENT. The time to start antiretroviral treatment (ART) for HIV depends upon several factors, including your T cell count, age, underlying medical conditions, history of an AIDS-defining illness, and your willingness to commit to lifelong treatment. T cell count T helper cells, also known as CD4 cells, are white blood cells that help to organize the immune system. A low T cell count indicates that your immune system is not healthy and that there is a significant risk of developing an opportunistic infection. The normal T cell count is 500 to 1400 cells/mL.

A person with HIV gradually develops lower T cell counts over time as the immune system weakens. The lower the T cell count, the higher the risk of developing opportunistic infections, particularly in patients with T cell counts <200 cells/microL. Once started, HIV treatment is usually lifelong. It is very important to be compliant with the medication regimen. You must take your medicines regularly. Skipping a few medicines will increase your risk of developing drug resistance. Be sure to tell your doctor or nurse if you need to stop because of an illness, surgery, or loss of insurance. Be certain to refill your medications on time.

  • The medicines used for HIV all have possible side effects that you need to be aware of, since a few are serious and require discontinuation of the drug. Most side effects can be managed by changing the regimen. The decision to start ART means that you are ready to commit to a lifetime of taking medications on a daily basis. Pregnancy ART is recommended to all HIV-positive women who are pregnant, regardless of their T cell count. This will decrease the risk of transmitting the virus to the fetus. The decision about which medications to use will depend on many issues, such as whether or not you have any drug resistance to any HIV medications. Goals of therapy .The following are goals of antiretroviral treatment for HIV.

  • Suppress the HIV virus to prevent it from multiplying. The goal is to have no detectable virus in the blood for as long as possible. At this level, the virus is essentially "shut down."

  • Improve quality of life.

  • Preserve future treatment options, meaning that there will be drugs available if you develop toxicity or resistance to some drugs.

  • Restore immune function (as indicated by T cell count).The goal is to see the T cell count increase by 100 to 200 cells/microL during the first few years of treatment and then remain high. Each medicine has specific dosing instructions, side effects, and interactions with other prescription, nonprescription, and herbal medications.