I was just diagnosed with HIV. How do I start treatment?

Question

Hello doctor,

I am a 34-year-old male, and I was recently diagnosed with HIV (human immunodeficiency virus) infection during a routine health check. My latest CD4 (cluster of differentiation 4) count is 320 cells/µL (normal: 500 to 1500), and my viral load is 85,000 copies/mL.

I have been feeling fatigued and have experienced occasional low-grade fevers, night sweats, and unintended weight loss of 8.8 pounds over the past two months. I also notice persistent oral thrush and occasional diarrhea.

I have no history of opportunistic infections so far. My liver and kidney function tests are within normal limits. I am concerned about starting antiretroviral therapy (ART) and understanding the possible side effects and adherence requirements.

Could you guide me on the most effective ART regimen for my stage of HIV?
How frequently should I monitor my CD4 count and viral load?
Are there lifestyle changes, vaccinations, or precautions I should take to reduce the risk of infections and maintain overall health?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

It is mentioned that you have been recently diagnosed with HIV infection (human immunodeficiency virus, a virus that attacks the body's immune system) with a CD4 (cluster of differentiation 4, a protein on immune cells, mainly helper T cells, crucial for fighting infections) count of less than 350 and with a high viral load. It is recommended to get yourself registered in the nearest HIV/ART (human immunodeficiency virus/antiretroviral therapy) centre.

HIV treatment, along with various investigations required to monitor the disease response to treatment and side effects, has been made free of cost by the government. Treatment to control this infection is very effective and safe to initiate and continue.

There are very few side effects, occasionally only, in the form of derangement in biochemical parameters, which can be easily managed with supportive medications. Monitoring of various parameters, CD4 count (cluster of differentiation 4 count), and viral load is done as per recommendations in the treatment guidelines.

Before starting treatment, your doctor will likely screen you for other infections that can occur when immunity is lower, especially since you are experiencing symptoms like oral thrush and weight loss. Treating or ruling out these conditions first helps ensure a smooth and safe start to HIV medications.

After treatment begins, your CD4 count and viral load will be monitored at regular intervals, based on standard guidelines, to make sure the medicines are working as expected and that your body is tolerating them well.

Taking your medications exactly as prescribed every day is extremely important. Good adherence helps achieve an undetectable viral load, protects your immune system, and prevents transmission to others.

Alongside treatment, maintaining a healthy lifestyle with balanced nutrition, regular physical activity, adequate sleep, and avoiding smoking or excessive alcohol will further support your long-term health.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.