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Benefits and Risks of Early Antiretroviral Therapy for HIV


Benefits and Risks of Early Antiretroviral Therapy for HIV

Medical experts recommend that people begin treatment for HIV as soon as they know that they are infected.1, 2 Treatment is especially important for pregnant women, people who have other infections (such as tuberculosis or hepatitis), and people who have symptoms of AIDS. You may want to think about these benefits and risks and discuss all the issues with your doctor.

Benefits and risks of antiretroviral therapy for HIV
Type of therapy

Early therapy: Treatment with antiretroviral medicines as soon as HIV is diagnosed.

Delayed therapy: Treatment with antiretroviral medicines some time after HIV is diagnosed.

Benefits
  • Increases ability to achieve and maintain control of viral replication.
  • Delays or prevents weakening of the immune system.
  • Slows or prevents progression of HIV to AIDS.
  • Lowers risk of resistance to the medicines, if viral suppression is complete.
  • Reduces risk of HIV transmission. Even with early therapy, the risk of HIV transmission still exists. Antiretroviral therapy cannot substitute for primary HIV prevention measures, such as condom use and safe sex practices.
  • Reduces inflammation caused by HIV. This may reduce problems linked to HIV infection such as kidney or liver damage.
  • Avoids negative effects on quality of life, such as the cost of the medicine.
  • Avoids side effects of the medicines.
  • Delays development of resistance to the medicines.
  • Preserves the maximum number of medicine options when HIV disease risk is highest.
Risks
  • Medicine-related side effects that may reduce your quality of life.
  • Earlier development of resistance to the medicines if viral suppression is not complete.
  • Limitation of future antiretroviral treatment options.
  • Possible risks of starting antiretroviral therapy before HIV-related symptoms develop.
  • Irreversible damage to the immune system, which might have been avoided by earlier treatment.
  • Greater chance of getting sick.
  • Greater difficulty in preventing the virus from multiplying.
  • Possible increase in the risk of HIV transmission.
  • Increase in the risk of death from an AIDS-related illness.

References

Citations

  1. U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2012). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Available online: http://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf.

  2. Thompson MA, et al. (2012). Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society—USA Panel. JAMA, 308(4): 387–402.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerPeter Shalit, MD, PhD - Internal Medicine
Last RevisedNovember 7, 2012

eMedicineHealth Medical Reference from Healthwise

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