Patient FAQs

Of course not, only if you take your medication properly and adhere to the treatment.

Yes, it is all dependent on you and your approach towards the infection. However, point to note over here is HIV infection is not the same progressive fatal illness as it was in `80s and `90s. With the right treatment and proper follow up with the doctor, HIV infection has now become a chronic manageable disease.

You can overcome the challenges with this infection and need not worry about it.

Yes, you can have a normal life….with few adjustments. Compared to someone without any chronic medical conditions, you will have more medical visits and will take medications.

The biggest adjustments are often the ones that you have to do with your relationships with others. Friends and family will have to be educated before they can treat you like they did before. Sexual relationships present a challenge.

Over a period of time, you will get adjusted to the medication, follow-ups with your doctor, and your relationships with your family and friends. Your positive approach towards your medical condition will help you lead a near normal life.

Maintaining sexual relationships with your current partner present a special challenge. It will be your responsibility to disclose and discuss your HIV status with your partner after taking her/him into confidence. You can take help of counselor if need be to disclose your status with your partner. Give your partner some time to understand and adjust to the situation.

Entering into new relationships involves the complex issue of disclosure and the fear of rejection or loss of confidentiality.

Here are some important things you should do.

• Get all the myths cleared about HIV infection.
• Please think of informing your contact who might have infected you or whom you might have infected.
• Get support. Seek out the people in your life, with whom you can talk to about your HIV infection and talk to them. We are there to help you in case you need any help.
• Adhere to the treatment that is initiated by your doctor for the infection.
• Seek advice whenever you are in doubts.
• Don’t go through this alone, we are there to help you.

Telling people about your HIV status is a big step.

It is important to tell people who you might have infected or who might have infected you, your sexual partners or people with whom you must have shared needles. They should know this as they can get tested for their own benefit and also to protect others.

Think about telling friends or family members you can rely on for emotional support. Think about the important people in your life. Will they be there for you? Will they respect your confidentiality?

You don’t have to tell your boss, your coworkers or the guy sitting next to you in bus or train.

Please discuss with your doctor about your occupation and try to get clarity from him.

AIDS refers to the advanced stage of HIV infection. Appropriate treatment can prevent HIV infected person from progressing to AIDS. However, in case a person presents with an advanced stage/AIDS, appropriate treatment can also restore the health of the people with AIDS.

Everyone who has AIDS has HIV infection, but not everyone with HIV infection has AIDS.

AIDS is Acquired Immunodeficiency Syndrome. Its “acquired” because you have got the infection from someone else who was infected. “Immunodeficiency” stands for damage to the immune system. It is a “Syndrome” because it is a collection of symptoms and complications, including infections and cancers.

There are few ways by which HIV infection can spread:

• Sexual transmission: For HIV infection to spread through sex, the semen, vaginal fluids, or blood of an infected person must enter the body of an uninfected person. HIV can also be transmitted by oral sex, if the infected semen, vaginal fluid or the menstrual blood gets in the mouth. The risk is higher if the gums are damaged.
• Blood exposure: HIV can be transmitted if a person received blood transfusion from a person who has the infection. In today’s scenario, this risk is reduced as the blood received in blood banks is tested for HIV.
• Injection Drug Users: The transmission occurs by sharing of syringes and needles in drug addicts.
• Mother to child transmission during childbirth and breastfeeding: HIV infected women can transmit the infection to the child usually at the time of birth (labor) or shortly before and by breastfeeding the child.

HIV is not transmitted by mosquito bite, exposure of body fluids to intact skin, holding hands, kissing, hugging, sharing drinking glasses or eating utensils.

HIV is an entirely preventable disease. The means of prevention are directly related to the modes of transmission.

• Best option is abstinence, but not all people support this because of various factors.
  Other options are:
  • Limit the number of sexual partners
  • Usage of condoms
  • Avoid getting semen and vaginal fluid in your mouth or eyes.

Pre-exposure prophylaxis involves taking certain anti-retroviral medication to prevent transmission. This is a new approach that is not being currently widely used.

The HIV virus hides (is present) in the DNA of the long lived human cell. This makes it difficult to attack and kill in the virus.

Hence, currently, there is no cure for HIV infection. In fact with the advance in the treatment strategies, it has become a chronic manageable disease from a deadly disease.

Your blood contains red blood cells (RBC), white blood cells (WBC) and platelets.

Lymphocytes are a type of WBC. CD4 cell is a specific type of WBC that is affected the most in HIV infection.

The CD4 count measures the health of your immune system. Hence in HIV infection, CD4 count is continuously measured to monitor the progress. Once you are on treatment, CD4 count should increase in response to treatment over a period of time.

The viral load measures the amount of the virus in your blood. Along with CD4 count, viral load is also monitored to see how you are responding to the treatment.

The viral load can range from very low (less than 20 to 75 copies per milliliter of blood) to very high (millions). It is highest in people who are in advanced stage and not on treatment and in patients who are in initial stage of HIV infection. When the treatment is effective, viral load should be undetectable. Having undetectable levels does not mean that the virus is not there in the body, but it simply means that it cannot be measured by the standard laboratory tests.

Viral load should be measured at regular intervals to see the progress of the treatment.

Resistance testing is done to identify whether the virus has developed resistance to any of the antiretroviral drugs that you are likely to start or you are on. Resistance testing helps your doctor to choose the best drugs to treat your infection.

Resistance testing is to be done at the time of diagnosis of HIV, at the time of initiation of ART, at the time of changing ART if due to virological failure and in case of pregnant women starting ART.

Antiretroviral drugs act by inhibiting the multiplication of the virus. However, they don’t kill the virus. If the replication is stopped, we stop the virus from infecting the new cells.

Antiretroviral therapy is always started as combination therapy. The reason to combine the drugs is to prevent the development of resistance.

The answer depends on your current state, CD4 count and if you have developed any other infection. Most important is that you should be able to make a complete commitment to continue and adhere to the treatment as guided by your doctor.

There are certain guidelines that recommend the initiation of the treatment. Your doctor is the best person to guide you on initiation of treatment.

Adherence is your ability to stick to the treatment recommendations as guided by your doctor. It has a special role in HIV infection, as if you do not adhere to the treatment; there is a risk of development of resistance to the drugs.

Antiretroviral therapy stops the multiplication of the virus. If you miss any of the doses, the drug levels might fall down which might be low enough for the virus to start multiplying. This is the time when there are chances of mutation and development of resistance. The resistant virus multiplies in the presence of drug and eventually replaces the wild type virus. This is when the treatment regimen starts falling and there is a need of change of drugs.

If you adhere to the treatment, there is a lower risk of developing resistance and hence to change the drugs. Never discontinue the treatment without consulting your doctor.

Once you start the medication, there are chances that you might experience side effects. Some of the side effects are minor and manageable and disappear over a period of days to weeks. Some side effects may be prolonged.

When you develop any side effect, please discuss the same with your doctor. Considering the side effects, your doctor may or may not change the therapy for you. Always consult your doctor for any concerns you have.

Yes, the HIV drugs you are taking can interact with many other drugs.

Hence, always carry a list of the medication you are on and show it to the doctor who is treating you for any other condition or disease.

You have to continue taking treatment life-long.

No, Since the virus cannot be killed and keeps on hiding in different cells of the body, it has to be always kept under control. Hence, treatment is life-long.

It is difficult to say whether your treatment is working or not on the basis of how you are feeling. The best way to find out is to keep measuring the viral load and the CD4 count.

Viral load has to be undetectable when you are on therapy. If the viral load remains detectable or is increasing, then there is some problem with the treatment regimen. Your doctor will guide you what to do next.

If you have been advised to start medication for treatment of HIV infection, you should initiate it at the earliest. It is for your own benefit and also reduces the risk of transmission to your partner. Not initiating and adhering to the treatment will endanger your life along with your partner.