Question: What is antiretroviral therapy? How does it work?

Answer: Currently there is no cure for AIDS. However, there are drugs that can slow down the progress of HIV and thus slow down the damage to your immune system. These drugs are called antiretrovirals (ARV's). ARV's slow down the reproduction rate of HIV. Once the virus is reproducing at a slower rate, it is less able to harm your immune system. If your immune system is functioning properly, your body is less likely to become sick. Your immune system is your body's defense system against infection. Since ARV's slow down the damage to your immune system, if they are used properly, they allow you to live a longer, healthier life.

The goals for ARV treatment are:
1. to ensure maximum and lasting control of the amount HIV in your body;
2. to restore and protect the immune functioning of the body by allowing the CD4 cells to replenish their numbers;
3. to reduce HIV-related illnesses and deaths and
4. in the long run to improve the quality of life for people living with AIDS.

In order to understand how ARV's work we need to know about the lifecycle of the HI Virus. HIV infects cells of the immune system and turns the cells into virus factories: one virus can create millions more of itself, using our own cells for this purpose. The cells that HIV targets are called CD4 cells, which form an important part of the immune system. Once HIV enters these cells it goes through several steps before new HI viruses are produced. Each type of ARV works at a different step of the HIV lifecycle. You medical doctor or health care worker can explain to you in more detail how this works.

In order for ARV treatment to be effective for a long time there is a need to take more than one ARV at a time. This is known as combination therapy and refers to the use of a combination of ARV drugs in treating HIV infection. For ARV's to be effective, they need to be taken strictly according to your medical doctor's instructions.

ARV's can cause side effects such as diarrhoea, tiredness and headaches etc., even if they are taken correctly. This does not mean that the drugs are not working. If you happen to experience some of these side effects, you will need to discuss it with your doctor who will help to manage the side-effects. Always consult your doctor before making any changes to your treatment.

You will not start ARV treatment immediately once you have been diagnosed HIV positive. ARV treatment will start once your CD4 count is below 200 and/or once you have an AIDS defining illness. In addition you will need to receive special counselling to prepare you for the ARV treatment before you start taking the drugs.

ARV's will not get the HI virus out of your body. However, the benefits of taking ARV's include the fact that the functioning of your immune system will be restored and protected; the production of the virus will be able to be controlled; your health will improve and ultimately your life will be prolonged. ARV treatment is a complex process and it is advised that you discuss all your options with your doctor and counsellor who will be able to help you and support you during your treatment. Unlike most medications ARV's need to be taken strictly as prescribed, under medical supervision, for the rest of your life.