What is the best treatment for HIV?

HIV treatment has come along way, and a lot has changed since the first reported case in 1981. Throughout the 80s and 90s, HIV infection rates and AIDs-related deaths rapidly increased, and by 2005, we saw the peak of AIDS-related deaths where 2 million people died in one year. Fast forward to 2020 and death rates have been dramatically reduced by 60%, thanks to the expanded access to HIV testing and treatment.

While there isn’t yet any widespread drug that can cure the disease, treatments today are extremely effective, allowing individuals to live a long and healthy life and with effectively no risk of sexually transmitting HIV to their HIV-negative partners.

We spoke to Dr Indrajith Karunaratne, a leading consultant in genitourinary medicine and a specialist in treating HIV, who explained to us the various treatment options available and what the general outlook looks like now for people living with HIV.

What is the outlook for patients who contract HIV?

Modern-day treatment for HIV infection is extremely effective. In established HIV infected individuals, a millilitre of blood can contain millions of viruses, however, modern treatment can now bring down the virus numbers to an undetectable level in as quickly as two weeks.

How is HIV currently treated?

HIV is treated with antiretroviral medication (ART). These work by preventing the virus from replicating in the body.

Historically, HIV treatment consisted of three different drugs, known as combination therapy or ‘the cocktail’ as many called it. However, some of the modern drugs are now so effective that even two-drug regimens can be used to effectively to treat HIV-positive patients.

Often two or three drugs are available as combined single tablets, which is easier to take than three. Most drugs are taken as a single tablet which are taken once a day and have minimal side-effects.

What is the best treatment method?

There are several effective HIV treatment regimens available to patients. These are just a few examples of effective, single pill, once-daily treatment options.

• Biktarvy
• Triumeq
• Symtuza

For the majority of patients, these HIV medicines are very tolerable and have very little side-effects. If patients do experience side-effects, they must work with their doctor to find a solution. Fortunately, there are now many excellent medicines for HIV so you can find the one most suited to you.

When should HIV medication be started?

The earlier HIV is diagnosed, the better the treatment outcome and the less chance of more serious illnesses developing. The death rate and serious illness rate in advanced HIV infection are twice as high as a new HIV infection.

Do you have to take the medication for life?

Yes. As of now, there is no cure for HIV. So to ensure the virus is kept under control, medication will need to be taken for life.

Can lifestyle habits support treatment?

Once a patient is well established on treatment and the virus is kept under control, they can expect to live a normal life span. It is therefore important to maintain a healthy lifestyle to prevent other common illnesses such as diabetes, high blood pressure and kidney failure shortening their life span.

Examples of a healthy lifestyle involve the following:

• stopping smoking
• keeping weight within a healthy range
• ensuring you have a varied and nutritious diet
• not exceeding the safe limits of alcohol consumption
• regularly exercising

Does treatment help prevent the spread of HIV?

Once an HIV-positive individual's viral load in the blood becomes undetectable following treatment, the infection becomes ‘untransmittable’. Then as long as they continue taking their medication as prescribed to keep their viral load undetectable, there is effectively no risk of infecting others.

Dr Indrajith Karunaratne is an expert in treating STIs, HIV and male and female sexual dysfunctions. Go to his Top Doctors profile to book a consultation with him.