The wait is over

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Post by Adrian Ogier20 Mar 2014

What has changed?

Until April 2014, the Pharmaceutical Benefits Scheme (PBS) did not allow doctors to prescribe HIV treatment to people with CD4 counts above 500 who had no clinical symptoms.

This barrier has now been removed, and today anyone in Australia with HIV who has a Medicare card can receive subsidised treatment through the PBS .

Whether you choose to start treatment or not is something you need to think carefully about in consultation with your doctor.

Treating for your health

Many experts and people with HIV believe that untreated HIV causes damage from the time you become infected. So, controlling HIV with treatment as early as possible is a good idea.

Treatment can reduce the amount of inflammation that HIV causes inside the body. Early treatment may keep you healthy for longer and may even protect you from developing health problems later on in life.

Treatment as prevention

Successful HIV treatment will reduce the amount of HIV in your bloodstream to undetectable levels. This means that you are far less likely to pass on HIV to a sexual partner. In fact, current findings show that the risk of transmission is extremely low. This fact motivates many people to start treatment.

Are you ready?

HIV treatment used to be hard to take. In the early days, there were a lot of pills and many of them caused severe side effects.

This has all changed. Today, HIV treatment is much simpler. The side effects are fewer, milder and usually don’t last. Most people find taking HIV treatment much easier than they thought it would be.

Taking HIV treatment is a daily commitment. For treatment to work properly, you need to commit to taking every dose every day. If you don’t, you could develop resistance to the drugs you are on.

There are many different treatment combinations. Talk to your doctor about what would suit you best.

Also, ask your local HIV community organisation for advice or support. You’ll find them listed here.

Further reading:

  1. Two presentations on the optimal time to start treatment were delivered by French researchers at the IAS conference in 2013. They are summarised here.
  2. In addition to the previously established prevention benefits, the latest results from the ongoing HPTN 052 trial provide further evidence to support starting treatment earlier for individual health benefits. The authors argue that in light of the latest HPTN 052 findings, the debate about the value of early ART initiation should now be viewed as settled from both patients’ and public health perspectives.
  3. This study talks about how starting antiretroviral therapy very early (during the seroconversion period) may limit gut damage and immune activation
  4. The PARTNER study presented at the CROI Conference in March 2014 is the second large study of serodiscordant couples (the first being HPTN 052) to demonstrate the impact that treatment has on preventing HIV transmission.
    See also Abstract and Q and A attachments below.
  5. Two US bloggers comment on the PARTNERS study and its impact: Mark King and Gus Cairns.
  6. The authors of this Canadian study argue that their findings support the real world and long-term effectiveness and sustainability of the “treatment as prevention” strategy, within a resource-rich setting with an effective health care system.