Frequently asked
questions (FAQ) about Anti-Retroviral Therapy (ART)
FAQ List
What is Anti-Retroviral
Therapy (ART)?
Anti-Retroviral Therapy (ART) is the administration of at least
three different medications known as Anti-RetroViral drugs (ARV)
in order to suppress the replication of the human immunodeficiency
virus (HIV). Treatment with these combinations of drugs is also
known as Highly Active Antiretroviral Therapy (HAART). ART is
not a cure. It must be taken for life and is costly. ART is
delivered as part of a comprehensive care, which includes Voluntary
Counseling and Testing (VCT), the diagnosis and treatment of
Sexually Transmitted Diseases (STDs), Tuberculosis (TB), Opportunistic
Infections (OI), and the prevention of mother to child transmission
(PMTCT) as well as the treatment of pregnant women.
ART changes a uniformly fatal disease to a manageable chronic
illness. Successful use of ART suppresses HIV viral replication,
consequently slowing down disease progression, improving immunity
and delaying mortality. Even if ART is not a cure, it prolongs
and enhances the quality of life of People Living with HIV/AIDS
(PLWHA). Once ART is started, it has to be taken for life with
better than 95% adherence.
What are Anti Retroviral Drugs (ARV)?
There are currently three major classes of ARV drugs: nucleoside
or nucleotide analogue reverse transcriptase inhibitors (NRTIs),
non-nucleoside reverse transcriptase inhibitors (NNRTIs) and
protease inhibitors (PIs). The difference between AntiRetroViral
(ARV) and AntiRetroviral Therapy (ART) is that ARVs are drugs
that have suppressive effect on HIV while ART is an anti HIV
treatment using a combination of a minimum of at least three
ARVs.
Are ARVs a cure for AIDS?
No, ARVs are not a cure for AIDS. These drugs suppress HIV
viral replication, consequently delaying disease progression,
thereby improving immunity and delaying mortality. They prolong
and enhance the quality of life of PLWHA, changing a uniformly
fatal disease to a manageable chronic illness.
How should an HIV positive person access
ART?
Clinical and non-clinical eligibility criteria will be used
to evaluate if HIV patients should be on ART. HIV patients will
initially be evaluated at their nearest health centers. Those
who have signs and symptoms of WHO Stage III or AIDS defining
illnesses will be referred to ART hospitals for further evaluation
and treatment. Other points of referral for ART services include
TB clinics, hospital outpatients and inpatients, antenatal care
(ANC) and the Voluntary Counseling and Testing (VCT) center.
Once the patients are examined by the ART physicians, hospital
level quota, priority for vulnerable groups and the readiness
of the patients will be taken into account before ART is started.
If a clinically eligible patient is not started on ART as a
result of not meeting any of the above non-clinical criteria,
the patient will be put on a waiting list for ART and will be
continually monitored and treated for other OI. Patients on
ART waiting list must be able to see their providers at any
time they feel there is need for evaluation.
When does an HIV patient need to start
ART?
All HIV patients do not need to be on ART. In the natural
course of HIV infection, it takes up to eight years before an
individual infected with HIV develops AIDS symptoms. It then
takes another 1 – 3 years before death. HIV infected patients
are started on ART when they manifest signs and symptoms of
WHO Stage III or their CD4 count falls below 200 (the laboratory
definition of AIDS). With or without ART, HIV infected individual
can live a long and productive life by following healthy living,
which includes balanced nutrition, exercise, safe sexual practices,
and avoidance of harmful practices such as smoking, alcohol
and drug abuse. In addition, close monitoring of the disease
status and ensuring timely access to health care, can minimize
damage to the immune system. As the disease progresses, prevention
and treatment of OI become an essential component of HIV treatment.
How long should an HIV patient be on
ART and why?
Once a patient starts on ART, the medications must be taken
for life near 100% adherence. ARVs only suppress the virus,
but do not destroy it. Therefore, the drugs need to be taken
all the time to continuously suppress the virus since it will
always be in the body.
Can an HIV patient interrupt taking
ARVs for any reason?
No, an HIV patient should never interrupt taking ARVs for
any reasons expect when recommended by the physician. Interruption
will cause viral drug resistance resulting in treatment failure.
The consequence of non-adherence is the emergence of viral drug
resistance. As resistant strains replicate within a patient,
ARVs will fail to suppress the virus. There is then the potential
of this strain being transmitted within the community and nation,
starting an additional epidemic of resistant HIV with very little
or no options for treatment. Lack of adherence is the major
contributing factor to drug resistance and must be not only
the patient’s, but also the nation’s concern.
What are the side effects of ARV?
This question is best deferred to appropriate caregivers.
Side effects could be numerous and relatively common because
three different drugs are being administered at the same time.
Most of the side effects, however are minor and will be tolerated
as patients continue to take the drugs. In rare instances, the
side effects could be severe and life threatening requiring
medication adjustment or complete discontinuation and change
to completely different drug regimen. It is, therefore, highly
advisable that patients return to their providers for scheduled
visit and close follow up.
Do ARVs eliminate the transmission of
HIV/AIDS?
No, ARVs do not eliminate the transmission of HIV/AIDS. They
only suppress virus replication. Therefore, an HIV patient on
ART still transmits HIV. Safe sexual practices should always
be practiced.
Can children be on ART?
Yes, HIV positive children can be on ART once their clinical
stage is determined by their physician. ART have a markedly
positive effect on children, by improving their development
and growth. The ARV preparation and dosage for children are
different than those of adults, thus children should not be
given ARVs prescribed for adults.
Can HIV positive pregnant women be on
ART?
Yes, HIV pregnant women can be on ART. Most ARVs are relatively
safe, except a couple that are harmful to the fetal development.
The physician will prescribe the appropriate ARV drugs for pregnant
women.
What are the nutrition requirements
and how important are they?
Nutrition plays a significant role in building up immunity
and fighting disease. HIV patients need to maintain a balanced
diet.
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