The phrase, “You don’t know what you have until it’s gone,” applies to many things in this life and having a healthy, functioning immune system is high on the list of things most people don’t appreciate enough before it is gone. People diagnosed with HIV quickly learn this lesson. For us and other immunodeficient patients, it is vital that we keep our immune systems as healthy as possible because, without those essential CD4 cells (commonly referred to as T cells), our bodies cannot fight off infections or infection-related cancers.
Before the introduction of antiretroviral therapy (ART) in the mid-1990s, someone diagnosed with HIV could expect the disease to progress to AIDS in just a few years. However, with these medical breakthroughs, a person diagnosed with HIV who receives treatment can expect to live as long as a person without HIV. Taken as prescribed, ART keeps the virus from multiplying billions of times a day. The medications in this protocol come from one of several classes of drugs:
- nucleoside reverse transcriptase inhibitors (a.k.a. NRTIs or “nukes”)
- non-nucleoside reverse transcriptase inhibitors (a.k.a. NNRTIs or non-nukes)
- Protease inhibitors (a.k.a. PIs)
- Entry inhibitors
- HIV integrase inhibitors
ART is not one medication, but a cocktail of multiple medications that prevent the increase of virus load in a person’s body. Usually, three or more drugs from more than one of these classes are taken to prevent drug resistance, which can occur any time the virus is allowed to mutate. New mutations mean our current medications risk no longer being as effective. Once HIV figures its away around our meds, we need to switch to a new combination.
Strict adherence to our prescribed ART schedule is one of two ways to ensure our medicines keep working for us. The other is to only ever purchase FDA-approved medications from a licensed U.S. pharmacy. Counterfeit and black market drugs have been found to have too little active ingredient, no active ingredient or the wrong active ingredient. All three of these possibilities would make a person's current cocktail useless. It doesn’t matter how affordable the medication is. If it does not keep our viral load down, it is stealing our money and our health.
If all of our medications don’t have enough active pharmaceutical ingredients, they will not stop the virus from multiplying. Even if just one of our medications does not have enough, that is all of an opening the HIV needs. Our virus loads will increase and, eventually, we will need to switch to entirely new drugs. Those new drugs all come with the potential for unwanted side effects. Some of those new side effects will be mild, but some of them may be severe enough that these new medications are not something you can stay one. If that happens, a person may soon run out of effective options for keeping your HIV in check.
If we want to keep our immune systems as healthy as possible so we can live the full, productive lives that we wish to, it is essential that people living with HIV do two things: only ever get your FDA-approved medications from a licensed U.S. pharmacy and strict adherence to your ART. Doing anything less than that puts our lives at risk and increases the chance of transmission to other people.