"For HIV treatment to be effective, good adherence is very important. Good
adherence means taking all your antiretroviral medicines every day, at the right time
and with food if necessary. Poor adherence can have very serious consequences.
WHAT IS ADHERENCE?
- For HIV treatment to be effective, good adherence means taking all your ARV
medicines, every day, at the right time.
- Good adherence is important with most medicines, but it’s absolutely vital with
antiretrovirals.
- When we start taking antiretrovirals, we stop HIV from making copies of itself. This
gives the immune system a chance to recover.
- As the viral load goes down, the number of CD4 cells goes up. When our
adherence is good and our antiretroviral treatment is working, our viral load can
become 'undetectable'. Undetectable does not mean the virus has gone. It just
means that the amount of virus in our blood is too small to be measured (less than
50 copies per tiny drop of blood).
- When you start ARVs, you take a combination of at least three different ARV
drugs. Sometimes this is called triple therapy or HAART (Highly Active
Antiretroviral Therapy). The three drugs together form your ARV regimen. The first
ARV regimen that you will take will probably be Nevirapine, 3TC and d4T (or
Efavirenz instead of Nevirapine).
WHY GOOD ADHERENCE IS IMPORTANT
- If your adherence is bad, the HIV in your body becomes drug-resistant (it learns to
fight the drugs).
- ARVs stop HIV from making copies of itself. Taking our pills on time is important
because if we miss a dose, the virus immediately takes advantage and starts to
replicate itself again. These copies will be a little bit different and the ARVs will be
less effective against this changed virus.
- With HIV, avoiding resistance is very important. The only way to treat drug resistant HIV is to move on to a different combination of ARVs. We call this a new regimen. In South Africa at present, there are only two regimens available in the public sector.
- HIV that is resistant can be passed on to someone else and the drugs will not work
for that person either."
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