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You do not necessarily need to take anti-HIV (also called antiretroviral) medications just because you are HIV positive. You and your doctor will determine the best time to start treatment. When to take anti-HIV medications depends on your overall health, the amount of virus in your blood (viral load), and how well your immune system is working.

How will I know when to start anti-HIV medications?

You and your doctor should consider three factors in deciding when to start treatment: 1) symptoms of advanced HIV disease, 2) viral load, and 3) CD4 count.

You should start treatment if:

	you are experiencing severe symptoms of HIV infection or have been diagnosed with AIDS
	your viral load is 55,000 copies/mL or more
	your CD4 count is 200 cells/mm3 or less

You may also consider starting treatment if your CD4 count is between 200 and 350 cells/mm3; this is something you should discuss with your doctor.

If the anti-HIV medications can help me stay healthy, why wait to start treatment?

Once you begin treatment, you may need to continue taking anti-HIV medications for the rest of your life. Although newer anti-HIV medications are easier to take, starting treatment usually means a significant adjustment in your lifestyle. Some anti-HIV medications need to be taken several times a day at specific times and may require a change in meals and mealtimes.

In addition to their desired effects, anti-HIV medications may have negative side effects, some of which are serious. If the virus is not suppressed completely, drug resistance can develop. Side effects and drug resistance may limit your future treatment choices.

What treatment is right for me?

There are 20 anti-HIV medications approved by the U.S. Food and Drug Administration (FDA) for adults and adolescents. The HIV treatment guidelines recommend that you take a combination of three or more medications in a regimen called Highly Active Antiretroviral Therapy (HAART). The guidelines list "preferred" HAART regimens. However, your regimen should be tailored to your needs. Factors to consider in selecting a treatment regimen include:

number of pills
how often the pills must be taken
if pills can be taken with or without food
how the medications interact with one another
other medications you take
other diseases or conditions
pregnancy

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