Antiretroviral Therapy

Overview

Antiretroviral therapy, usually called ART, is the combination of medicines used to treat HIV. HIV is a virus that attacks the body’s immune system. ART does not cure HIV, but it keeps the virus at very low levels. This protects the immune system and helps people with HIV live long, healthy lives.

HIV is common around the world, and ART is used widely. Millions of people take ART every day.

ART is for anyone living with HIV, including children, teenagers, adults, and older adults. It is also used in pregnancy to protect both the parent and the baby.

Symptoms

Common symptoms

• Many people with HIV have no symptoms for years, which is why testing matters.
• Early HIV infection can cause flu-like symptoms such as fever, sore throat, tiredness, swollen glands, or a rash.
• Some people notice side effects when starting ART, such as nausea, headache, tiredness, sleep changes, or a mild rash. These often settle, but your clinic can help.

Symptoms in children

• Children with HIV may have slow growth, frequent infections, diarrhea, swollen glands, or delayed development.
• Children on ART need regular checkups, growth monitoring, and support with taking medicine consistently.
• Side effects in children should always be discussed with the child’s healthcare team.

Symptoms in older adults

• Older adults may be diagnosed with HIV later and may already have other health conditions.
• ART is chosen carefully because older adults often take other medicines and may have kidney, liver, or heart health to consider.
• Regular monitoring helps make sure ART works well and does not cause problems with other treatments.

Causes

Main causes

• ART is needed because HIV attacks immune cells called CD4 cells. Without treatment, HIV multiplies and weakens the immune system.
• HIV spreads through blood, semen, vaginal fluids, and breast milk. It is not spread by hugging, sharing food, or mosquito bites.
• ART is not a sign of failure or blame. It is the recommended medical treatment for anyone with HIV.

Risk factors

• Sex without a condom or without other protection
• Sharing needles or equipment for injecting drugs
• Being exposed to HIV through blood or body fluids at work or in healthcare settings
• A parent with HIV passing it to a baby during pregnancy, birth, or breastfeeding if prevention is not used
• Limited access to HIV testing, treatment, or prevention services

When to see a doctor

See a doctor urgently if:

• You have a severe allergic reaction such as swelling, trouble breathing, or a blistering rash
• You cannot keep your ART down because of vomiting or diarrhea
• You have a fever and feel very unwell, or you have signs of a serious infection
• You notice yellowing of the eyes or skin, severe stomach pain, or dark urine
• You feel confused, have a seizure, or have sudden weakness or vision changes

Book a routine appointment if:

• You are about to start ART or have questions about your treatment plan
• You have side effects that bother you or do not go away
• You have missed doses or have trouble taking ART every day
• You are planning pregnancy, are pregnant, or are breastfeeding
• You start a new medicine, supplement, or herbal product and want to check for interactions
• You are traveling and need enough medicine or advice about storage

Diagnosis

ART is prescribed after HIV is diagnosed. Diagnosis uses HIV blood tests, often starting with a quick test and confirming with a lab test. Before and during ART, your clinic checks how the virus and immune system are doing.

Tests that may be done

• HIV antibody and antigen blood tests
• HIV viral load test, which measures how much virus is in the blood
• CD4 count, which shows how strong the immune system is
• Kidney and liver blood tests
• Drug resistance testing to help choose the best ART combination
• Screening for hepatitis, tuberculosis, and other infections
• Pregnancy testing when relevant

What to expect at your appointment

HIV testing and care are confidential. Your clinic will explain results, offer support, and discuss when to start ART. You will usually have regular visits and blood tests, especially early on. The goal is to find a combination that suits you and keeps the virus suppressed.

Treatment

ART is a combination of HIV medicines taken regularly, usually every day. It is not a cure, but it controls HIV very well. The right combination depends on your health, other medicines, pregnancy plans, side effects, and test results.

Self-care at home

• Take ART exactly as prescribed and at the same time each day if possible.
• Use reminders, pill boxes, or phone alarms to help you stay on track.
• Refill your medicine before you run out, and plan ahead for travel.
• Tell your clinic about side effects, missed doses, or problems taking the medicine.
• Ask your pharmacist or clinic before taking new medicines, supplements, or herbal products.
• Use condoms or other protection during sex, and never share needles or injecting equipment.
• Keep regular appointments and blood tests.
• Ask your clinic about vaccines and screening tests that are right for you.

Medical treatments

ART uses a combination of medicines from different groups to block HIV at different steps. Most people take one or more pills daily, and some take a single tablet that contains a full combination. Your healthcare team chooses a plan based on your health, test results, other medicines, pregnancy plans, and any side effects. ART is lifelong for most people. Do not start, stop, or change ART without advice from your HIV clinic.

When is surgery considered?

Surgery is not a treatment for HIV itself. If you need surgery for another health problem, tell the surgical team about your ART so they can plan your care safely.

Living with this condition

Living with HIV usually means taking ART every day and having regular checkups. Many people work, study, travel, and have relationships as usual. Keeping a routine and staying connected to your clinic makes treatment easier.

Lifestyle tips

• Build a daily routine for taking ART and keep a small supply with you when out.
• Store medicines as advised and check expiry dates.
• Avoid sharing needles or injecting equipment.
• Use condoms or other protection during sex, or discuss other prevention options with your clinic.
• Limit alcohol and avoid smoking, as these can affect your overall health.
• Get enough sleep and manage stress where you can.
• Tell trusted people if you want support, and ask your clinic about confidentiality.

Diet and exercise

A balanced diet and regular movement support your immune system and overall health. There is no special HIV diet, but eating regularly, drinking enough water, and staying active can help you feel better. Ask your clinic if you need advice about food, weight, or medicine timing with meals.

Mental health and emotional wellbeing

HIV and daily treatment can cause stress, anxiety, depression, or fear of stigma. These feelings are common and treatable. Talk to your clinic or a counselor. If you have thoughts of harming yourself or feel in crisis, contact your local emergency number or local crisis service immediately.

Prevention

HIV can be prevented. Using condoms, using sterile needles, testing regularly, and treating HIV with ART all reduce transmission. When ART keeps the virus undetectable, HIV cannot be passed through sex. Preventive HIV medicines are also available for people at higher risk — ask your clinic. Prevention of parent-to-child transmission is very effective when started early in pregnancy.

Vaccines

There is no vaccine to prevent HIV. People with HIV may be advised to have routine vaccines, such as flu, hepatitis, pneumonia, and others, depending on their health and local guidance.

Screening programmes

Everyone should know their HIV status. Regular HIV and sexually transmitted infection screening is important, especially if you have new or multiple partners. Pregnant women are usually offered HIV testing. People on ART need regular monitoring tests.

Complications

If left untreated

• Without HIV treatment, the virus weakens the immune system over time.
• This can lead to serious infections and some cancers that the body would normally fight off.
• Untreated HIV can also affect the heart, kidneys, brain, and other organs.
• HIV can be passed to others more easily when the virus is not controlled.

Long-term outlook

With ART taken regularly, most people with HIV can live a long, healthy life and have a near-normal lifespan. Treatment also protects partners and babies. Staying in care and taking ART consistently gives the best chance of good health.

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