HIV treatment - today's reality of living with HIV

The continuous development of new and improved medical treatment, both for HIV and the illnesses associated with it, has led to major changes in the pattern of HIV disease progression which people in the UK, and in other countries where people have good access to HIV treatment and care, can expect to experience.

In the mid-1990s, effective HIV treatment that targets HIV itself became available. Use of a combination of antiretroviral drugs has been shown to prevent the weakening of the immune system by HIV. Antiretroviral therapy has also been shown to work for people with advanced HIV disease, including people with AIDS, and for many people anti-HIV drugs have brought about a remarkable recovery in health.

It's also worth noting that there have been further significant improvements in HIV treatment since the mid-1990s, with anti-HIV drugs becoming available that are more powerful, easier to take and less likely to cause problematic side-effects. As drugs have become available in fixed-dose combination pills, for many people living with HIV in the UK combination therapy now involves taking just one or two pills, once a day.

With the right treatment and care, many people living with HIV can expect to live just as long as their HIV-negative peers.

The prognosis, or life expectancy, for people with HIV has changed dramatically since the first cases of AIDS were diagnosed in the early 1980s. Before the introduction of effective HIV treatment, it was thought that it would take between 8 and 15 years (on average) after infection for HIV to cause life-threatening illness or death.

Effective HIV treatment has brought about an incredible change. Many doctors now believe that, provided a person with HIV receives effective HIV treatment before their immune system has been severely damaged by the virus, and if they take their drugs as prescribed, they can live a normal life span.

That's not to deny that people with HIV still become ill. Indeed, a few hundred people with HIV die each year in the UK, many as a direct consequence of their HIV infection. But these deaths often involve people who are diagnosed with HIV late in the disease process, when their immune system is already severely damaged.

For a long time the UK treatment guidelines recommended that patients should start HIV treatment once their CD4 count fell below 200, an indicator that HIV has damaged the immune system to such an extent that it becomes vulnerable to serious illness. Since 2008, the UK guidelines have recommended people start treatment sooner, when their CD4 cell count is around 350, and in some circumstances even sooner. 

You can find out more about when to start HIV treatment in the section HIV treatment.

However, much of the serious illness seen in people with HIV in the UK now is no longer directly caused by HIV itself. 

Some illnesses are seen more frequently in people with HIV than in the general population. These include liver disease caused by hepatitis viruses B or C; tuberculosis, heart disease; and certain cancers. Taking steps to look after your health, such as not smoking, eating a balanced diet and taking regular exercise, is an important part of keeping yourself well.

It’s also important to look after your mental health and emotional wellbeing. Depression and anxiety are common issues, and acknowledging how you feel and finding support to deal with mental health issues should not be overlooked. Talk to your HIV doctor, to someone else at your HIV clinic, or to your GP about the support available to you through the NHS. In addition, local HIV organisations can often arrange counselling, if you feel that would be helpful. Coping with depression is considered in more detail in the section onEmotional wellbeing and mental health.