Taking antiretroviral treatment for HIV

If you’ve been diagnosed with HIV then starting treatment as soon as possible is the first step to taking care of yourself and keeping your immune system strong. Although antiretroviral treatment is not a cure for HIV, it does keep the virus under control. Like a lot of medication, you may experience some side effects in the first few months. If they persist and are affecting your quality of life, you should be able to switch to a different drug regimen. Once you start treatment, the key to staying well is to make sure that you take it regularly as prescribed – which usually means every day at the same time. Skipping doses, or taking it at different times each day, will stop it from protecting your immune system.

How can I increase my CD4 count naturally?

CD4 cells (also known as CD4+ T cells) are white blood cells that fight infection. CD4 cell count is an indicator of immune function in patients living with HIV and one of the key determinants for the need for opportunistic infection (OI) prophylaxis. CD4 cell counts are obtained from bloodwork as part of laboratory monitoring for HIV infection. CD4+ cell counts are usually measured when you are diagnosed with HIV (at baseline), every 3 to 6 months during the first 2 years, or until your CD4 count increases above 300 cells/mm³. Otherwise, your CD4+ cell count may be measured every 12 months. Most people who are on HIV treatment can expect an average increase of about 50-100 cells/mm³ a year. Patients who initiate therapy with a low CD4 count or at an older age may not have the same increase in their CD4 count despite virologic suppression. HIV viral load tests measure the amount of HIV in the blood. Lower levels are better than higher levels. The main goal of HIV drugs is to reduce the HIV viral load to an "undetectable" level, meaning that the HIV RNA is below the level that the test is able to count. The lower your viral load, the better.

The only reliable way to increase CD4 cell count over time is with HIV treatment - antiretroviral therapy (ART). This treatment is recommended for those who are HIV positive - no matter how long they may have the virus, and it ultimately works towards keeping the viral load low and CD4 count high. Starting treatment early can help in reducing any potential long-term damage of the virus as well as reducing the amount of HIV in the blood.

Healthy and Balanced Diet

Good nutrition is important for everyone’s health. Nutrition plays an important role in the health of the immune system and its ability to fight infection. Having HIV doesn’t mean that you have to make big changes to your diet. But eating the right foods can make you feel better, have more energy, and can keep your heart and bones healthy as you get older. Nutrition is important for everyone because food gives our bodies the nutrients they need to stay healthy, grow, and work properly. Foods are made up of six classes of nutrients, each with its own special role in the body:

• Protein builds muscles and a strong immune system.
• Carbohydrates (including vegetables, fruits, grains) give you energy.
• Fat gives you extra energy.
• Vitamins regulate body processes.
• Minerals regulate body processes and also makeup body tissues.
• Water gives cells shape and acts as a medium where body processes can occur.

Having good nutrition means eating the right types of foods in the right amounts so you get these important nutrients. Nutritional advice for people living with HIV is the same as for people with a negative status: eat a balanced diet, without too much processed fat, sugar, or salt. This will also help your body to absorb the treatment and fight off everyday infections. You may benefit from talking to your healthcare professional about your diet if you:

• are underweight (perhaps because HIV was already making you unwell by the time you were diagnosed)
• are overweight
• have any particular dietary problems
• are experiencing side effects that make it hard to eat well.

Do I need a special diet?

There are no special diets, or particular foods, that will directly boost your immune system. But there are things you can do to keep your immunity up. When you are infected with HIV, your immune system has to work very hard to fight off infections--and this takes energy (measured in calories). For some people, this may mean you need to eat more food than you used to. If you are underweight--or you have advanced HIV disease, high viral loads, or opportunistic infections--you should include more protein as well as extra calories (in the form of carbohydrates and fats) in your diet.

To add calories to your diet

The best way to increase calories is to add extra fat and carbohydrates to your meals.

Fats are more concentrated sources of calories. Add moderate amounts of the following to your meals:

• butter, sour cream, cream cheese, peanut butter
• sour cream, cream cheese, grated cheese
• avocados, olives, salad dressing

Carbohydrates include both starches and simple sugars.

Starches are in:

• bread, muffins, biscuits, crackers
• oatmeal and cold cereals
• pasta
• potatoes
• rice

Simple sugars are in:

• fresh or dried fruits
• jelly, honey, and maple syrup

Exercising regularly

Being active is a part of maintaining your health for everyone – it builds muscle, keeps your bones strong, your heart healthy and burns fat. Some people who are living with HIV lose muscle mass and strength - exercising regularly helps prevent this. Exercise also reduces feelings of stress and symptoms of depression.

Avoid excessive alcohol or drug use

If you are living with HIV, there are specific risks associated with alcohol and recreational drug use that you should be aware of. Alcohol can damage the liver which the body uses to process anti-HIV drugs, so it is good to keep your alcohol consumption within the recommended limits. Heavy drinking and taking recreational drugs can also weaken your immune system, making it harder for your body to recover from infections. Certain anti-HIV drugs can interact with recreational drugs and alcohol to cause unwanted side effects, some of which can be severe. For example, you could feel dizzy or pass out, making you potentially vulnerable. If you are worried about drug interactions, have an honest conversation with a healthcare professional and they will be able to advise you. You should also be aware that being under the influence of alcohol or other drugs may stop you from taking your HIV medication properly, for example, you may forget to take a dose of too much alcohol may make you vomit. If you are sick within one hour of taking your HIV medication you should retake the dose.

Effects of Alcohol on your immune system

Drinking too much alcohol can weaken your immune system. A weaker immune system will have a harder time fighting off common infections (such as a cold), as well as HIV-related infections. A weaker immune system also increases the chance that you will experience more side effects from your HIV medications. Smoking marijuana or other drugs irritates the lungs. You may be more likely to get serious lung infections, such as pneumonia.

Other common recreational drugs, such as cocaine or crystal methamphetamine, can leave your body dehydrated and exhausted, as well as lead to skin irritation. These stimulants also shunt blood away from your extremities, risking higher rates of infection and significantly increased blood pressure. If you also have hepatitis, your liver is working very hard to fight hepatitis, and using alcohol or drugs can cause additional damage to your liver.

Managing stress and getting support

Looking after your mental wellbeing and emotional health is just as important as taking care of your body. Finding out you have HIV can be a shock, and it may take you some time to adjust. Talking to your friends and family, and other people living with HIV can really help when things get difficult. You could look for a peer mentoring or buddying service in your area.

Once you adjust to living with HIV, it’s a good idea to think about what you want out of life. What are your goals? What’s important to you? Maybe you want to study, travel, have a family, or change your career? Don’t let HIV stop you, there’s no reason why it should.

Coping Tips to improve your Mental Health:

It is completely normal to have a negative reaction when you are diagnosed with HIV. These reactions do not last forever. As noted in this lesson, there are many things that you can do to help take care of your mental health needs. Here are just a few ideas:

• Start HIV medications (ART) right away--an effective ART regimen will improve and protect your health, and protect your sex partners, and the knowledge you are taking this positive step may improve your feelings about yourself and the future.
• Talk about your feelings with your providers, friends, family members, or other supportive people.
• Try to find activities that relieve your stress, such as exercise or hobbies.
• Try to get enough sleep each night to help you feel rested.
• Learn relaxation methods like meditation, yoga, or deep breathing.
• Limit the amount of caffeine and nicotine you use.
• Eat small, healthy meals throughout the day.
• Join a support group.

The most important thing to remember is that you are not alone; there are support systems in place to help you, including doctors, psychologists, social workers, family members, friends, support groups, and other services.

What else can I do to take care of myself?

Many of the things we do to take care of ourselves are common sense, such as eating well, exercising, and getting plenty of rest and sleep. However, if you’re living with HIV, checking in with your healthcare professional regularly is also important. They should monitor you for other health conditions, which you may experience more as you age, and adjust your treatment as needed.

Written by Dude Arnel Flores Lopez, BSN, RN  28 May 2021

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