Living With HIV: Staying Healthy and Avoiding Complications
Healthy Living With HIV: Talk to Your Doctor
When you first start on an HIV medication regimen, communication with your doctor is critical -- especially within the first six weeks. "Our job is to educate patients before taking medications and to look out for problems that can be permanent and prevent those that can escalate,” Taiwo says.
Ask your doctor what to expect in terms of side effects and know which ones are likely to subside during the first few weeks. Make sure you have all your providers’ numbers, including after-hours, and know exactly what to do if you run into a problem.
"Some side effects will go away, so try to have a little bit of patience after talking with your provider," Gandhi says. Reassure yourself that these are not dangerous side effects that require a switch or discontinuation of therapy. And when they’re over, you’ll probably only need to check in with your doctor about every three months.
"As long as there is good communication, we can usually help people get through that initial discomfort," Gandhi says. "The most important thing is that there is a line of communication so the patient is not at risk of stopping therapy without checking in about how to make things more comfortable."
Even a potentially life-threatening problem such as immune reconstitution inflammatory syndrome (IRIS) doesn't necessarily require a switch in regimens. That's because it tends to go away by itself. IRIS occurs at the beginning of treatment when the immune system suddenly becomes more active. This can make symptoms of pre-existing conditions temporarily much worse. If it is too severe, steroids may be needed. Again, close communication with your doctor can help sort out which side effects are signs of more serious complications.
How to Decrease the Risk of Complications with HIV
Many factors contribute to how successfully you can manage HIV complications. This includes other medications you’re taking or conditions you have, such as tuberculosis. It also depends on your tolerance to side effects and schedules for certain medications, and which alternative regimens are available for you.
Try these strategies to help lower your risk of HIV complications and stay healthier with HIV:
Take medications as directed. Drugs can stop working if you don't take them exactly at the right time in the right way each day. For example, if you are using a drug twice a day, try to take it 12 hours apart. If this is difficult for you to maintain, talk with your doctor about a once-a-day regimen.
Prevent drug interactions. Tell your doctor about all other medications you're taking, including over-the-counter and recreational drugs, and supplements. Antacids, for example, can interact poorly with atazanavir.
Be screened for the most common complications. Your doctor can screen for some of the more common complications of HIV, including risk factors for heart disease and stroke, as well as bone and kidney disease. "Malignancies are more difficult to plan for or head off at the pass," Gandhi says. "But there are multiple malignancies that should be screened for in HIV-infected patients."
Move toward a healthier lifestyle. You're managing your HIV well, but still smoking, not exercising, and eating a poor diet. What’s wrong with this picture? Taiwo challenges his smoking patients by saying, "Maybe you should just continue smoking and not take any medications because at this rate you're more likely to die from cancer or heart attack than from HIV." If you need help stopping a health-compromising habit, get it.