The diagnosis "HIV-positive" is accompanied by numerous
concerns about one's own health and future. The general practitioner
has answered some of the most frequently asked questions for you.
have recently become HIV positive. Can I grow old with HIV infection?
treatment of an HIV infection has changed completely over the past 15
years. In 1996 there was a revolutionary improvement in the treatment
the introduction of a new group of substances (protease inhibitors)
and the simultaneous combined administration of at least three
substances (combination therapy, also ART/antiretroviral therapy) a
lasting therapeutic success could be achieved. The life expectancy of
HIV-positive people is therefore almost normal in countries where
this therapy is available.
do I have to imagine under a modern antiretroviral therapy?
the first years after the introduction of antiretroviral therapy
(ART) in the mid-1990s, the lack of alternatives sometimes meant that
serious side effects and a high number of tablets had to be accepted.
In the meantime, however, more than two dozen different drugs have
been approved and are in use.
this selection, the doctor can select the substances best suited to
the patient. He will not only consider possible side effects, but
also his personal daily routine, such as sleeping and eating habits,
possible already existing resistances or pre-existing conditions. As
a rule, the patient swallows a few tablets once or twice a day -
three or four times a day, often more than 20 tablets, are
fortunately a thing of the past.
drugs are currently available?
we can choose from 5 different substance groups, all of which block
virus replication in different ways. The basis for almost every
antiretroviral therapy is still the oldest substance in use, the
nucleoside reverse transcriptase inhibitor (NRTI), which prevents the
"reverse transcription" of the "viral language"
(RNA) into the human "hereditary language" (DNA). In order
to keep the number of tablets as low as possible, two of these
substances are usually administered in the form of a combination
addition, a third substance belongs to the group of non-nucleoside
reverse transcriptase inhibitors (similar to the NRTI), protease
inhibitors (block the protein maturation of HIV), integrase
inhibitors (prevent the integration of HIV into the nucleus of the
human cell) or CCR5 blockers (impede the docking of HIV to the human
cell). Modern antiretroviral therapy today usually consists of only 1
to a maximum of 5 tablets per day.
will change in my life?
most important first step after the diagnosis is to accept the HIV
infection. For many people a world collapses in the first moment.
should be aware, however, that there are much more dangerous diseases
that reduce life expectancy. In this phase, the support of an
experienced psychologist is very helpful in addition to the support
of good friends. From a medical point of view, not much will really
change as a rule.
immune system is usually not restricted in this period, which means
that there is no increased risk of infection with infectious
diseases. Only regular laboratory checks of the immune system (CD4
helper cells) and the virus concentration (viral load) every 3 months
should I start antiretroviral therapy (ART)?
mentioned above, not all HIV infections are treated equally. The
European AIDS Society recommends starting antiretroviral therapy in 3
- in the presence of AIDS, an immunodeficiency disease (i.e. the occurrence of so-called AIDS-defining diseases), or
- if the CD4 helper cells fall below the critical limit of 350 cells/µl, or
- if the CD4 helper cells drop below 500 cells/µl and other indicators are present simultaneously (hepatitis B or C, age from 50 years, rapid drop in CD4 helper cells)
should I tell about my HIV infection?
a legal point of view, the obligation to inform other people about
HIV infection exists only in relation to the respective (sexual)
partner. Often it is also very supportive to initiate a very close
person, such as close friends or family members. Employers or
colleagues do not need to be informed.
only need to be informed insofar as it is necessary for the
respective diagnosis and therapy (clarification or treatment of
special illnesses related to HIV infection) or for their own
protection against infection (contact with blood, dental treatment,
HIV infection become "harmless" in the meantime?
No! HIV infection is still an incurable infectious disease that leads to death if left untreated. For this reason, a timely therapy is life-saving, but this requires a timely diagnosis. For this reason every person who has a potential risk of HIV infection should regularly undergo an HIV test!