Deciding whether to start therapy

Though HIV drugs can be lifesavers, there are reasons NOT to start taking them right away. For one thing, the virus sometimes becomes resistant to drugs. That means the virus has changed in a way that makes the drug no longer work. The most common cause of drug resistance is not taking medications correctly. The longer you are on a drug, the more likely the virus will develop resistance to it. Also, all drugs have side effects, some of them long-term.

For these reasons, it can be best to wait to start therapy, as long as you and your doctor monitor your condition, so that you can start therapy before your immune system becomes too weakened to protect you.

In general, experts say you should think about these four things:

• Symptoms of HIV disease (also called your clinical status, or how well you feel)
• Your CD4 count and viral load
• Whether or not you have AIDS
• Whether you can and will stick to your treatment plan (called adherence)

We will look at each of these more closely.

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