HIV

Q: Why change your HIV regimen when you've been on it for years, and it's working?

If your HIV medications (antiretrovirals, or ARVs) have kept your HIV viral load suppressed as much as possible (ideally to "undetectable" levels), and your CD4 count is stable (or higher), and your health is stable, then your meds are working well. You may think that "if it ain't broke, don't fix it," but there may be some advantages to changing.

There are many possible reasons why a provider might suggest a change in ARVs to someone whose meds are keeping the HIV viral load under control. Here are a few:

• HIV therapies develop over time, and in recent years a lot of new potent and "kinder, gentler" ARVs have become available. In addition, there are a number of combination drugs that decrease the number of individual pills that patients must take, including several that contain an entire regimen in a single pill. So, your provider may want you to switch to meds that have less risk of side effects or switch to a simpler regimen with fewer pills.
• Your provider may have noticed a side effect that you are not aware of or may be concerned about a potential side effect.
• Your provider may want you to start a new medicine that interacts with one of your HIV medicines, so they may want to change your ARVs to avoid a problematic interaction or side effect.

So, although your current ARVs may be working well to control your HIV virus, there may be good reasons to consider a change of therapy. Talk to your provider about your concerns, ask questions about why they want you to change and about the new ARVs being proposed, and make a decision together about your therapy.