What do you mean by the term Opportunistic Infections (OIs)?

Opportunistic infections (OIs) are illnesses that occur more frequently and are more severe in people with HIV. This is because they can have damaged immune systems if they are not on effective treatment. Taking HIV medicine as prescribed is the best way to prevent getting OIs. HIV medicine can keep your immune system strong and healthy. Examples of OIs include tuberculosis and certain pneumonias. If you develop an OI, talk to your health care provider about how to treat it. 

What if I missed my dose? In most cases, you can take your pill as soon as you realize you missed a dose. Then take the next dose at your usual scheduled time (unless your healthcare provider has told you otherwise).However, never take two doses the next day to make up for a missed dose on the previous day.

What are some of the common side effects of ART? New drugs are safe and effective. Few people may experience stomach upset from starting a new medication, though this usually resolves after a few weeks by itself. Some drugs may also rarely cause lack of sleep, headache, dizziness, tiredness, and allergic reactions. Some people may experience weight gain as well. If you experience any side-effects, consult with your healthcare provider immediately.

Can I stop taking ART once my health improves? No. ART needs to be taken lifelong. Taking ART regularly keeps people with HIV healthy and prevents HIV transmission. Taking ART every day as prescribed also reduces the risk of drug resistance.

How can we know that the ART is working? To know if the treatment is effective, one needs to take HIV medication the right way every day as prescribed for at least 6 months. One also needs to get a VL test done. If the viral load is suppressed, that is below 1,000 copies/ml it indicates that the ART is working. Continue to take your HIV medicines as prescribed.

What is TND in a viral load test? All viral load tests have a cut-off point below which they cannot reliably detect HIV viral particles. This is called the limit of detection. When your viral load is below the level of detection of the specific test that is being used, it is said to be undetectable or “Target not detected” (TND).

If my viral load comes out to be TND, does it mean I am cured of HIV and can stop taking HIV medications? No, just because the level of HIV is too low to be measured doesn’t mean that HIV has disappeared completely from your blood. It might still be present in the blood, but in amounts too low to be measured. Continued ART is necessary to ensure that the viral load remains undetectable.

What should I do if my VL is ≥1000 copies/ml (unsuppressed)? Patient with viral load ­ 1000 copies/ml should undergo robust counselling to improve adherence. 

What does U=U mean? U=U stands for Undetectable equals Un transmittable. Undetectable means that the amount of HIV in your blood is too low to be detected on a viral load test. An undetectable VL for U=U is less than 200 copies/ml or TND (target not detected). If you take your ART daily and maintain an undetectable viral load, you will not pass HIV to your partners through sex. You need to continue to take your ART every day and have your viral load checked as advised by your doctor, to be sure your viral load stays undetectable. Undetectable does not mean that your HIV is cured; it means that you are taking ART regularly and the ART is working well and has stopped the virus from growing.

When is my ART adherence adequate? If ART adherence is more than 95% in a month, it is termed as good adherence. Ideally, you shouldn't miss any dose, you should take ART every day as advised by your doctor.

What is advanced HIV disease? For adults and adolescents, and children older than 5 years, advanced HIV disease is defined as CD4 cell count <200cells/mm3 or WHO stage 3 or 4. All children younger than 5 years of age (who are not already receiving ART and are clinically stable) with HIV are considered as having advanced HIV disease.