Benefits and risks of early antiretroviral therapy for HIV

Early antiretroviral therapy may offer benefits to people with HIV who do not have symptoms.¹ You should not start antiretroviral therapy until you have considered the following benefits and risks and discussed all the issues with your health professional.

**Benefits and risks of antiretroviral therapy for HIV**
Type of therapy	Early therapy: Treatment with antiretroviral medicines before HIV-related symptoms develop	Delayed therapy: Treatment with antiretroviral medicines after HIV-related symptoms or AIDS develops
Benefits	Increases ability to achieve and maintain control of viral replication Delays or prevents immune system compromise Slows progression of HIV to AIDS Lowers risk of resistance to the medicines, if viral suppression is complete Possibly reduces risk of HIV transmission. Note: Even with early therapy, the risk of HIV transmission still exists. Antiretroviral therapy cannot substitute for primary HIV prevention measures, such as condom use and safer sex practices.	Avoids negative effects on quality of life, such as the cost of the medicine Avoids serious problems related to the medicines Delays development of resistance to the medicines Preserves the maximum number of medicine options when HIV disease risk is highest
Risks	Medicine-related side effects that may reduce your quality of life Earlier development of resistance to the medicines if viral suppression is not complete Limitation of future antiretroviral treatment options Possible risks of starting antiretroviral therapy before HIV-related symptoms develop	Irreversible damage to the immune system, which might have been avoided by earlier treatment Greater chance of getting sick Greater difficulty in preventing the virus from multiplying Possible increase in the risk of HIV transmission Increase in the risk of death from an AIDS-related illness

References

Citations

U.S. Department of Health and Human Services (2007). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Adult and Adolescent Guidelines. Available online: http://www.aidsinfo.nih.gov/guidelines/GuidelineDetail.aspx?MenuItem=Guidelines&Search=Off&GuidelineID=7&ClassID=1.

Credits

Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Peter Shalit, MD, PhD - Internal Medicine
Last Updated	May 8, 2008