HIV is often described as having the impact of ‘rapidly ageing’ the immune system; although this effect is far more pronounced in untreated HIV infection. At this stage, the ongoing impact of HIV on the immune system—even in treated HIV infection—is not yet fully understood and is still being researched.
What can you do?
Know about HIV treatments and when to start taking them
Improvements in treatments for HIV have been accompanied with an increased life expectancy for people living with HIV. Prior to the advent of effective treatments in the 1990s life expectancy for people with HIV was an average of just over 10 years from the time of infection. Studies soon after the advent of effective treatments suggested that life expectancy for people with HIV infected before they were 40 was now somewhere between 8—15 years less than people without HIV infection. Recent studies with even more improved treatments show that the life expectancy of many people with HIV is now becoming quite close to the life expectancy of people without HIV.
Follow the recommended dosing instructions
Those people who are likely to have close to a normal life expectancy are those who get diagnosed early, get the best treatments before their immune system is damaged and are able to follow the recommended dosing for their treatments without interruption for the rest of their lives.
Following the recommended dosing instructions means:
- taking the full dose of each drug as prescribed
- taking them at regular intervals as prescribed (if you have to take your pills once a day it is often good to associate taking them with a daily event such as reading the morning paper or having breakfast).
Some other tips to help with your pills
- If you miss a dose then don’t double up
- If you find you often get well into the day and can’t remember if you’ve taken your pills or not, then get a pill box (dosette box) from your doctor which allows you to put your pills in an allocated slot for each day of the week—so you can go and check whether you’ve taken them or not
- Keep a backup or emergency supply of pills at the places you regularly spend a lot of time and keep them in a safe place, for example your workplace, partner’s place, or a place you go to on weekends
- If there is going to be an interruption to your usual routine—plan ahead—to make sure you can still take your pills.
Know about therapeutic drug interactions and inform your doctor about all the drugs you are taking
Prescription drugs, over-the-counter drugs and complementary/natural therapies can all interact with HIV treatments, and may affect how well both the HIV drugs and other treatments work. This includes the contraceptive pill and implants for women, with some HIV medications making the pill less effective as a contraceptive.
Avoid any long treatments breaks — even missing one to two doses has been shown to increase the chance of resistanceHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant.
For a period of time when ARVs first became available there were doubts about how long these treatments would remain effective against HIV—and some of the earlier drugs were associated with serious side effects.
However, we now know that ARVs can work for the long term and that there are a lot more treatment options available should side effects become a problem for one drug.
It also used to be common for people with HIV to take a break from their treatments. We are now more certain that staying on treatments all of the time is more likely to produce the best long-term outcome.
Know about recreational drug interactions
Recreational or party drugs can harm your health and the effects can be harmful for both the short and longer term.
The use of ecstasy, crystal/ice and other types of methamphetamines may cause dangerous, even fatal interactions with some types of HIV treatments, as the HIV drugs slow down the body’s elimination of recreational drugs.
Some drugs interact with HIV treatments, leading to treatments that don’t work as well or have worse side effects.
Using ecstasy, crystal/ice and other types of methamphetamines and other party drugs is likely to further suppress your immune system, making it more difficult for your body to fight off disease. Heavy drinkingcan further suppress your immune system and may slow down your recovery from infections.
In addition to the drugs, the partying lifestyle, itself, can weaken your immune system. Staying up for long periods of time, not eating enough, or not eating the right foods can damage the immune system of any person, even if they are in great health.
Methamphetamines and ecstasy can also make eating difficult, which can be a problem for people who need to take treatments with food.
Heavy alcohol use can also have potentially serious consequences for people taking HIV medications and may affect how well you adhere to your HIV medications.
Complete the checklist for healthy ageing at the end of this resourcce and have a discussion with your HIV doctor and other specialists you are seeing
There is a lot of research that shows things like smoking, having a lot of stress in your life, not getting enough exercise, not getting enough sleep, depression, and being socially isolated are bad for your health. One of the body’s systems that may be affected is your immune system. Following the tips for healthy living is not just good for your overall health, but is probably good for your immune system as well.
Speak to your doctor about getting vaccinated against:
- hepatitis A
- hepatitis B
- bacterial pneumonias
- influenza (Flu)—a yearly vaccine.
These infections can cause more difficulties with adherence to HIV treatments, as well as contribute to the rapid progression of the infection in people with HIV, so it is important to speak with your doctor about the range of vaccinations that are now available.
You can also speak to your doctor about information on other vaccinations available, such as vaccines for the human papillomavirus (HPV); the virus that may cause genital warts, cervical cancer and anal/penile cancer (although this may not be effective if you have already been exposed to HPV).
You should also speak to your doctor about vaccinations that you may want to avoid. For example, if you are planning on travelling, you should speak to your doctor about the vaccinations that you can safely have and leave plenty of time to get them.
Ahead of Time: A practical guide to growing older with HIV