HIV, though chronic, is now a manageable disease with over 20 medications available to treat it. However, successful treatment requires not missing a single dose of medication (adherence); otherwise, resistance will develop and future therapies may be less successful. Plus, maintaining an undetectable viral load usually prevents disease progression. It can be said that maintaining an undetectable virus <50 copies and a CD4 count above 500 for 5 years can result in a normal life span.
The HIV virus can cause a generalized inflammatory state in the body that can have harmful consequences, such as premature aging, heart disease, lipid abnormalities and more. Taking one aspirin daily may be of benefit as an anti-inflammatory agent. Aspirin also reduces the risk of heart attack and stroke by preventing blood clots in the circulatory system.
New recommendations by the Department of Health and Human Resources (www.aidsinfo.nih.gov/guidelines) now recommend starting HIV therapy earlier. The benefits of earlier therapy outweigh the risks. Older and complicated therapies, including those with side effects, can now be safely changed to simpler ones that are easier to take, often just once a day, and maintain their effectiveness.
HIV prevention remains a priority worldwide. The test and treat strategy is an option currently being explored. This would involve an increase in HIV testing of the population at large and treating all positive individuals regardless of their CD4 or viral load counts. This has some risk, including resistance; however, the potential is the reduction of the transmission of HIV.