Like most medicines, antiretroviral drugs for HIV can also cause side effects. Scientists explain how HIV patients can still keep the virus in remission after stopping ART.

Antiretroviral therapy (ART) is recommended for people living with human immunodeficiency virus (HIV). It involves taking a combination of antiretroviral drugs that slow the progression of the virus in your body every day. If left untreated, HIV can lead to development of different types of life-threatening infections and even cancers. While ART is considered the standard of care for treatment of HIV infection, the requirement for lifelong medication poses multiple challenges for the patient, including stigma, long-term side effects and the threat of viral resistance.

Here is the good news for people living with HIV: A study led by scientists at the National Institutes of Health (NIH) has identified two distinct ways that helped HIV patients put the virus into remission for an extended period after stopping antiretroviral therapy. This means people with HIV may not need lifelong medication.

The study led by Tae-Wook Chun, chief of the HIV Immunovirology Section in the Laboratory of Immunoregulation at the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH; and Anthony S. Fauci, NIAID director and chief of the Laboratory of Immunoregulation was recently published in the journal Nature Medicine.

What happens when people with HIV stopped taking ART?

In the study, two adults with HIV stopped taking ART under medical supervision. They had started the treatment soon after acquiring the virus and continued with the medications for more than six years, successfully suppressing HIV. After stopping the antiretroviral therapy, one patient was followed for four years and the other for more than five years, monitoring the timing and size of viral rebounds in each of them.

One participant suppressed the virus with intermittent rebounds for nearly 3.5 years until he began taking suboptimal ART without telling the investigators. The other one almost completely suppressed HIV for nearly 4 years before he became infected with a different HIV strain, a phenomenon known as “superinfection.”

As reported by Science Daily, the scientists found high levels of HIV-specific immune cells called CD8+ T cells that can kill virus-infected cells in the first participant. Although the second participant had a weaker CD8+ T cell response against HIV, he had a very strong neutralizing antibody response throughout the follow-up period until the sudden viral rebound. The findings indicate that each person had a different mechanism of control. In the second participant, neutralizing antibodies may have played a significant role in facilitating near-complete HIV suppression until he acquired a different strain of the virus, the researchers suggested.

Thus, to avoid the emergence of viral resistance, the researchers emphasized the need to conduct routine antiretroviral drug testing of people with HIV who halt ART for extended periods.

Additionally, HIV superinfection was identified as a potential cause of sudden virologic breakthrough in people with HIV who halt treatment.

The researchers are hopeful that this information could be useful in developing new tools to help HIV patients put the virus into remission without taking lifelong medication.

Beware of the side effects from ART

Like most medicines, antiretroviral drugs for HIV can also cause side effects, but fewer people experience them. Side effects from ART medicine differ from person to person and they are also less severe now than in the past.

Some of the most commonly reported side effects of ART include nausea and vomiting, diarrhea, difficulty sleeping, dry mouth, headache, rash, dizziness, fatigue and pain.

If you experience any severe side effects or want to stop taking your HIV medication, talk to your doctor first. Skipping doses or stopping medication may lead to drug resistance, which not only can harm your health but also limit your future treatment options.