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Q: I am one of HIV carrier but I am afraid always by the virus. I sometimes forgot
my medication but the doctor said you have to take it. I know I have to take my med
if I did not take sometimes what would happen to me.
Berket

A: I can understand the possibility of medication fatigue you may have
encountered by taking these drugs for long time or some of the side effects of the
drugs might have been the reason for your defaulting in not taking your medications
properly.

Dear friend, First of all I am glad that you mentioned that you fear the Virus,
because if one has understood how bad the virus is, then there is a good chance to
take the case seriously before things gone out of hand.

Secondly, based on your health situation (i.e. your Viral load, CD4 count and Stage
of your illness) before starting your medication, your physician has started you with
the Anti-retroviral drugs. Although you did not mention your health condition
currently, missing your doses have some meager consequences, to mention the
important negative consequences resulting from missing doses,

A. The longer the time you miss your medication, the higher the chance for the virus
to mutate into a new drug resistance variant, this means your drugs will no more be
effective to hold the virus from multiplying and this leads to treatment failure ending
up in developing to the stage of AIDS, which again need new drugs with multiple
side effects which you will not need to have it.

B. Depending on where you are leaving, the chance of getting new second-line
ARV's may also be difficult (if you are leaving in developing countries like Ethiopia
your chance of getting it will be less) and the need for additional drug resistance
study in laboratory makes life difficult.
C. Once you have failed with certain types of ARV drugs narrows your feature
chance of getting better drugs to effectively control the viral multiplication and
recovery of your CD4 level.
D. Most of the second line drugs have also long term unwanted adverse effects
such as developing high cholesterol, diabetes, hypertension and heart diseases,
though not always and not for every body.

Thus let me conclude saying that even though you have HIV now, there is still a
room to stop the development of drug resistant virus by strictly following your
medication schedule as advised by your physician.
But the way forward is to get advise from your physician by telling him openly that
you are not taking your medications as prescribed and your reasons for not taking
it, then he will consider simplifying your drug regimen and making your drugs
suitable for you so that your compliance will improve and your health situation will
progress in a good way.
For people who forget their medication there is a special watch to use to remind you
taking your medication on the time you want to take it, or use your mobile phone as
an alarm to be reminded. If your problem is linked to the timing of your medication,
like taking your medication late night or too early in the morning then you can shift it
to an ideal time that is suitable for you, the only thing is the difference in time
between the two doses of medication should be 12 hours if you are taking twice
daily (BID).
Finally, please feel free to raise more questions if you have any.

With regards,
Dr. Gerageru

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