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He Medical Clinic

Next Steps After an HIV Positive Test in Malaysia: Your Guide

Testing positive for HIV often leaves a person overwhelmed with questions and concerns. It’s important to remember that HIV can be treated effectively with HIV medicines.


Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. HIV medicines help people with HIV live longer, healthier lives and reduce the risk of HIV transmission.


If you don’t get treatment right away, the virus will continue to weaken your immune system and put you at risk for opportunistic infections, which can be fatal.


The first step after testing positive for HIV is to see a health care provider, even if you don’t feel sick. Prompt medical care and treatment with HIV medicines as soon as possible is the best way to stay healthy.

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Which lab tests are used to make decisions about HIV treatment?

A health care provider reviews a person’s lab test results to:
  • Determine how far the person’s HIV infection has advanced (called HIV progression)

  • Decide which HIV medicines to recommend


What is the process of treating HIV?

A person living with HIV may have to visit the doctor frequently at the beginning of treatment to have blood tests done. This is done to ensure that the patient is responding well to treatment. Once a patient has reached a state of stability, visits to the doctor can be as infrequent as once a year or even less frequently. During these sessions, the doctor will perform a variety of tests.

The HIV Viral Load test and the CD4 Cell Count test are the two most common testing performed.

  • HIV Viral Load


The HIV Viral Load test determines the number of HIV viruses in each millilitre of a patient’s blood. We rarely find any HIV virus in the blood of patients who take their HIV treatment on a regular basis. This level of undetectable viral load indicates that the patient is receiving appropriate treatment and that the HIV infection is under control.

  • CD4 Cell Count


Doctors use the CD4 Cell Count test to determine the health of the immune system. The higher the number, the better the immune system of a person. The CD4 Cell Count of HIV patients frequently rises slowly as treatment progresses. The CD4 Cell Count, however, can be affected by a variety of causes, including various illnesses. As a result, we expect it to change from time to time. Do not panic if your CD4 count drops a little and consult with your doctor to look out for the possible causes.


To determine your response to HIV medication, your doctor will track your viral load and CD4 cell counts. These will be checked every three to six months at first, then every one to two years.

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Why is HIV treatment important?

Getting and staying on HIV treatment is very important as it lowers the amount of HIV virus in your blood or what is known as viral load.

HIV-positive people who take their medication as directed and maintain an undetectable viral load have virtually minimal chance of sexually transferring the virus to their HIV-negative partners which is known as UVLHIV (UNDETECTABLE VIRAL LOAD HIV)


HIV destroys your immune system if you don’t get treatment, and it can lead to a variety of life-threatening illnesses and malignancies. You’re at danger of contracting an opportunistic infection if your CD4 cell count drops below a certain threshold.

There are illnesses that ordinarily do not harm those with healthy immune systems, but can infect people whose immune systems have been damaged by HIV. Your doctor may prescribe medications to help you avoid these infections.


When you know what to expect from your HIV treatment and are committed to taking your medications exactly as prescribed, the treatment is more likely to be effective. Working with your health-care provider to build a treatment plan will assist you in learning more about HIV and effectively managing it.


How to treat HIV?

Previously, HIV treatment consisted of a variety of medicines. A person living with HIV had to take a lot of pills every day. This heavy tablet load was frequently a source of anxiety. Patients also had a hard time remembering which tablet to take at what time.

HIV therapy has now been simplified to as little as one tablet per day. This considerably boosts a person’s ability and willingness to comply with therapy, making them more likely to take it on a regular basis and thus control their HIV infection and stay healthy.


Previously, HIV treatment was reserved for people whose immune systems had already been shown to be severely compromised. Now, on the other hand, antiretroviral treatment is started as soon as possible. This is because scientific studies have shown that starting HIV treatment early leads to significantly better health outcomes for HIV patients.

Antiretroviral medications can be classified into several types which include:
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs): turn off a protein that HIV uses to replicate itself. E.g.: efavirenz (Sustiva), rilpivirine (Edurant) and doravirine (Pifeltro).

  • Nucleoside or nuclueotide reverse transcriptase inhibitors (NRTIs): they are the false versions of the building blocks required for the virus to make copies of itself. E.g.: tenofovir (Viread), emtricitabine (Emtriva). Combination of drugs are available as well such as emtricitabine/tenofovir (Truvada) and emtricitabine/tenofovir alafenamide (Descovy).

  • Protease inhibitors (PIs): these drugs inhibit a protein that HIV uses to replicate which is HIV protease. E.g.: lopinavir/ritonavir (Kaletra).

  • Integrase inhibitors: they work by inactivating a protein integrase which is essential for HIV to insert its genetic materials into CD4 cells. E.g.: raltegravir (Isentress) and dolutegravir (Tivicay).


Does ART have any side effects?

Antiretroviral therapy (ART), like most drugs, can produce negative effects. ART, on the other hand, does not cause adverse effects in everyone. Today’s HIV drugs have fewer adverse effects, experienced by fewer people, and are milder than in the past. Each type of ART treatment has its own set of side effects, which might vary from person to person.

Some of the most commonly reported side effects of ART include:

  • Nausea

  • Vomiting

  • Diarrhea

  • Difficulty to sleep

  • Dry mouth

  • Headache

  • Dizziness

  • Fatigue

  • Development of rashes


If you have severe adverse effects or wish to stop taking your HIV medicine, talk to your health care provider or pharmacist before missing any doses or stopping the drug. Drug resistance can develop as a result of skipping doses or abruptly starting and stopping medicine, putting your health at risk and limiting your treatment options in the future.

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