This decrease in AIDS morbidity and mortality has mainly been associated with the use of protease inhibitors as part of potent triple, sometimes quadruple combinations of anti-HIV medications. The Department of Health and Human Services and the International AIDS Society Treatment Guidelines suggest that any individual who has a detectable level of HIV should initiate a potent antiretroviral regimen. Even though they provide several options for initial combinations of medications, it is not clear at this time with which combination of antiretrovirals a person should start. It has been documented that starting antiretroviral therapy early on is more likely to control the replication of HIV for a prolonged period of time and help preserve the functioning of the immune system. In contrast, initiation of therapy is usually associated with side effects and an increase in the possibility of someone's quality of life becoming worse.
Adherence is extremely important.
If a person is not able to adhere, he or she might be better off waiting than starting therapy. Not all the information related to the long-term side effects of regimens containing protease inhibitors is in yet. More and more reports are coming to light regarding the high incidences of hyperglycemia, diabetes, high levels of cholesterol, abnormal fat distribution and other conditions. Because of all cited above, many are considering the initiation of therapy with a combination of medications that does not include a protease inhibitor. These type of regimens are known as protease-sparing regimens.