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Treatment for HIV infection
This document discusses various methods for preventing and treating HIV, including: 1) Safe sex practices and male circumcision to prevent transmission. Screening blood donors and treating mothers and babies can also reduce mother-to-child transmission. 2) Pre-exposure prophylaxis with antiretroviral drugs like tenofovir may prevent new infections. 3) Post-exposure prophylaxis within 72 hours of exposure can reduce risk if started quickly. 4) Highly active antiretroviral therapy using combinations of antiretroviral drugs can suppress the virus and allow immune recovery.
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Treatment for HIV infection
- 1. PROHYLAXIS &TREATMENT HIV HIV YOGASRINIVAS ANANTHA
- 2. Transmission prevention / Safersex Abstinence from sexual relations use of condoms Male circumcision sexual Avoidance of sharing of needles and other paraphernalia Avoiding sterile needles IDA’S Screening of all blood donors for HIV Antibody nucleic acid in addition clotting factor concentrates are heat treated, essentially eliminating the risk to haemophiliacs who require these products. BloodMTCT AZT (reduces risk by 3 fold) Mother @before delivery Baby @6 weeks NEOVIRAPINE (reduce transmission by 50%) Mother @at onset of labour Neonate @1st three days HIV
- 3. PRE EXPOSURE PROPHYLAXIS Anew strategy? 2011& 2012 results support this – TENOFOVIR It prevented HIV transmission & new infections HIV
- 6. Effectiveness of PEPdepends on…. • Efficacy of PEP is best if administered within two hours of exposure. • PEP need to be given within 72 hours of exposure. • Do not delay PEP while waiting for result of HIV testing. • Informed consent must be obtained before testing a source as per National guidelines. • Base line rapid HIV testing before PEP. • Negative result does not exclude HIV infection. • Positive HIV result helps in stopping the PEP
- 7. TOPICAL MICROBICIDES Reports from2010 research A candidate vaginal gel containing the antiviral drug TENOFOVIR reduced HIV acquisition by 39% HIV
- 8. VACCINES AGAINST HIV Allcandidate vaccines tested as of 2011 proved ineffective at preventing infection. One goal of vaccine research is to design “IMMUNOGENS” HIV
- 9. GENE THERAPY BEING DEVELOPEDTO ACHIEVE “INTRA-CELLULAR IMMUNISATION” HIV
- 10. HEALTH EDUCATION It playsan important role and important part of prophylaxis HIV
- 11.
- 12. ANTI RETRO VIRALTHERAPY • GOALS • CLINICAL GOALS • VIROLOGICAL GOALS • IMMUNOLOGICAL GOALS • THERAPEUTIC GOALS • REDUCTION OF HIV TRANSMISSION IN INDIVIGUALS
- 13. FUSION INHIBITORS @2003 ENTRYINHIBITORS @2007 INTERGRASE INHIBITORS @2007 ANTIVIRAL DRUGS HIV Nucleoside & Non nucleoside inhibitors of viral enzyme Inhibitors of viral “PROTEASE ENZYME”
- 23. HAART HIGHLIGHTES: • It oftencan suppress viral replication below the limits of detection in plasma • Decreases the viral load in lymphoid tissues • Allow the recovery of immune response's HIV
- 24. Recommended choices offirst-line regimens • Principles for selecting the first-line regimen • 1. Choose 3TC (lamivudine) in all regimens • 2. Choose one NRTI to combine with 3TC (AZT or d4T) • 3. Choose one NNRTI (NVP or EFV) • First choice: AZT + 3TC + NVP • for patients with Hb > 8 g/d Substitute NVP with EFV, for patients with TB or toxicity to NVP
- 25. What to Expectin the First Six Months of Therapy CD4 recovery Early ARV toxicity IRIS
- 26. IRIS • “occurrence ormanifestations of new OIs or existing OIs within six weeks t six months after initiating ART; with an increase in CD4 count”.
- 27. Drug resistant variantsin treatment of naïve patients A NEW CHALLENGE ??? In 2004 & 2005; patients with newly diagnosed HIV were found to carry drug resistant mutants 8% and10% of cases in USA & Europe respectively. Infants (PI) USA 2002, 19% - Resistant mutants HIV
- 28. COMBINATION THERAPY A BOON!! CTturned HIV infection in to chronic treatable disease Highlights: • Suppression of viral replication can be achieved • Restoration of immune function DRAWBACKS HIV ZIDOVUDINE + LAMIVUDINE Combivir ZIDOVUDINE + ABACAVIR Epzicom ZIDOVUDINE + LAMIVUDINE + ABACAVIR Trizivir TENOFOVIR + EMTRICITABINE Truveda TENOFOVIR + EMTRICITABINE + EFAVIRENZ Atripla STAVUDINE + LAMIVUDINE + NEVIRAPINE Triomune COMBINATION FORMULATION