World AIDS Day, 2017

1. Prevention
S and
control of
Hiv/aidS
AFREEN USMANIAFREEN USMANI
Research Scholar,Research Scholar,
Faculty of Pharmacy,Faculty of Pharmacy,
Integral University,Integral University,
LucknowLucknow

2. Percent of HIV transmissionPercent of HIV transmission
routes, 2015-16routes, 2015-16
Note: HIV is not transmitted by casual contacts.
Unsterilized needles
for tattooing

3. Preventions for HIV-negative
person
HIV/AIDS awareness: “Know HIV, No AIDS”.
Educate yourself and others.
Know the HIV status of any sexual partner.
Use a new latex or polyurethane condom every time you have sex.
Consider male circumcision.
Use a clean needle.
Be cautious about blood products.
Health care workers should wear latex gloves, eye protection and other personal
protective equipment in order to avoid contact with blood or with fluids.
Get regular screening tests.

4. Control for HIV-positiveControl for HIV-positive
individualindividual
Follow safe-sex practices.
Tell your sexual partners you have HIV.
Don't share needles or syringes.
Don't donate blood or organs.
Don't share razor blades or toothbrushes.
If you're pregnant, get medical care right now.
WHO recommends immunization of asymptomatic HIV infected children
with the EPI vaccines; those who are symptomatic should not receive BCG
vaccine.
You should start antiretroviral medication immediately.
*EPI: Expanded Program on Immunization

5. Goals of AntiretroviralGoals of Antiretroviral
Therapy (ART)Therapy (ART)
 Reduce HIV-associated morbidity
and prolong the duration and
quality of survival.
Restore and preserve immunologic
function.
Maximally suppress plasma HIV
viral load.
Prevent HIV transmission.

6. WHO: ART Guidelines,WHO: ART Guidelines,
20152015
*WHO: World Health Organization
New recommendations on when to
start ART now support ART initiation in all
adults, adolescents and children with HIV at
any CD4 cell count or disease stage.

7. Anti retroviralAnti retroviral
therapytherapy
NRTI's: Nucleoside Reverse Transcriptase Inhibitors, NNRTI's: Non-Nucleosides Reverse Transcriptase
Inhibitors, PI's: Protease Inhibitors

8. HAART Regimens
FIRST LINE
2NRTI+ 1NNRTI
PREFFERED
REGIMEN TDF + 3TC
(or FTC) + EFV
SECOND LINE
8
2NRTI+ RITONAVIR
BOOSTED PI
PREFFERED
REGIMEN TDF + 3TC
(or
FTC) + ATV/RTV
THIRD LINE
INTEGRASE
INHIBITOR+2ND
GENERATION
NNRTI+ PI
PREFFERED
REGIMEN
RAL +ETV+RTV/DRV
The use of 3 or more anti-HIV drugs from at least 2 different class with the aim of
achieving long lasting viral suppression is known as Highly Active Antiretroviral
Therapy (HAART).
HAART decreases the patient's total burden of HIV, maintains function of
the immune system, and prevents opportunistic infections that often lead to death.

9. Pre and Post exposurePre and Post exposure
prophylaxisprophylaxis
Pre-exposure prophylaxis
• PrEP is a way for people
who do not have HIV, but
who are at risk of getting it.
• PrEP with a daily dose of the
medications tenofovir, with
or without emtricitabine, is
effective.
Post-exposure Prophylaxis
PoEP has greatest effect if begun
within <72 hrs of exposure.
Basic (2 drugs)
regimen
For low risk
Zidovudine300 mg +
lamivudine 150 mg
Twice daily for 4
weeks
Expanded (3 drugs)
regimen
For high risk
Zidovudine 300 mg +
Lamivudine 150 mg
+
Indinavir 800 mg
Twice daily
Thrice daily
All for 4 weeks

10. ART centersART centers
• In order to make treatment more accessible and free of cost,
ART centers are located in medical colleges, district hospitals
and non-profit charitable institutions for providing care,
support and treatment services to PLHA.
• There are 528 ART centers operating in India (2016).
Dr. R. M. L.Hospital, Gomtinagr,
Lucknow
Deptt. of Medicine KGMU, Lucknow

11. Future Anti retroviralFuture Anti retroviral
drugsdrugs
COMPOUNDS CATEGORY
Dolutegravir plus rilpivirine
(Coformulation)
INSTI plus NNRTI
Albuvirtide Long acting fusion inhibitor
COMPOUNDS CATEGORY
BMS-955176 Maturation inhibitor
Apricitabine NRTI
PRO140 CCR5-specific humanized monoclonal
antibody
Ibalizumab (TMB-355) CD4-specific Humanized IgG4
monoclonal antibody
Cabotegravir oral and long acting
formulations
INSTI
Cenicriviroc (TBR-652) CCR5 inhibitor
Phase1Phase2
INSTI : Integrase strand transfer inhibitor, CCR5: chemokine receptor 5

12. COMPOUNDS CATEGORY
Tenofovir alafenamide fumarate (TAF) NtRTI
(tenofovir prodrug)
Doravirine (MK- 1439) NNRTIs
Elvucitabine NRTI
Bevirimat Maturation inhibitors
Vicriviroc CCR-5 inhibitors
Fostemsavir (BMS-663068) Attachment inhibitor (gp 120)
Phase 3
*CCR5: chemokine receptor 5
The number of HIV Vaccine are under clinical trials (2017):
Source:
AVAC.org
Phase III: (1)
AIDSVAX
Phase II: (11) Phase I: (16)

13. NEEDSNEEDS
In general
• Continuous surveillance.
• Awareness programmes.
• Increase health care allocations.
• Identification of high risk groups.
• Access to treatment for all.
• Removal of stigma and
discrimination.

14. NEEDSNEEDS
Based on Research
• We need some different ways to treat HIV/AIDS are:
Gels, foams or creams
that people can use in
vagina or rectum
during sex to prevent
HIV transmission
Currently, there is no
vaccine to prevent
HIV, this would be the
best long term hope for
ending HIV
Based on the concept
that blocking HIV’s
ability to multiplying
may prevent the
infection
Microbicides Vaccines Pre-exposure
prophylaxis

15. Support People Living with HIV/AIDS.Support People Living with HIV/AIDS.
Know HIV, No AIDSKnow HIV, No AIDS
,