SEXUALLY TRANSMITTED DISEASE(AIDS), STD's, communicable disease, reverse transcriptase enzyme,HIV

1. Dr. B.Venkata SubbareddyPharm.D
Asst.Professor
Sri Lakshmi Venkateswara Pharmaceutical Sciences, Proddatur

5. AIDS
(Acquired Immune Deficiency syndrome)
• Acquired: means you
can get infected with it
• Immune Deficiency:
means a weakness in the
body's system that fights
diseases.
• Syndrome: means a
group of health
problems that make up
a disease

6. Percentage of Peoples Affected

8. Introduction
AIDS is caused by HIV
infection and is
characterized by a severe
reduction in CD4+ T
cells, which means an
infected person develops
a very weak immune
system and becomes
vulnerable to contracting
life-threatening
infections

13. Common Symptoms
• Pain areas: in the abdomen
• Pain circumstances: can occur while swallowing
• Cough: can be dry
• Whole body: fatigue, fever, loss of appetite, malaise, night
sweats, or sweating
• Gastrointestinal: nausea, persistent diarrhoea, vomiting, or
watery diarrhoea
• Mouth: ulcers or white tongue
• Groin: sores or swelling
• Throat: difficulty swallowing or soreness
• Also common: opportunistic infection, headache, oral thrush,
pneumonia, red blotches, severe unintentional weight loss, skin
rash, or swollen lymph nodes

14. Mode of Transmission

15. First Stage: Acute HIV Infection
Most people don't know right away when they've been infected with HIV, but a short
time later, they may have symptoms. This is when your body's immune system puts up
a fight, typically within 2 to 6 weeks after you've gotten the virus. It's called acute
retroviral syndrome or primary HIV infection.
The symptoms are similar to those of other viral illnesses, and they're often compared
to the flu. They typically last a week or two and then completely go away. They
include:
Headache Diarrhea
Nausea and vomiting Fatigue
Aching muscles Sore throat
Swollen lymph nodes Fever
Doctors can now prevent HIV from taking hold in your body if they act quickly. People
who may have been infected -- for example, had unprotected sex with someone who is
HIV-positive -- can take anti-HIV drugs to protect themselves. This is called PEP. But
you must start the process within 72 hours of when you were exposed, and the
medicines can have unpleasant side effects.

16. Second Stage: Chronic HIV Infection
After your immune system loses the battle with HIV, the flu -like
symptoms will go away.
 Doctors may call this the asymptomatic or clinical latent period. Most
people don't have symptoms you can see or feel. You may not realize
you're infected and can pass HIV on to others. This stage can last 10
years or more.
During this time, untreated HIV will be killing CD4 T-cells and
destroying your immune system. Your doctor can check how many you
have with blood tests (normal counts are between 450 and 1,400 cells per
microliter). As the number drops, you become vulnerable to other
infections.
Fortunately, a combination, or "cocktail," of medications can help fight
HIV, rebuild your immune system, and prevent spreading the virus. if
you're taking medications and have healthy habits, your HIV infection
may not progress further.

17. Third Stage: AIDS
AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell
number drops below 200. You can also be diagnosed with AIDS if you have an "AIDS
defining illness" such as Kaposi's sarcoma (a form of skin cancer) or
pneumocystis pneumonia (a lung disease).
If you didn't know you were infected with HIV earlier, you may realize it
after you have some of these symptoms:
Being tired all of the time Swollen lymph nodes in your neck
Fever that lasts for more than 10 days Night sweats
Purplish spots on your skin that don't go away Unexplained weight loss
Shortness of breath Severe, long-lasting diarrhea
Yeast infections in your mouth, throat, or vagina
bleeding you can't explain
People with AIDS who don't take medication only survive about 3 years,
even less if they get a dangerous infection. But with the right treatment
and a healthy lifestyle, you can live a long time.

21. Treatment
• Antiretroviral therapy (ART) is the use of HIV medicines to
treat HIV infection. People on ART take a combination of
HIV medicines (called an HIV treatment regimen) every day.
ART is recommended for everyone who has HIV. ART
can't cure HIV, but HIV medicines help people with HIV live
longer, healthier lives.
• Abacavir , or ABC (Ziagen)
• Didanosine, or ddl (Videx)
• Emtricitabine, or FTC (Emtriva)
• Lamivudine, or 3TC ( Epivir)
• Stavudine, or d4T (Zerit )
• Tenofovir alafenamide, or TAF (Vemlidy)
• Tenofovir disoproxil fumarate, or TDF (Viread),
• Zidovudine or ZDV (Retrovir)

22. Medications

23. • Nucleoside/Nucleotide
Reverse Transcriptase
Inhibitors (NRTIs)
• NRTIs force the HIV virus to
use faulty versions of
building blocks so infected
cells can't make more HIV.
• Abacavir, or ABC (Ziagen)
• Didanosine, or ddl (Videx)
• Emtricitabine, or FTC
(Emtriva)
• Lamivudine, or 3TC (Epivir)
• Stavudine, or d4T (Zerit)
• Tenofovir alafenamide, or
TAF (Vemlidy)
• Tenofovir disoproxil
fumarate, or TDF (Viread),
• Zidovudine or ZDV
(Retrovir)
• Non-nucleoside Reverse
Transcriptase Inhibitors
(NNRTIs)
• These are also called "non-
nukes." NNRTIs bind to a
specific protein so the HIV
virus can't make copies of
itself, similar to jamming a
zipper.
• Delavirdine or DLV
(Rescripor)
• Doravirine, or DOR (Pifeltro)
• Efavirenz or EFV (Sustiva)
• Etravirine or ETR (Intelence)
• Nevirapine or NVP (Viramune)
• Rilpivirine or RPV (Edurant)

24. Protease Inhibitors (PIs)
• These drugs block a protein
that infected cells need to put
together new HIV virus
particles.
• Atazanavir or ATV (Reyataz)
• Darunavir or DRV (Prezista)
• Fosamprenavir or FPV
(Lexiva)
• Indinavir or IDV (Crixivan)
• Lopinavir + ritonavir, or
LPV/r (Kaletra)
• Nelfinavir or NFV (Viracept)
• Ritonavir or RTV (Norvir)
• Saquinavir or SQV
(Invirase, Fortovase)
• Tipranavir or TPV (Aptivus)
Fusion Inhibitors
• Unlike NRTIs, NNRTIs, and
PIs -- which work on infected
cells -- these drugs help block
HIV from getting inside
healthy cells in the first place.
• Enfuvirtide, or ENF or T-20
(Fuzeon)

25. CCR5 Antagonist
Maraviroc, or MVC (Selzentry), also
stops HIV before it gets inside a
healthy cell, but in a different way
than fusion inhibitors. It blocks a
specific kind of "hook" on the outside
of certain cells so the virus can't plug
in.
Monoclonal Antibody
• This is a new class of antiviral medication
specifically for adults living with HIV who
have tried multiple HIV medications and
whose HIV has been resistant to current
available therapies. Ibalizumab-
uiyk (Trogarzo) blocks your body’s HIV
infected cells from spreading the virus into
those which are uninfected. It is administered
by IV.
• Cobicistat (Tybost)
• Atazanavir + cobicistat, or ATV/c (Evotaz)
• Darunavir + cobicistat, or DRV/c (Prezcobix)
• Elvitegravir + TDF + FTC + cobicistat, or
EVG/c/TDF/FTC (Stribild)
• Elvitegravir + TAF + FTC + cobicistat, or
EVG/c/TAF/FTC (Genvoya)
Integrase Inhibitors
• These stop HIV from making
copies of itself by blocking a
key protein that allows the virus
to put its DNA into the healthy
cell's DNA. They're also called
integrase strand transfer
inhibitors (INSTIs).
• Bictegravir or BIC (combined
with other drugs as Biktarvy)
• Dolutegravir or DTG (Tivicay)
• Elvitegravir or EVG (Vitekta)
• Raltegravir or RAL (Isentress)

27. Prevention
Preventing OIs is key to extending life expectancy with late-stage HIV. Aside from
managing HIV viral load with medications, a person who lives with the disease must
take precautions, including the following steps:
Wear condoms to prevent other STIs.
Receive vaccinations for potential OIs. Discuss these with your
primary care physician.
Understand the germs in your surrounding environment that could lead
to an OI. A pet cat, for example, could be a source of toxoplasmosis.
Limit exposure and take precautions, such as wearing protective gloves
while changing litter
Avoid foods that are at risk of contamination, such as undercooked
eggs, unpasteurized dairy and fruit juice, or raw seed sprouts.
Do not drink water straight from a lake or river or tap water in certain
foreign countries. Drink bottled water or use water filters.
Ask your doctor about work, home, and vacation activities to limit
exposure to potential OIs.
Antibiotic, antifungal, or antiparasitic drugs can help treat an OI.