Regarding Awareness of prevention & spreading of HIV/ AIDS

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. HIV/AIDSHIV/AIDS
HIV is “Human Immunodeficiency Virus”, it is the virus that
cause AIDS (Acquired Immunodeficiency Syndrome).
HIV Infection
Progressive deterioration of the
immune system
Breaking down the body's ability
to fight out infections & diseases
by opportunistic infections.
HIV-Infected T- cells
2

3. Status of HIV epidemic inStatus of HIV epidemic in
IndiaIndia
World Population: 7124
million.
People Living with HIV/AIDS
(PLHA): 33 million.
India Population: 1324 million
(2016).
New infections in India have
fallen to 80,000 in 2016 from
150,0 00 in 2005.
India remains the country with
the third largest population of
people with HIV after South
Africa and Nigeria.

4. Natural History of HIV InfectionNatural History of HIV Infection
IncubationPeriods2-10yrs

5. Percent of HIV transmissionPercent of HIV transmission
routes, 2015-16routes, 2015-16

6. HIV is not Transmitted byHIV is not Transmitted by
• Coughing, sneezing
• Insect bites
• Touching, hugging
• Water, food
• Kissing
• Public baths
• Handshakes
• Work or school contact
• Using telephones
• Sharing cups, glasses,
plates, or other utensils.

7. Opportunistic InfectionsOpportunistic Infections
Associated With AIDSAssociated With AIDS
Mycobacterium
tuberculosis
Herpes zoster
Toxoplasmosis
Oral candidiasis Histoplasmosis
Herpes simplex
virus
Human
Papilloma Virus
Mucormycosis

8. Breaking the Chain ofBreaking the Chain of
TransmissionTransmission
HIV-negative Individual prevention:
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.
• Get regular screening tests.
HIV positive individual prevention:
Follow safe-sex practices.
Application of a vaginal gel containing
tenofovir.
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.
You should start antiretroviral medication
immediately.

9. 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.

10. Treatments (ART)Treatments (ART)
NRTI's: Nucleoside Reverse Transcriptase Inhibitors, NNRTI's: Non-Nucleosides Reverse Transcriptase
Inhibitors, PI's: Protease Inhibitors

11. DHHS ART GuidelinesDHHS ART Guidelines
*DHHS: Department of Health and Human Services, 2017
Recent guidelines support earlier treatment and recommend that a CD4 count of
350/μL is the lowest count to begin ART.
Symptomatic Asymptomatic
CD4 < 350/μL CD4 > 350/μL
Individualized treatment
-Active TB
-Pregnancy , to prevent perinatal
transmission
-HIV- associated nephropathy ,
-Hepatitis B or C co-infection.
ART recommended

12. HAART Regimens
FIRST LINE
2NRTI+ 1NNRTI
PREFFERED
REGIMEN TDF +
3TC (or FTC) + EFV
SECOND LINE
12
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
*HAART (Highly Active Antiretroviral

13. Pre and Post exposurePre and Post exposure
prophylaxisprophylaxis
Pre-exposure prophylaxis
• Antiretroviral treatment among
people with HIV whose CD4
count ≤ 550 cells/μL is a very
effective way to prevent HIV
infection of their partner.
• PrEP with a daily dose of the
medications tenofovir, with or
without emtricitabine, is
effective.
Post-exposure Prophylaxis
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

14. Anti HIV agents underAnti HIV agents under
Clinical trialsClinical trials
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

15. COMPOUNDS CATEGORY
Tenofovir alafenamide fumarate (TAF) NtRTI
(tenofovir prodrug)
Doravirine (MK- 1439) NNRTIs
Elvucitabine NRTI
Bevirimat Maturation inhibitors
Vicriviroc CCR-5 #
Fostemsavir (BMS-663068) Attachment inhibitor (gp 120)
Phase 3

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

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