This document summarizes research on adverse drug reactions (ADRs) experienced by patients taking highly active antiretroviral therapy (HAART) to treat HIV/AIDS. Several studies cited found that the most common ADRs were anemia, hepatotoxicity, gastrointestinal issues, hematological issues, neurological issues, and skin problems. Risk factors for ADRs included CD4 count below 200 cells/μl, female gender, tuberculosis co-infection, and hepatitis C co-infection. While ADR rates were high, some studies found they did not often lead to HAART interruptions. Overall the document examines the incidence and types of ADRs experienced on HAART as well as risk factors. Close patient monitoring
Highly Active Antiretroviral Therapy (HAART) involves using a combination of at least three antiretroviral drugs to suppress the HIV virus and stop the progression of HIV disease. HAART decreases the viral load, improves immune function, and prevents opportunistic infections. The goals of HAART are to prolong life, improve quality of life, achieve maximal viral suppression, restore immune function, reduce HIV transmission, and rationally sequence drugs to limit toxicity while maintaining treatment options. Current guidelines recommend starting ART for all individuals regardless of CD4 count. Second line regimens are recommended when clinical or immunological failure occurs on first line therapy. Managing adverse events and comorbidities like hepatitis co-infection is also
The document discusses the goals of antiretroviral (ART) therapy in India, which include improving quality of life, reducing HIV-related illness and mortality, and maximally suppressing viral load. It outlines the classes of drugs used for ART, including reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, and fusion inhibitors. The national program in India provides several first-line drug combinations. Principles for selecting first-line regimens include using lamivudine and choosing one NRTI and one NNRTI. Routine monitoring of ART patients and recommendations for treating HIV-infected pregnant women are also covered.
An overview of the acquired immune deficiency syndrome (AIDS) caused by the human deficiency virus (HIV) and the drugs used for its treatment, including a classification of the established drugs, the HAART regimen, and investigational approaches
This document provides guidelines for the management of persons living with HIV, including recommendations for antiretroviral therapy (ART). It discusses the goals of ART which are to suppress HIV viral load, improve CD4 counts, delay drug resistance, and confer clinical benefits. Initiation of ART is recommended for all individuals regardless of CD4 count to reduce morbidity and mortality and prevent transmission. First-line regimens usually consist of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (INSTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor (PI) with a booster. Adherence counseling and management of comorbid
This document discusses HAART (Highly Active Antiretroviral Therapy) for treating HIV. It describes the goals of ART in reducing morbidity and prolonging survival. It classifies antiretroviral drugs into five types that inhibit HIV enzymes or block viral entry. Common first line regimens are described along with guidelines for monitoring patients and changing therapy. It also outlines recommendations for preventing opportunistic infections in HIV-infected individuals.
This is a presentation of Anti-Retroviral Therapy (ART) guidelines for HIV infection by the World Health Organization (WHO) updated as of December 2018.
The document provides information about HIV/AIDS, including:
1) It describes what HIV and AIDS are, how HIV causes AIDS by compromising the immune system over time.
2) It provides statistics on HIV infections in the US since 1981, including that 1 in 5 people living with HIV are unaware of their status.
3) It summarizes research showing that HIV likely originated from transmission from chimpanzees to humans in the early 20th century.
4) It lists symptoms that can emerge when HIV progresses to AIDS and compromises the immune system.
This document discusses various challenges in using antiretroviral drugs to treat HIV, including factors related to the virus, the drugs, and the host. It covers existing drug classes like nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors. It also introduces new drug classes in development, such as entry inhibitors that target chemokine receptors or fusion. While antiretroviral treatment has improved life for many, ongoing research aims to address ongoing challenges like toxicity, resistance, and management of lifelong therapy.
Highly Active Antiretroviral Therapy (HAART) involves using a combination of at least three antiretroviral drugs to suppress the HIV virus and stop the progression of HIV disease. HAART decreases the viral load, improves immune function, and prevents opportunistic infections. The goals of HAART are to prolong life, improve quality of life, achieve maximal viral suppression, restore immune function, reduce HIV transmission, and rationally sequence drugs to limit toxicity while maintaining treatment options. Current guidelines recommend starting ART for all individuals regardless of CD4 count. Second line regimens are recommended when clinical or immunological failure occurs on first line therapy. Managing adverse events and comorbidities like hepatitis co-infection is also
The document discusses the goals of antiretroviral (ART) therapy in India, which include improving quality of life, reducing HIV-related illness and mortality, and maximally suppressing viral load. It outlines the classes of drugs used for ART, including reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, and fusion inhibitors. The national program in India provides several first-line drug combinations. Principles for selecting first-line regimens include using lamivudine and choosing one NRTI and one NNRTI. Routine monitoring of ART patients and recommendations for treating HIV-infected pregnant women are also covered.
An overview of the acquired immune deficiency syndrome (AIDS) caused by the human deficiency virus (HIV) and the drugs used for its treatment, including a classification of the established drugs, the HAART regimen, and investigational approaches
This document provides guidelines for the management of persons living with HIV, including recommendations for antiretroviral therapy (ART). It discusses the goals of ART which are to suppress HIV viral load, improve CD4 counts, delay drug resistance, and confer clinical benefits. Initiation of ART is recommended for all individuals regardless of CD4 count to reduce morbidity and mortality and prevent transmission. First-line regimens usually consist of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (INSTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor (PI) with a booster. Adherence counseling and management of comorbid
This document discusses HAART (Highly Active Antiretroviral Therapy) for treating HIV. It describes the goals of ART in reducing morbidity and prolonging survival. It classifies antiretroviral drugs into five types that inhibit HIV enzymes or block viral entry. Common first line regimens are described along with guidelines for monitoring patients and changing therapy. It also outlines recommendations for preventing opportunistic infections in HIV-infected individuals.
This is a presentation of Anti-Retroviral Therapy (ART) guidelines for HIV infection by the World Health Organization (WHO) updated as of December 2018.
The document provides information about HIV/AIDS, including:
1) It describes what HIV and AIDS are, how HIV causes AIDS by compromising the immune system over time.
2) It provides statistics on HIV infections in the US since 1981, including that 1 in 5 people living with HIV are unaware of their status.
3) It summarizes research showing that HIV likely originated from transmission from chimpanzees to humans in the early 20th century.
4) It lists symptoms that can emerge when HIV progresses to AIDS and compromises the immune system.
This document discusses various challenges in using antiretroviral drugs to treat HIV, including factors related to the virus, the drugs, and the host. It covers existing drug classes like nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors. It also introduces new drug classes in development, such as entry inhibitors that target chemokine receptors or fusion. While antiretroviral treatment has improved life for many, ongoing research aims to address ongoing challenges like toxicity, resistance, and management of lifelong therapy.
The document provides an overview of pharmacotherapy for HIV management. It discusses the HIV virus, pathophysiology of AIDS, classes of antiretroviral drugs including their mechanisms and side effects. It summarizes WHO 2013 guidelines for starting ART including preferred first and second line regimens for different populations. The guidelines define treatment failure and recommend third line regimens. The document concludes that lifelong ART with combination of minimum 3 drugs from 2 classes is required to control HIV replication.
Early initiation of haart why, when and how 21 juneanil kumar g
This document discusses guidelines for early initiation of HIV treatment. It recommends starting antiretroviral therapy (ART) for all people living with HIV, including pregnant and breastfeeding women, regardless of CD4 count or clinical stage. The benefits of early treatment include reduced progression to AIDS, lower rates of illness and death, and decreased HIV transmission. First-line ART regimens preferably include tenofovir, lamivudine and efavirenz. Viral load testing is the best way to monitor treatment response and detect treatment failure.
This document summarizes advances in HIV treatment including HAART and its complications. It discusses how HAART effectively suppresses HIV but can have toxicities over the long term such as body changes, metabolic abnormalities, and liver or bone complications. Adherence is critical for treatment success. Resistance testing helps address treatment failure and resistance. New drugs and strategies continue to be developed and treatment interruption remains experimental. Management requires weighing risks and benefits of therapy changes and treatment goals.
The document discusses HIV treatment goals, interventions, and guidelines. The goals are to prevent immune system deterioration, decrease coinfections, and ultimately decrease mortality rates. Primary care involves screening for other illnesses and monitoring viral loads and CD4 counts. Studies show mortality rates decreased from 7% to 1.3% from 1996 to 2004 due to antiretroviral therapy (ART). Guidelines recommend initiating ART when CD4 is below 500 or in special cases like coinfection or pregnancy. Future hopes include monoclonal antibodies, gene therapy, and stem cell transplants to provide resistance.
Anti retroviral therapy for Acquired Immunodeficiency Syndromesiva subramanian
This presentation included goals of antiretroviral therapy, ART regiments, side effects of individual drugs, ART is special population such as children, IRIS, post exposure prophylaxis, WHO clinical staging of AIDS, treatment failure, AIDS is acquired immunodeficiency syndrome, Anti Retroviral therapy, People Living with HIV and AIDS
The document discusses the pharmacotherapy of HIV/AIDS, including:
- Classification of antiretroviral drugs into NRTIs, NNRTIs, PIs, entry inhibitors, integrase inhibitors, and maturation inhibitors.
- Guidelines for starting antiretroviral therapy (ART) and recommendations for first and second line regimens.
- "Off label" uses of drugs like azithromycin, foscarnet, and hydroxyurea to treat opportunistic infections in HIV patients.
D1 Highly Active Antiretroviral Treatment (HAART) DHHS Guidelines 2009 DuffusDSHS
The document discusses guidelines for initiating highly active antiretroviral treatment (HAART) based on CD4 count and viral load. Guidelines from 1998-2009 increasingly recommended treating HIV at higher CD4 counts and without a specific viral load threshold. Studies show the magnitude of CD4 increase is greatest when starting HAART at low counts, but normalization is more likely the earlier therapy begins. A CD4 count below 350 cells/mm3 increases the risk of cardiovascular and other non-AIDS complications.
HIV AIDS is one of the most dreadful of all diseases. Newer drugs and drug combination are coming quite frequently. Attempts to design an HIV vaccine is also underway.
This seminar is my attempt this interesting topic with all the latest data I could collect on the internet.
MANAGEMENT OF HIV FALLS UNDER THREE MAJOR CATEGORIES
1.POST EXPOSURE PROPHYLAXIS(P.E.P)
2.TREATMENT/MANAGEMENT OF HIV-AIDS
3.TREATMENT OF ADJOINING CONDITIONS
eg-
-Fungal Infections
-Bacterial infections
-Viral infections
-NEOPLASIAS
-misc.( recurrent apthos ulcers, xerostomia,salivary G. enlargement)
This document discusses the management of AIDS. It provides an outline covering the epidemiology of HIV/AIDS in India, the HIV life cycle, clinical staging of HIV/AIDS, antiretroviral drugs and their mechanisms of action, guidelines for antiretroviral therapy, and post exposure prophylaxis. It then goes on to provide more detailed information on these topics, including statistics on HIV prevalence in India, the stages of natural HIV infection, WHO clinical staging criteria, classes of antiretroviral drugs and their mechanisms of action and side effects, recommended first-line antiretroviral regimens, and principles of antiretroviral therapy.
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.
This document summarizes HIV infection and treatment. It describes how HIV was identified in the 1980s as the cause of AIDS. HIV can be transmitted through bodily fluids. Left untreated, HIV weakens the immune system and allows opportunistic infections. Treatment aims to suppress the virus and restore immune function. Highly Active Antiretroviral Therapy (HAART) uses a combination of three antiretroviral drugs from two classes to control the virus. Guidelines recommend starting treatment based on CD4 count. The goals of treatment are to improve quality of life and prevent disease progression.
This document provides information on HIV/AIDS including:
- HIV is a retrovirus that causes AIDS by infecting CD4 cells. It can be managed but not cured.
- AIDS is the late stage of HIV infection when the immune system is severely damaged.
- The natural history of the virus is described from its discovery in 1981 through treatments developed.
- The virus's structure and life cycle involve invading cells and integrating its DNA for dormancy.
- Transmission occurs through bodily fluids like blood, semen, breastmilk. Testing and treatment can control spread.
The document discusses the history and management of HIV/AIDS. It describes the early treatments for HIV/AIDS and the development of highly active antiretroviral therapy (HAART). It then discusses the symptoms of HIV/AIDS and how the virus destroys CD4+ T cells. It provides details on diagnosing HIV and the replication cycle of the virus. The remainder of the document outlines the different classes of antiretroviral drugs used to treat HIV, including entry inhibitors, nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, integrase inhibitors, and protease inhibitors. It also discusses initiating antiretroviral therapy and considerations for special populations such as children,
This document provides an introduction to HIV treatment, including guidelines on when to start treatment, current treatment options, and tips for getting the most out of treatment. The key points are:
- Current guidelines recommend antiretroviral therapy (ART) for all HIV-positive individuals, especially those with a CD4 count below 350 or those at risk of transmitting HIV.
- ART involves taking a combination of at least three antiretroviral drugs from two different classes to suppress the virus and prevent drug resistance. Common classes include nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integra
02.01 adult art classification,action a nd side effects gsnDavid Ngogoyo
This document discusses the classification, sites of action, and common side effects of antiretroviral drugs (ARVs) used to treat HIV/AIDS. It describes the main classes of ARVs which target different stages of the HIV lifecycle, including reverse transcriptase inhibitors, protease inhibitors, and entry inhibitors. Common side effects are outlined for different drug classes and specific drugs, such as peripheral neuropathy, lipodystrophy, hepatotoxicity, and rashes. Rare but serious side effects like lactic acidosis are also mentioned.
This document provides an overview of the management of HIV patients, including children. It defines AIDS and describes the epidemiology, etiology, transmission, pathogenesis and diagnosis of HIV. It also discusses oral manifestations of HIV in children, such as candidiasis and viral infections. Treatment approaches for conditions like candidiasis, viral infections and bacterial infections are covered. The global strategy for preventing sexual and blood-borne transmission is also summarized.
HIV treatment and PrEP options have advanced significantly since 2015. Key points:
1) Treatment as prevention is now recommended, with antiretroviral therapy shown to reduce HIV transmission by 96% and dramatically lower prevalence over time if treatment is scaled up.
2) PrEP using daily oral Truvada was found to reduce HIV risk by up to 92% in multiple studies when taken consistently, though adherence is important. Intermittent or on-demand PrEP was also found highly effective in some populations.
3) Several real-world demonstration projects confirmed PrEP's effectiveness in different settings and populations, with up to 86% reduced risk of HIV acquisition when PrEP was provided.
This document provides information on managing patients with AIDS. It discusses the introduction and global impact of HIV/AIDS. It then covers basic facts about HIV and AIDS, including causative agents, transmission, clinical staging, opportunistic infections, cancers, and complications. The remainder of the document outlines diagnosis, treatment, nursing management including common nursing diagnoses, and prevention of HIV/AIDS. It aims to inform on all aspects of caring for patients living with HIV/AIDS.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This document summarizes constraints in effectively managing HIV/AIDS with antiretroviral (ARV) therapy in Nigeria. It discusses how ARV drugs are scarce and expensive in Nigeria, requiring strict medical supervision and often causing side effects, all of which can lead to non-compliance. It also notes that non-adherence to the drug regimen could result in drug-resistant strains of HIV, further complicating treatment. The document provides suggestions for how the government can help ensure adherence, such as making ARV drugs more available, affordable, and regularly supplied, and employing more trained medical personnel to administer the drugs.
The document provides an overview of pharmacotherapy for HIV management. It discusses the HIV virus, pathophysiology of AIDS, classes of antiretroviral drugs including their mechanisms and side effects. It summarizes WHO 2013 guidelines for starting ART including preferred first and second line regimens for different populations. The guidelines define treatment failure and recommend third line regimens. The document concludes that lifelong ART with combination of minimum 3 drugs from 2 classes is required to control HIV replication.
Early initiation of haart why, when and how 21 juneanil kumar g
This document discusses guidelines for early initiation of HIV treatment. It recommends starting antiretroviral therapy (ART) for all people living with HIV, including pregnant and breastfeeding women, regardless of CD4 count or clinical stage. The benefits of early treatment include reduced progression to AIDS, lower rates of illness and death, and decreased HIV transmission. First-line ART regimens preferably include tenofovir, lamivudine and efavirenz. Viral load testing is the best way to monitor treatment response and detect treatment failure.
This document summarizes advances in HIV treatment including HAART and its complications. It discusses how HAART effectively suppresses HIV but can have toxicities over the long term such as body changes, metabolic abnormalities, and liver or bone complications. Adherence is critical for treatment success. Resistance testing helps address treatment failure and resistance. New drugs and strategies continue to be developed and treatment interruption remains experimental. Management requires weighing risks and benefits of therapy changes and treatment goals.
The document discusses HIV treatment goals, interventions, and guidelines. The goals are to prevent immune system deterioration, decrease coinfections, and ultimately decrease mortality rates. Primary care involves screening for other illnesses and monitoring viral loads and CD4 counts. Studies show mortality rates decreased from 7% to 1.3% from 1996 to 2004 due to antiretroviral therapy (ART). Guidelines recommend initiating ART when CD4 is below 500 or in special cases like coinfection or pregnancy. Future hopes include monoclonal antibodies, gene therapy, and stem cell transplants to provide resistance.
Anti retroviral therapy for Acquired Immunodeficiency Syndromesiva subramanian
This presentation included goals of antiretroviral therapy, ART regiments, side effects of individual drugs, ART is special population such as children, IRIS, post exposure prophylaxis, WHO clinical staging of AIDS, treatment failure, AIDS is acquired immunodeficiency syndrome, Anti Retroviral therapy, People Living with HIV and AIDS
The document discusses the pharmacotherapy of HIV/AIDS, including:
- Classification of antiretroviral drugs into NRTIs, NNRTIs, PIs, entry inhibitors, integrase inhibitors, and maturation inhibitors.
- Guidelines for starting antiretroviral therapy (ART) and recommendations for first and second line regimens.
- "Off label" uses of drugs like azithromycin, foscarnet, and hydroxyurea to treat opportunistic infections in HIV patients.
D1 Highly Active Antiretroviral Treatment (HAART) DHHS Guidelines 2009 DuffusDSHS
The document discusses guidelines for initiating highly active antiretroviral treatment (HAART) based on CD4 count and viral load. Guidelines from 1998-2009 increasingly recommended treating HIV at higher CD4 counts and without a specific viral load threshold. Studies show the magnitude of CD4 increase is greatest when starting HAART at low counts, but normalization is more likely the earlier therapy begins. A CD4 count below 350 cells/mm3 increases the risk of cardiovascular and other non-AIDS complications.
HIV AIDS is one of the most dreadful of all diseases. Newer drugs and drug combination are coming quite frequently. Attempts to design an HIV vaccine is also underway.
This seminar is my attempt this interesting topic with all the latest data I could collect on the internet.
MANAGEMENT OF HIV FALLS UNDER THREE MAJOR CATEGORIES
1.POST EXPOSURE PROPHYLAXIS(P.E.P)
2.TREATMENT/MANAGEMENT OF HIV-AIDS
3.TREATMENT OF ADJOINING CONDITIONS
eg-
-Fungal Infections
-Bacterial infections
-Viral infections
-NEOPLASIAS
-misc.( recurrent apthos ulcers, xerostomia,salivary G. enlargement)
This document discusses the management of AIDS. It provides an outline covering the epidemiology of HIV/AIDS in India, the HIV life cycle, clinical staging of HIV/AIDS, antiretroviral drugs and their mechanisms of action, guidelines for antiretroviral therapy, and post exposure prophylaxis. It then goes on to provide more detailed information on these topics, including statistics on HIV prevalence in India, the stages of natural HIV infection, WHO clinical staging criteria, classes of antiretroviral drugs and their mechanisms of action and side effects, recommended first-line antiretroviral regimens, and principles of antiretroviral therapy.
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.
This document summarizes HIV infection and treatment. It describes how HIV was identified in the 1980s as the cause of AIDS. HIV can be transmitted through bodily fluids. Left untreated, HIV weakens the immune system and allows opportunistic infections. Treatment aims to suppress the virus and restore immune function. Highly Active Antiretroviral Therapy (HAART) uses a combination of three antiretroviral drugs from two classes to control the virus. Guidelines recommend starting treatment based on CD4 count. The goals of treatment are to improve quality of life and prevent disease progression.
This document provides information on HIV/AIDS including:
- HIV is a retrovirus that causes AIDS by infecting CD4 cells. It can be managed but not cured.
- AIDS is the late stage of HIV infection when the immune system is severely damaged.
- The natural history of the virus is described from its discovery in 1981 through treatments developed.
- The virus's structure and life cycle involve invading cells and integrating its DNA for dormancy.
- Transmission occurs through bodily fluids like blood, semen, breastmilk. Testing and treatment can control spread.
The document discusses the history and management of HIV/AIDS. It describes the early treatments for HIV/AIDS and the development of highly active antiretroviral therapy (HAART). It then discusses the symptoms of HIV/AIDS and how the virus destroys CD4+ T cells. It provides details on diagnosing HIV and the replication cycle of the virus. The remainder of the document outlines the different classes of antiretroviral drugs used to treat HIV, including entry inhibitors, nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, integrase inhibitors, and protease inhibitors. It also discusses initiating antiretroviral therapy and considerations for special populations such as children,
This document provides an introduction to HIV treatment, including guidelines on when to start treatment, current treatment options, and tips for getting the most out of treatment. The key points are:
- Current guidelines recommend antiretroviral therapy (ART) for all HIV-positive individuals, especially those with a CD4 count below 350 or those at risk of transmitting HIV.
- ART involves taking a combination of at least three antiretroviral drugs from two different classes to suppress the virus and prevent drug resistance. Common classes include nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integra
02.01 adult art classification,action a nd side effects gsnDavid Ngogoyo
This document discusses the classification, sites of action, and common side effects of antiretroviral drugs (ARVs) used to treat HIV/AIDS. It describes the main classes of ARVs which target different stages of the HIV lifecycle, including reverse transcriptase inhibitors, protease inhibitors, and entry inhibitors. Common side effects are outlined for different drug classes and specific drugs, such as peripheral neuropathy, lipodystrophy, hepatotoxicity, and rashes. Rare but serious side effects like lactic acidosis are also mentioned.
This document provides an overview of the management of HIV patients, including children. It defines AIDS and describes the epidemiology, etiology, transmission, pathogenesis and diagnosis of HIV. It also discusses oral manifestations of HIV in children, such as candidiasis and viral infections. Treatment approaches for conditions like candidiasis, viral infections and bacterial infections are covered. The global strategy for preventing sexual and blood-borne transmission is also summarized.
HIV treatment and PrEP options have advanced significantly since 2015. Key points:
1) Treatment as prevention is now recommended, with antiretroviral therapy shown to reduce HIV transmission by 96% and dramatically lower prevalence over time if treatment is scaled up.
2) PrEP using daily oral Truvada was found to reduce HIV risk by up to 92% in multiple studies when taken consistently, though adherence is important. Intermittent or on-demand PrEP was also found highly effective in some populations.
3) Several real-world demonstration projects confirmed PrEP's effectiveness in different settings and populations, with up to 86% reduced risk of HIV acquisition when PrEP was provided.
This document provides information on managing patients with AIDS. It discusses the introduction and global impact of HIV/AIDS. It then covers basic facts about HIV and AIDS, including causative agents, transmission, clinical staging, opportunistic infections, cancers, and complications. The remainder of the document outlines diagnosis, treatment, nursing management including common nursing diagnoses, and prevention of HIV/AIDS. It aims to inform on all aspects of caring for patients living with HIV/AIDS.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This document summarizes constraints in effectively managing HIV/AIDS with antiretroviral (ARV) therapy in Nigeria. It discusses how ARV drugs are scarce and expensive in Nigeria, requiring strict medical supervision and often causing side effects, all of which can lead to non-compliance. It also notes that non-adherence to the drug regimen could result in drug-resistant strains of HIV, further complicating treatment. The document provides suggestions for how the government can help ensure adherence, such as making ARV drugs more available, affordable, and regularly supplied, and employing more trained medical personnel to administer the drugs.
Today is World AIDS Day, December 1st. Various government and non-government organizations in Nepal are organizing programs related to HIV/AIDS awareness and prevention. HIV is a virus that attacks immune cells and can develop into AIDS if left untreated. Common ways of transmitting HIV include unprotected sex, sharing needles, and mother-to-child transmission during birth or breastfeeding. While there is no vaccine, antiretroviral treatment can control the virus and prevent transmission. It is important to get tested, practice safe sex, and seek treatment to prevent the spread of HIV/AIDS.
HIV surveillance involves systematically collecting and analyzing HIV/AIDS data to guide prevention and treatment programs. Key aspects of HIV surveillance include monitoring prevalence, incidence, opportunistic infections, and antiretroviral drug resistance. Accurate case definitions and timely reporting are important for effective surveillance. The goals of HIV surveillance are to detect trends in the epidemic, identify at-risk groups, evaluate prevention programs, and inform research and policy.
The document provides an overview of HIV/AIDS, including its causes, symptoms, transmission, treatment, and global and national impact. It describes how HIV attacks and destroys CD4 cells, weakening the immune system and leaving the body vulnerable to opportunistic infections. While treatment can suppress the virus and prevent disease progression, there is currently no cure for HIV/AIDS. The document also outlines Nepal's national strategies to prevent new infections, improve quality of life for those living with HIV/AIDS, and reduce stigma through testing and counseling programs, condom promotion, harm reduction services, and antiretroviral treatment.
HIV is a retrovirus that causes AIDS by destroying CD4+ T cells and weakening the immune system. It is spherical in structure and contains two copies of RNA along with enzymes. HIV infection occurs through bodily fluids and replicates by reverse transcribing its RNA into DNA. There is no cure for HIV/AIDS but treatment can suppress the virus and prevent transmission through condom use, pre-exposure prophylaxis, testing and treatment of partners, and needle exchange programs.
This document provides an overview of recent advances in HIV/AIDS treatment. It discusses how combination antiretroviral therapy pills have simplified treatment regimens. New drug classes such as entry inhibitors and integrase inhibitors have been developed that target different parts of the viral lifecycle. Studies have also shown benefits of starting antiretroviral treatment earlier, even before symptoms develop. Vaccine research continues in an effort to develop a preventive vaccine, with some studies showing a limited level of effectiveness.
This document provides information about Highly Active Antiretroviral Therapy (HAART) for treating HIV. It discusses the history and development of HAART, which involves using multiple antiretroviral drugs together to suppress the virus. Early combinations included two nucleoside reverse transcriptase inhibitors with a protease inhibitor. The goals of ART are to prolong life, improve quality of life, and reduce viral load and transmission risk while maintaining treatment options. Guidelines recommend starting ART for all individuals to reduce disease progression.
Highly Active Antiretroviral Therapy (HAART) involves using a combination of at least three antiretroviral drugs to suppress the HIV virus and stop the progression of HIV disease. HAART decreases the viral load, improves immune function, and prevents opportunistic infections. The goals of HAART are to prolong life, improve quality of life, maximize viral suppression, and reconstitute the immune system. Current guidelines recommend starting HAART for all HIV patients regardless of CD4 count. Proper counseling, adherence, monitoring, and management of side effects are important for the success of HAART.
Acquired Immunodeficiency Syndrome is severe HIV infection.
There were 940,000 deaths from AIDS in 2017.
Lancet estimated that global incidence of HIV infection peaked in 1997 at 3.3 million/year.
The document discusses the ongoing HIV/AIDS epidemic and potential strategies to end it. It notes that since the first cases were identified in 1981, HIV has infected over 60 million people and killed over 35 million. While new infections and deaths have declined in recent years due to prevention and treatment efforts, over 2 million new infections still occur annually. The document outlines interventions like expanded access to antiretroviral therapy, pre-exposure prophylaxis, prevention of mother-to-child transmission, condom promotion, needle exchange programs, and targeting at-risk groups that could help reverse the epidemic if pursued sustainably. It calls for renewed global commitment to end the epidemic that has affected humanity for over 30 years.
This document provides an overview of HIV and AIDS. It discusses the background of HIV, including how it attacks the immune system. It describes the stages of HIV infection and provides a brief history of AIDS. The epidemiological triad of agent, host, and environment related to HIV transmission is examined. At-risk groups and behaviors are identified. Global and national statistics on prevalence and distribution are presented. Objectives of preventing and controlling HIV/AIDS through various strategies like education, testing, and treatment are outlined. Key findings around transmission modes, clinical features, and prevention/management approaches are summarized.
The HIV/AIDS pandemic has provided opportunities to advance scientific understanding while posing ongoing challenges to global health. Over decades of research, knowledge of HIV and AIDS has grown, yet millions remain affected and more work is needed on prevention and treatment. Priorities include increasing access to testing, treatment, and support worldwide while continuing vaccine research and efforts to eliminate HIV transmission.
ABSTRACT- Human immunodeficiency virus (HIV) is a major contributor to the global burden of the disease, opportunistic infections, and tumors follow. HIV also directly attacks the immune system and affects certain body’s system (like Central Nervous System, Respiratory and Cardiovascular Systems, Digestive System etc). HIV transmission is complex and depends on the number of behavioral and biological co-factors. The hallmark of HIV infection is the progressive depletion of CD4 helper T cells because of reduced production and increased destruction. Although the typical HIV infected patient shows a sustained CD4 cell increase, a remarkable number of subjects never achieve normal ranges of CD4. HIV infection is also characterized by a marked increase in immune activation, which includes both the adaptive and innate immune systems and abnormalities in coagulation. Extraordinary efforts in the fields of clinical, pharmacology, and biology care have contributed to progressively turn HIV infection from an unavoidably fatal condition into a chronic manageable disease, at least in the countries where HIV infected people have full access to the potent anti-retroviral (ARV) drug combinations that permit a marked and sustained control of viral replication. Although their pathogenesis is still under discussed, they are likely to originate from immune dysfunction associated with HIV infection and chronic inflammation. The last consideration regards the dis-homogenous pattern of HIV disease worldwide. Key-words- Human immunodeficiency virus (HIV), simian immunodeficiency viruses (SIV), Antiretroviral (ARV) therapy, Acquired immunodeficiency syndrome (AIDS), Cell mediated immunity (CMI), Anti-retroviral agents
Assessment of the level of awareness on AIDS/HIV in Johor, MalaysiaSriramNagarajan17
This document summarizes a study that assessed awareness of HIV/AIDS among 396 respondents in Johor, Malaysia. The study found that respondents had moderately high overall knowledge of HIV/AIDS, though some misconceptions remained. Most respondents knew that high-risk behaviors like needle sharing and unprotected sex can transmit HIV, but fewer were aware of risks from activities like tattooing or sharing personal items. While most knew there is no cure for HIV/AIDS, over half believed incorrectly that washing after sex prevents transmission. The study provides insight into awareness levels and information gaps regarding HIV/AIDS in Johor.
Major Health Issues in India: HIV/AIDS & CANCER IN INDIA...Ravi Spikey
This document provides information about the status of cancer in India. It states that cancer is characterized by abnormal cell growth that can spread to other tissues and organs, potentially causing death. It lists some of the most common cancers in India as lung, breast, colon, endometrial, pancreatic, kidney, prostate, thyroid, and skin cancer. It also discusses factors that contribute to cancer rates like tobacco use, alcohol consumption, environment, diet, and lifestyle. Tobacco is a major risk factor and is responsible for over 1 million deaths per year in India.
HIV (Human Immunodeficiency Virus) infects cells of the immune system and destroys or impairs their function.
Infection progressive deterioration of the immune system breaking down the body's ability to fight out infections & diseases by opportunistic bacteria, viruses and fungi.
AIDS (Acquired Immune Deficiency Syndrome) refers to the most advanced stages of HIV infection and a collection of signs and symptoms caused by more than 20 opportunistic infections or related cancers.
- An estimated 33 million people worldwide are living with HIV/AIDS. In Malaysia, there has been an alarming increase in HIV/AIDS cases among young people aged 20-30, with 78.8% of cases in this age group.
- Unsafe sex and drug use are the main contributors to the spread of HIV/AIDS worldwide and in Malaysia. The Malaysian health ministry works to provide prevention education and free condoms/needles to reduce transmission risks.
- In developing countries where refrigeration is limited, heat-stable versions of antiretroviral drugs like Mylan's generic version of ritonavir have increased access to HIV/AIDS treatment.
Patient compliance: Challenges in management of cardiac diseases in Kuala Lum...pharmaindexing
Background
The objective of this study was to investigate the degree of compliance among cardiac patients who attend the health facilities in Kuala Lumpur and Perak, Malaysia. The reasons for non-compliance and recommendations from healthcare professionals were also evaluated.
Method
A cross-sectional study of 400 patients and 100 healthcare professionals was carried out. This study utilizes variables on external factors and internal factors as the measurement tools. The questionnaire which consists of Morisky self-reported medication adherence questions was administered to patients and causes for non-compliance sought. Questionnaire for healthcare professionals was used to determine strategies that can improve compliance rate.
Results
The study revealed a 15.8% of high adherence rate, 54.3% of moderate adherence rate and 30% of poor adherence to cardiovascular disease medications. The chi-square tests showed the strong association between dependent and independent variables. The model chosen for testing the patient compliance through external and internal factors gives an R2 value of 85.0% with an adjusted R2 of 84.7%. The F value (317.187) was also significant (p=0.000) which means that the variables have better fit in the multivariate model. The major reasons determined for non-adherence were attitudes and beliefs, lifestyle, side effects and cost of medications. The study recommends that pharmacists and dispensing technicians should be adequately qualified to provide proper counselling to cardiac patients on their medicines and disease conditions.
Conclusion
The result of this study is of value to health care providers. Compliance to cardiovascular medications will avoid treatment failures encountered in therapy.
Overview on Recurrence Pregnancy Loss etiology and risk factorspharmaindexing
Recurrent pregnancy loss (RPL) can be defined as more than two to three consecutive miscarriages before 20 weeks’ gestation; it affects approximately 1% to 2% of women. RPL is a multifactorial disease. It is very important to study the etiology and risk factors of RPL to find the best diagnostic tests and suitable therapeutic intervention. This article will discuss the current understanding etiologies and risk factors of RPL.
Novel treatments for asthma: Corticosteroids and other anti-inflammatory agents.pharmaindexing
Asthma management is a challenge due to the prevalence of disease in the world. Based on the immunological and inflammatory mechanisms of asthma, corticosteroids and anti-inflammatory participate greatly in the treatment plan. Due to different reasons, there is still an unmet need to develop new agents in this field. A lot of compounds with anti-inflammatory effect are investigated in both pre-clinical and clinical studies.
A review on liver disorders and screening models of hepatoprotective agentspharmaindexing
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of bio chemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function long term, although liver dialysis can be used short term.
Carbamazepine induced Steven Johnson syndrome: A case reportpharmaindexing
Drugs are the most common cause that induces Steven Johnson syndrome (SJS) and includes antiepileptic drugs, antiretroviral drugs, anti-tuberculosis drugs, Sulphonamides, fluoroquinolones, penicillins, non-Steroidal anti-inflammatory drugs, Multivitamins. The genetic markers are also the cause for carbamazepine induced Steven Johnson Syndrome. In our study, the antiepileptic drug (Carbamazepine) is the cause for Steven Johnson Syndrome. A female patient aged 25 years came to the hospital with the complaints of bubbling over the skin and all over the body with papillary vesicles associated with pain and irritation, fever, myalgia, and nausea. The patient is known case of Phenytoin induced Steven Johnson Syndrome. In this case the patient developed the Steven Johnson Syndrome approximately after one month after starting the carbamazepine.By the withdrawal of the drug, the condition of the patient was improved.
Monoherbal formulation development for laxative activitypharmaindexing
The Ayurvedic Pharmacopoeia specifically approves flaxseed as a poultice for boils externally and demulcent or laxative internally. In this study monoherbal formulation development for laxative activity of flaxseed was undertaken. The plantLinumusitatissimumhasshowed higher percentage of total ash as well as alcohol soluble extractive values. The aqueous extract of Linumusitatissimumwas prepared by using pilot scale extraction plant and spray drying unit. The qualitative phytochemical studies reveal the presence of amino acids, carbohydrates, vitamins and proteins. From the available literatures it was found that Linumusitatissimum contains more number of amino acids. The formulated tablets showed acceptable pharmacopoeial limits and complies with specifications for thickness, hardness, friability and weight variation. The formulation has showed better laxative activity indicating additive property of the combined phytoconstituents of the plant.
Monoherbal formulation development for laxative activitypharmaindexing
The Ayurvedic Pharmacopoeia specifically approves flaxseed as a poultice for boils externally and demulcent or laxative internally. In this study monoherbal formulation development for laxative activity of flaxseed was undertaken. The plantLinumusitatissimumhasshowed higher percentage of total ash as well as alcohol soluble extractive values. The aqueous extract of Linumusitatissimumwas prepared by using pilot scale extraction plant and spray drying unit. The qualitative phytochemical studies reveal the presence of amino acids, carbohydrates, vitamins and proteins. From the available literatures it was found that Linumusitatissimum contains more number of amino acids. The formulated tablets showed acceptable pharmacopoeial limits and complies with specifications for thickness, hardness, friability and weight variation. The formulation has showed better laxative activity indicating additive property of the combined phytoconstituents of the plant.
Pneumonia and respiratory failure from swine origin influenza H1n1pharmaindexing
Swine influenza (swine flu) became alarming health concern when World Health Organization declared as “public health emergency of international concern” on April 25, 2009. After documentation of human-to-human transmission of the virus in at least three countries of two WHO regions, the WHO raised the pandemic level to 6.1 During the 1918, flu pandemic infected one-third of the world's population (an estimated 500 million people) and caused approximately 50 million deaths.2 In 1976, an outbreak of swine influenza occurred in New Jersey, USA, which involved more than 200 cases, some of them severe, resulting in one death.3 In 1988, another fatality was reported as a complication of swine influenza.
A descriptive study on newborn care among postnatal mothers in selected mater...pharmaindexing
The newborn health challenge faced by India is more formidable than that experienced by any other country in the world. The newborn health is inevitably affected by the traditional care practices of the mothers causing high infant morbidity and mortality.The aim of the study were determine the knowledge, attitude and practice of postnatal mothers regarding new born care and find out the association between knowledge, attitude and practice of postnatal mothers regarding new born care and to determine the association between these as well as with the selected demographic variables. A descriptive study was conducted to assess the knowledge, attitude and practice of postnatal mothers regarding new born care in selected maternity centres in Madurai. Survey approach was employed to select sample and it consisted of 100 postnatal mothers. Data was collected using structured interview schedule. Findings of the study showed that 65% of postnatal mothers had moderate knowledge; 61% had favourable attitude and 57% of them had high practice of new born care. There was a significant association between knowledge and attitude (r=+0.567), knowledge and practice (r=+0.388), attitude and practice (r=+0.321) .There was a significant association between knowledge and education, monthly family income and obstetrical score at p<0.05. Findings of the study indicated the need to conduct frequent assessment of knowledge, attitude and practice of postnatal mothers regarding new born care. Awareness and attitude of the mothers towards new born care still has lots of lacunae especially in those who belong to the lower socio economic statusand poorly educated postnatal mothers. So it is imperative to provide comprehensive training in the field of new born care for mothers during pregnancy
Late 19th century was evident of intelligent biomaterial; which has changed researcher’s perspective towards science and technology. This intelligent biomaterial are envisioned to have huge impact on Healthcare from sequential signalling of biomedical molecule, mimicking natural gene, an effective drug carrier, to high resolution diagnostic tool.From drug discovery aspect many of NCE fail to reach therapeutic potential due to PK/ PD profile. Nanotechnology has changed the face of drug discovery form chemical evaluation to structure of proteins in signalling pathways and development of chemical antibody. Nanotechnology from lab to market approval is long process due to regulatory evaluation. Though it seems to be bright future market it has to go through a long process from being innovation to complete market product. This makes whole process expensive making investor reluctant to invest in big projects.Western world is aware of dramatic potential of nano-projects; which has its limitation in financial investments; with major challenge of transforming nano science to commercial pharmaceutical product.
The Flaws in health practice in post-operative management of a patient in ter...pharmaindexing
This case study summarizes the treatment of a 4-year old child with congenital urinary tract obstruction who presented with constipation, fever, and cough. Laboratory tests found low electrolyte levels, high blood acids, and kidney damage. The child's treatment included surgery, dialysis to correct electrolyte imbalances, and antibiotics for chest infection. However, the case study notes discrepancies in the post-operative treatment, including questionable antibiotic selection and prescribing of calcium channel blockers not recommended for children. The study concludes there is a need for clinical pharmacists on the healthcare team to improve rational medication use.
Corticosteroid induced disorders – An overviewpharmaindexing
Glucocorticoids are important in the treatment of many inflammatory, allergic, immunologic, and malignant disorders, and the toxicity of glucocorticoids is one of the commonest causes of iatrogenic illness associated with chronic inflammatory disease.Glucocorticoid-induced muscle atrophy is characterized by fast-twitch or type II muscle fiber atrophy. Corticosteroid (CS) therapy is widely used in the treatment of rheumatic diseases.Osteoporosis remains one of its major complications.Steroid induced glaucoma is a form of open angle glaucoma occurring as an adverse effect of corticosteroid therapy. Glucocorticoids induce hepatic and extrahepatic insulin resistance.Glucocorticoid treatment impairs both glucose transport in fat and muscle cells. Corticosteroid-induced psychosis represents a spectrum of psychological changes that can occur at any time during treatment. Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol. Physicians must be aware of these adverse effects and be equipped to manage them.
Anti-inflammatory activity of pupalia lappacea L. Jusspharmaindexing
Pupalia lappacea (L) Juss is an erect shrub used in folklore medicine to treat bone fractures and in inflammatory conditions. Methanolic extract of aerial parts shown is claimed in traditional medicine that the leaves of the plant are used in the treatment of inflammation. In the present study, the methanolic extract of Pupalia lappacea was screened for its anti-inflammatory activity using carageenan induced rat paw edema egg white induced paw oedema models. The methanolic extract at the dose of 200 mg/kg p.o exhibited significant anti-inflammatory activity in carrageenan induced paw edema model (p<0.01). In egg white induced model, methanolic extract at the dose of 200 mg/kg inhibited paw oedema significantly (p<0.01) indicating that both test samples inhibit the increase in number of fibroblasts and synthesis of collagen and mucopolysaccharides during prostaglandin formation during the inflammation. These experimental results have established a pharmacological evidence for the folklore claim of the drug to be used as an anti inflammatory agent. HPTLC analysis of the extract shows the presence of gallic acid 1.24mg/ml, ferulic acid 2.00mg/ml, chlorogenic acid 46.25mg/ml and rutin 7.02mg/ml of the extract which were responsible for the claimed anti-inflammatory action in the animal models studied.
Lucinactant: A new solution in treating neonatal respiratory distress syndrom...pharmaindexing
This document summarizes research on Lucinactant, a novel synthetic surfactant approved by the FDA in 2012 for treatment of neonatal respiratory distress syndrome (RDS). It contains a peptide called sinapultide that mimics the function of human surfactant protein B. Studies found Lucinactant was as effective as or more effective than previous animal-derived surfactants in reducing mortality from RDS, but its pharmacokinetics are not fully understood. The document reviews clinical trials and mechanisms of Lucinactant and discusses its efficacy, safety profile, and potential cost benefits compared to other surfactants.
Bioactivity screening of Soil bacteria against human pathogenspharmaindexing
This study aimed to isolate soil bacteria with potential bioactive properties against human pathogens. 36 bacterial strains were isolated from 3 soil samples and screened against common pathogens. 14 isolates showed antibacterial activity, including against Staphylococcus aureus, Streptococcus faecalis, E. coli, Klebsiella aerogenes, Proteus vulgaris, Pseudomonas aureginosa and Salmonella typhi. The 3 most active bacterial isolates were selected for further production and isolation of their bioactive metabolites. Testing found the metabolites had prominent antibacterial effects against the clinical pathogens studied, indicating their potential as a source of new antimicrobials given the rise in drug resistance.
A study on sigmoid Volvulus presentation and managementpharmaindexing
A study on sigmoid volvulus presentation and management was a 2yr retrospective study done at RMMCH.The diagnosis of sigmoid volvulus was made from a history of large bowel obstruction (constipation, abdominal distension, and abdominal pain), which were often recurrent and plain abdominal radiographs.The morbidity associated isSuperficial wound infection occurred in four patients. All the infected wounds eventually healed with conservative measures. Clinical anastomotic dehiscence was noted in 1 patient for which during relaparotomy proximal colostomy and mucous fistula was done. The mortality associated is shown is there were 9 deaths of which 7 were due to sepsis and 2 were due to comorbid illness. Two out of eight patients for whom a colopexy was done had a recurrent attack of sigmoid volvulus. The duration of hospital stay ranged between 10 and 21 days. Use of sigmoidoscopic detorsion for viable colon should be encouraged. Sigmoidopexy, which is associated with a recurrence rate of 20% in our series of patients, should be used selectively.Hartmann’s procedure is a safe option in sigmoid volvulus with gangrenous bowel. Primary anastomosis in emergency situation can be carried out with morbidity and mortality in patients with viable colon
Evaluation of Preliminary phytochemical on various some medicinal plantspharmaindexing
The present study was carried out to evaluate the physical status and percentage yield of methanolic extract and its fractions of whole plant of Leucas cephalotes, leaves of Hiptage benghalensis and leaves of Kydia calycina were recorded for future references and Preliminary phytochemical screening of MLC, MHB and MKC revealed the presence of carbohydrates, glycosides, saponins, flavonoids, steroidal and phenolic compounds. MLC revealed the presence of all the above mentioned phytoconstituents except saponins and also MKC steroidal compounds. The fractions of MLC, MHB and MKC revealed the presence of glycosides, phenolic compounds, steroids and flavonoids.
Comparision of in vitro antibacterial activity of cefoperazone and levofloxac...pharmaindexing
This study compared the in vitro antibacterial activity of cefoperazone and levofloxacin against various clinical isolates. 120 bacterial isolates from patient samples were tested for susceptibility to cefoperazone and levofloxacin using disc diffusion. Results showed levofloxacin had lower resistance than cefoperazone for E. coli and P. aeruginosa, while cefoperazone was more effective against S. aureus. However, resistance to both antibiotics was gradually increasing, highlighting the need for regular surveillance of antibiotic susceptibility.
Concept of srotas from ayurvedic perspective with special reference to neurologypharmaindexing
Ayurveda is a life science. The researchers of ayurveda could rule out the presence of srotas (channels) spreading throughout the human body. These srotas (channels) are governed by vayu which is using all the srotas (channels) of the body to carry out the functional and physiological activities of the human body without which the human society will not exist. Several synonymous words have been described by the ayurvedicacharyas for srotas. Some are micro and some are macro in structures and they adopt the same colour of the particular dhatus of the body to which it belongs. The aim of the study is to justify that srotas are nothing but innurmerable channels or pathways of the nervous system governed by electric current without which no functional and physiological activities of the human body will develope.
Health promotion survey in overweight and obese students of universities in n...pharmaindexing
Introduction
Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately two-thirds of the population in the UK is either overweight or obese. Overweight and obesity is an important issue that causes distress to most women. Health promotion is the best method to educate overweight and obese women. It is defined as the process enabling people to increase control over and to improve their health by Ottawa Charter for Health Promotion. It is aimed to enhance the well-being of the individuals and their positive attitudes towards prevention of various diseases. In order to make any improvement to the health promotion for overweight and obesity, the risk factors and the opinions from the public should first be identified and addressed.
Methods
Cross-sectional survey design was selected with a questionnaire that consisted of 20 open and close ended questions. A sample size of 196 was determined. The data thus gathered was analyzed using SPSS V20 (Statistical Package for Social Science version 20). Descriptive statistics (fx) and (SD) were used and Chi-square X2 test for association was employed.
Results
Out of the total 196 responses, only (40%) of the students had normal weight (SD 1.1), (25%) students had a good understanding of health promotion (SD 1.6), half (50%) appeared concerned about their weight (SD 0.5), (60%) had an obese family member (0.5). The BMI of students was associated with the presence of an obese member in their family and their weight as a concern for them. (P-value <0.05).
Conclusion
The health promotion service is beneficial as it was found to have raised concerns in the mind of the students regarding over weight and obesity. However it was observed that the understanding of health promotion service was different among students and this is the root of the problem.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Highly active antiretroviral therapy incidence of adverse drug reactions
1. ~ 25 ~
* Corresponding author: Languluri Reddenna.
E-mail address: reddennapharmd@gmail.com.
IJAMSCR |Volume 1 | Issue 1 | Oct - 2013
www.ijamscr.com
Research article
Highly Active Antiretroviral Therapy: Incidence of Adverse Drug
Reactions
Languluri Reddenna*, Shaik Ayub Basha, Donthu Venu Gopal, Tedlla Rama Krishna
Pharm-D Intern, Department of Pharmacy Practice, P.Rami Reddy Memorial college of
Pharmacy, Utukur, Kadapa, Andhra Pradesh, India-516003.
ABSTRACT
The Acquired Immunodeficiency Syndrome (AIDS) was first recognized in 1981, in the United States of
America in young homosexual men who had Kaposi sarcoma and serious infections. HIV is transmitted through
unprotected sexual intercourse, transfusion of contaminated blood, sharing of contaminated needles and between
a mother and her infant during pregnancy, childbirth and breastfeeding. In India, an estimated 0.1 percent of
adults aged 15-49 are living with HIV, which seems low when compared to HIV prevalence in some parts of
sub- Saharan Africa.The HIV prevalence at antenatal clinics was 1% in 2007. This number is smaller than the
reported 1.26% in 2006, but remains the highest out of all states. HIV prevalence at STD clinics was very high
at 17% in 2007.Although adverse reactions are common and often predictable, their management must be
individualized.In addition, the patient's report of severity can be inconsistent with the clinical interpretation and
this must be considered when determining the management of adverse reactions.Antiretroviral therapy is
effective for HIV treatment but also increasingly complex. The many adverse effects of therapy may cause
symptoms affecting a variety of organ systems. Patient non adherence is the reason for the treatment failure for
antiretroviral therapy. To optimize adherence treating physicians must focus on early detection and prevention
of ADRs, when possible and distinguishing those that are self-limited from those that are potentially serious.
The pharmacist should be able to detect ADRs and the culture of reporting ADRs should be instructed. All ART
centers should have Pharmacovigilance cell. All ADRs reported should be analyzed as per WHO guidelines on
causal assessment. Our study concluded that there is a need of the active Pharmacovigilance Centre with
intensive monitoring for ADRs by the Pharmacist in Indian HIV positive patients.
Key words: ADRs, AIDS, ART, HIV, HAART
INTRODUCTION
India is one of the most populated countries in the
world, with over one billion inhabitants. Of this
number, it was estimated that around 2.4 million
people are currently living with HIV. [1]
HIV was
probably a mutation of an African monkey virus.
The presence of related retroviruses in African
monkeys and apes and the close relationship of
HIV to Chimpanzee. The Acquired
Immunodeficiency Syndrome (AIDS) was first
recognized in 1981, in the United States of
America in young homosexual men who had
Kaposi sarcoma and serious infections. HIV is
transmitted through unprotected sexual intercourse
(anal or vaginal), transfusion of contaminated
blood, sharing of contaminated needles, and
between a mother and her infant during pregnancy,
childbirth and breastfeeding. [2]
Treatment options
for HIV infected people were very limited, which
has been demonstrated to affect the behavior of the
virus itself, were not available.[3]
By the early 1990s, AIDS epidemics had emerged
in several Asian countries and by the end of the
decade; HIV was spreading rapidly in many areas
International Journal of Allied Medical Sciences
and Clinical Research (IJAMSCR)
2. Languluri Reddenna, et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-1(1) 2013 [25-30]
www.ijamscr.com
~ 26 ~
of the continent.At present, around 4.87 million
people are living with HIV in South, East and
South-east Asia. Even though, national HIV
prevalence in most Asian countries is relatively
low, the population of some countries is
consequently vast that these low percentages
actually represent very large numbers of people
living with HIV. In India, an estimated 0.1 percent
of adults aged 15-49 are living with HIV, which
seems low when compared to HIV prevalence in
some parts of sub- Saharan Africa.Andhra Pradesh
has a total population of around 76 million, of
whom 6 million live in or around the city of
Hyderabad. The HIV prevalence at antenatal clinics
was 1% in 2007. This number is smaller than the
reported 1.26% in 2006, but remains the highest
out of all states. HIV prevalence at STD clinics was
very high at 17% in 2007. Among high-risk groups,
HIV prevalence was highest among men who have
sex with men (MSM) (17%), followed by female
sex workers (9.7%) and injection drug users (IDUs)
(3.7%).[4]
Antiretroviral therapy (ART) is treatment for
human immunodeficiency virus (HIV) using anti-
HIV drugs. The standard treatment consists of
combination of at least three drugs (often-called
highly active antiretroviral therapy or HAART)
that suppress HIV replication.The introduction of
the highly active antiretroviral therapy (HAART)
has lead to significant reduction in AIDS- related
mortality and morbidity.The advent of
antiretroviral drugs in early 1990’s began a
revolution in the management of HIV infection.
Three groups of ARV drugs had successful in
interrupting the viral replication. Strict adherence,
the use of combination of three drugs leads to
sustained viral suppression for several
years.However, antiretroviral therapy (ART) does
not cure HIV/AIDS, but effective antiretroviral
regimens inhibit the efficient replication of the HIV
virus, and reduce viremia to undetectable levels.
The first drug effective against HIV, Zidovudine
(AZT, ZDV) was approved as early as 1986. Until
early nineties, only Zidovudine (ZDV) &
Didanosine were available and used as
monotherapy. By the year 1995, results from
several studies had demonstrated that use of two-
nucleoside analogue combined (dual therapy) was
quite effective in delaying the disease progression,
showed an impressive clinical improvements and
increase in CD4 counts.The situation changed
dramatically in 1996 with the introduction of
Protease Inhibitors (Pls), which were very potent
drugs and reduced the viral load by 10 – 100
times. Because of effective triple combination
therapy, hospitalization rates of HIV infected
individuals reduced dramatically. The drugs were
no doubt quite efficacious but were associated with
problems of significant toxicities, adherence to
large number of pills (20 – 30 per day) and high
costs.
Currently, we had 21 anti-retroviral agents
approved by US FDA, of which 15 currently
available in India. The efficacy of drugs was well
documented, options available are several and large
numbers of patients are on ARV therapy. Yet, the
management of HIV is becoming increasingly
complex as problems of long-term toxicities; drug-
drug interaction and drug resistance are emerging.
There are matters about wide availability of
monitoring facilities like viral load, drug resistance
testing, and second line ARV drugs.[5]
Goals of Anti retroviral therapy
The primary goals of antiretroviral therapy were
maximal and durable reduction in plasma viral
levels, restoration of immunological functions
aimed at prolongation of life and improvement in
quality of life.[6]
Principles of Anti retroviral therapy
A continuous high level of replication of HIV takes
place in the body right from the early stages of
infection. The HIV destroys CD4 Cells, while body
produces more CD4 cells. This balance is
maintained for some years after which the rate of
CD4 destruction becomes more than that of CD4
production. This progressive immune system
damage results in susceptibility to different
opportunistic infections (OI), malignancies,
neurological diseases, wasting and, ultimately,
death.A combination of at least three agents from
different classes of ARV drugs is the regimen of
choice and gives maximal achievable suppression
of HIV replication over a prolonged period.Regular
measurements of CD4 cell count and plasma HIV
RNA levels (if possible) are necessary to determine
the risk of disease progression in HIV infected
patients and to determine when to initiate or
modify ART regimens. The viral load levels
indicate the magnitude of HIV replication while
CD4 counts indicate the extent of HIV induced
immune damage. The antiretroviral drugs act on
various stages of replication of HIV in the body
and interrupt the process of viral replication.
Commonly used agents, target the virus mainly by
inhibiting the enzymes reverse transcriptase (RT
Inhibitors), and protease (Protease Inhibitors). The
3. Languluri Reddenna, ,et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-1(1) 2013 [25-30]
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~ 27 ~
newer group of drugs includes Fusion Inhibitors,
integrase inhibitors, CCR5 antagonist and second
generation NRTIs.
ART Initiative in India
There is an estimation of 2.31 million people living
with HIV/AIDS in India. As per estimates, at any
given time approximately 10-15% of the total
numbers of people with HIV infection are expected
to be in need of ART. This means nearly 3-4 lakh
patients will need ART presently. Until now, the
high costs and complicated treatment regimens
were the major barriers in introducing free ART.
With advent of newer ARV drugs with lesser side
effects and lowered costs, it was considered
appropriate to introduce provisioning free ART
through public sector health facilities in a phased
manner.[7]
ART had initiated and when the patient becomes
eligible according to the technical guidelines.
However, before starting the ART, it is of utmost
importance to ensure that the patient was well
prepared for the therapy. The preparedness includes
that the patients has adequate understanding of the
disease, should aware of the treatment regimens,
importance of adherence to therapy, and is willing
to take the treatment. The adequate preparedness of
the patient is critical in ensuring a high level of
adherence to ART. It is also important to have
reliable laboratory services for investigations such
as complete blood count and biochemistry, access
to CD4 count and viral load facilities are needed.
One has to ensure reliable, affordable and
uninterrupted access to quality antiretroviral drugs,
and drugs to treat opportunistic infections and other
related illness.
Prior to starting therapy, it is essential to undergo a
clinical evaluation, so as to assess the present stage
of HIV infection, presence of any Opportunistic
Infection (Present or Past) and identifying co-
existing medical conditions. The patient should
have a detailed physical examination and should
undergo investigations like complete blood count,
chest X-Ray, renal and liver function, lipid levels,
VDRL, Hepatitis B & C serology, pregnancy
testing and urine for routine and microscopic
examination and CD4 counts.[8]
Adverse drug reactions with HAART
therapy
Any drug my produce unwanted or unexpected
adverse reaction. Detection, recording and
reporting of these reactions is of vital importance.
Doctors, pharmacists and nurses have the
responsibility to participate in this programme.
Adverse reactions are significant cause of
morbidity, mortality and can affect adherence to
treatment schedule and increase risk of resistance
and relapse of disease.ARV drugs have lower
safety profile and given the facts that they need to
taken on chronic basis, patients who are immuno-
deficient consume them and immuno-deficient
patients are more prone to develop adverse reaction
to any drug. Hence, it is important that patients
receiving ARV drugs or other drugs closely
monitored for ADRs and they are managed
appropriately so that adherence to the prescribed
treatment is ensured.[9]
A study conducted by Radhakrishnan rajesh et al,
[10]
found that anemia and hepatotoxicity were the
most commonly observed ADRs. The organ system
commonly affected by ADR was red blood cell
(21.4%).The ADRs were moderate in 77% of
cases. Type A reactions (77%) were more common.
10.8% ADRs were definitely preventable. The
incidence rate of ADRs (65.9%) was highest with
Zidovudine + Lamivudine + Nevirapine
combination. 84% interruptions to highly active
antiretroviral therapy were due to toxicity. CD4
less than 200 cells/μl, female gender and
tuberculosis were observed as risk factors for
ADRs. They concluded that incidence of ADRs in
intensively monitored patients was found to be
43.8%. Anemia in HIV patients is an influential
risk factor for occurrence of ADRs. With the
increasing access to antiretroviral in India,
clinicians must focus on early detection and
prevention of ADRs to highly active antiretroviral
therapy.Another study conducted by Hossein
Khalili et al, [11]
found that 87.6% of patients
showed at least one ADR. Prevalence of ADRs
based on affected organ was gastrointestinal (GI)
(63.7%), hematological (32.6%), neurological
(30%), cutaneous (22%), musculoskeletal (21.3%),
hepatic (20%), metabolic (18.6%), and renal (2.6%)
adverse effects. The most important results of this
study was finding of hematological ADRs as the
most common cause of ART interruption,
supporting the hypersensitivity nature of
antiretroviral induced hepatotoxicity especially
cholestasis and new finding of the significant
positive correlation between hepatitis C virus co-
infection and the occurrence of ART induced skin
reactions.DR. Marfatia Y.S. et al, [12]
review on
adverse drug reactions (ADR) due to
Antiretrovirals (ARV): Issues and challenges. In a
review of over 1000 patients in a Swiss cohort that
received combination ARV therapy, 47% and 27%
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of the patients were reported to have clinical and
laboratory adverse events, respectively.Cutaneous
manifestations of ADR can serve as surrogate
marker of internal involvement.
Dermatovenereologists can play a crucial role in
identifying and managing ADR.
Michelle M Foisy et al [13]
conducted a study
hospitalization due to adverse drug reactions and
drug interactions before and after HAART. To
characterize and compare the rates of adverse drug
reactions (ADRs) and interactions on admission in
two, one-year periods: pre-highly active
antiretroviral therapy (HAART) (phase 1) and post-
HAART (phase 2 In phase 1, 436 of 517
admissions, and, in phase 2, 323 of 350 admissions
were analyzed. Over 92% of patients were male,
with a mean age of 38 years. Significant
differences (P<0.05) in the mean length of stay
(12.08 versus 10.02 days), the CD4 counts (99.25
versus 129.45) and the number of concurrent
diseases (4.20 versus 3.63) were found between
phase 1 and 2, respectively. The mean number of
medications taken (5.52 versus 5.94) and the rates
of hospitalization with ADRs (20.4% versus
21.4%) or interactions (2.5% versus 2.16%) were
similar between the two phases. Antiretrovirals
were more common in ADR admissions post-
HAART (21.3% versus 36.2%), while
antiparasitics, psychotherapeutics and
antineoplastics were more common pre-HAART.
Other classes of drugs involved in both phases
were sulphonamides, narcotics, ganciclovir,
foscarnet, antimycobacterials and antifungals. ADR
causality was possible or probable in more than
80% of cases. Over 60% of ADRs were grades 3 to
4, and about 85% were either the main or
contributing reason for admission. About 65% of
patients had at least partial recovery at the time of
discharge. In phases 1 and 2, 8.9% and 2.9% of
admissions, respectively, with ADRs were fatal.
Michael Carter et al,[14]
found that HAART patients
at greater risk of severe side effects. The
investigators wished to establish the incidence and
determinants of serious or life-threatening
treatment side effects, AIDS-defining illnesses and
death. Data was analyzed from 2,947 patients who
were followed for a median of 20.7 months,
contributing 5,940 person-years of follow-up. The
cumulative percentage of patients with a severe or
life threatening side effect at month twelve was
15.6%, at month 24, 23.7% and at month 36,
30.8%. The corresponding percentages for AIDS
events were 7.3%, 10.8%, 16.5%, and the
percentages for deaths were 3.9%, 7.9% and
13.1%. When the investigators looked at the risk
factors for the experience of severe or life-
threatening side-effects, they found that the risk
was lower in younger patients (hazard ratio [HR]
0.83 for every decade in years, p=0.0001), and
patients who had never taken anti-HIV drugs
before (HR=0.59, p=0.0001). The risks were
increased for individuals with a history of injecting
drug use (HR=1.41, p=0.0006), lower baseline
CD4 cell count (for every 100 cells/mm3,
HR=1.06, p=0.04), and a prior AIDS-defining
illness (HR=1.22, p=0.03).
Harminder Singh et al, [15]
found that 79 HIV
positive patients were analyzed.Among them,68
(86%) had at least one ADR. The most common
ADR in our study was peripheral
neuropathy(20,83%),followed by skin
rashes(15.83%),Female patients had more ADRs
(45.71%),than Males (11.36%).Thus management
requires a highly precise balance between benefits
of durable HIV suppression and the risks of drug
toxicity to achieve the therapeutic goals,with
conventional drug or with newer less toxic agents.
Valentina Montessori et al, [16]
found that the
suppression of plasma viral loads to less than the
limit of quantification of the most sensitive
commercially available assays (i.e., less than 50
copies/mL) and the coincident improvement in
CD4 T cell counts is associated with resolution of
established opportunistic infections and a decrease
in the risk of new opportunistic infections.
However, prolonged treatment with combination
regimens can be difficult to sustain because of
problems with adherence and toxic effects. All
antiretroviral drugs can have both short-term and
long-term adverse events. The risk of specific side
effects varies from drug to drug, from drug class to
drug class, and from patient to patient. A better
understanding of the adverse effects of
antiretroviral agents is of interest not only for HIV
specialists as they try to optimize therapy, but also
for other physicians who care for HIVpositive
patients.
Le Beller C et al, [17]
found that distribution of
ADRs were metabolic (26%), digestive (22%),
psychiatric (13.5%) and cutaneous (12.5%)
disorders. Specified in 37 cases, the level of
discomfort induced by ADRs was important, very
important or unbearable in 70% of cases.
According to PV criteria of seriousness, only five
cases (12%) were recorded as serious. All ADRs
reported by patients were well known and no new
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signal on HAART safety was detected. However,
this study has given information about the feeling
of HIV patient experiencing ADRs under HAART,
which could lead to discontinue therapy. The two
ADRs reporting systems might be complementary.
A significant difference was outlined between
patient opinion and PV criteria for ADRs
seriousness compared to patient discomfort and
causal relationship between ADRs and HAART.
O.M.S. Minzi et al,[18]
found that anaemia, liver
toxicity, skin rash and peripheral neuropathy were
the most reported ADRs. The NVP plasma level
determination revealed that there was no difference
between those who had experienced skin rashes
and those who did not (mean of 6.05 and 5.5µg/ml
respectively). There was a slight increase in
reported ADRs between 2005 and 2006.
Adverse effects had reported with all antiretroviral
drugs and are among the most common reason for
switching or discontinuing therapy as well as
medication non-adherence. The incidence of ADRs
with newer antiretroviral regimens is generally
declining now (less than 10%).Several factors may
predispose individuals to certain antiretroviral
associated ADRs viz., women seem to have higher
propensity of developing “Steven-Johnson
Syndrome” and “Symptomatic drug Hepatic”
events with nevirapine and high rate of lactic
acidosis with NRTIS. Other factors include
concomitant use of medication, co-morbid
condition co-infections, - drug interactions or
generic predisposition viz., abacour
hypersensitivity reaction.
Although therapeutic goals of antiretroviral therapy
include achieving, maintaining viral suppression
and improving patient immune function, an
overarching goal should be to select a regiment that
is not only effective but is also safe. This requires
taking into account an individual patient’s
underlying conditions, concomitant medication and
history of drug intolerance.[19]
Clinicians and patients face many challenges
associated with antiretroviral (ARV) therapy.
These include decisions about when to start
therapy, what regimen to start with, when to
change medications, and how to switch if a
regimen is failing. Although clinical research
should guide the selection of ARV regimens, it is
important to remember that the best regimen for
any individual patient is the regimen he or she is
willing and able to take. No regimen, no matter
how potent, will be effective if the patient does not
take it properly. Adherence to ARV therapy is one
of the most important predictors of treatment
efficacy. Although many factors may interfere with
adherence to ARV therapy, adverse reactions to the
medications are among the most important. In one
trial, patients with adverse events were 13 times
less likely than those without adverse events to
have 95-100% adherence. Monitoring and
managing adverse reactions to ARVs are crucial to
establishing a successful HIV regimen.[20, 21]
CONCLUSION
Although adverse reactions are common and often
predictable, their management must be
individualized. Several factors will affect the
management of adverse reactions, including
comorbid conditions; the patient's other current
medications, the availability of alternative
regimens, and the patient's history of medication
intolerance. In addition, the patient's report of
severity can be inconsistent with the clinical
interpretation (i.e., some patients may
overemphasize symptoms, whereas others under
emphasize symptoms), and this must be considered
when determining the management of adverse
reactions.
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