Done by me for my colleague! Treatment for hiv infection.

1. PROHYLAXIS &TREATMENT
HIV
HIV YOGA SRINIVAS ANANTHA

2. Transmission prevention /
Safer sex
Abstinence from sexual relations
use of condoms
Male circumcision
sexual
Avoidance of sharing of needles and other
paraphernalia
Avoiding sterile needles
IDA’S
Screening of all blood donors for HIV Antibody nucleic acid in
addition clotting factor concentrates are heat treated,
essentially eliminating the risk to haemophiliacs who require
these products.
BloodMTCT
AZT (reduces risk by 3 fold)
Mother @before delivery
Baby @6 weeks
NEOVIRAPINE (reduce transmission by 50%)
Mother @at onset of labour
Neonate @1st three days
HIV

3. PRE EXPOSURE PROPHYLAXIS
A new strategy?
2011& 2012 results support this – TENOFOVIR
It prevented HIV transmission & new infections
HIV

6. Effectiveness of PEP depends on….
• Efficacy of PEP is best if administered within two hours of
exposure.
• PEP need to be given within 72 hours of exposure.
• Do not delay PEP while waiting for result of HIV testing.
• Informed consent must be obtained before testing a source as
per National guidelines.
• Base line rapid HIV testing before PEP.
• Negative result does not exclude HIV infection.
• Positive HIV result helps in stopping the PEP

7. TOPICAL MICROBICIDES
Reports from 2010 research
A candidate vaginal gel containing the antiviral drug
TENOFOVIR reduced HIV acquisition by 39%
HIV

8. VACCINES AGAINST HIV
All candidate vaccines tested as of 2011 proved ineffective at
preventing infection.
One goal of vaccine research is to design “IMMUNOGENS”
HIV

9. GENE THERAPY
BEING DEVELOPED TO ACHIEVE
“INTRA-CELLULAR IMMUNISATION”
HIV

10. HEALTH EDUCATION
It plays an important role and important part of prophylaxis
HIV

11. TREATMENT

12. ANTI RETRO VIRAL THERAPY
• GOALS
• CLINICAL GOALS
• VIROLOGICAL GOALS
• IMMUNOLOGICAL GOALS
• THERAPEUTIC GOALS
• REDUCTION OF HIV TRANSMISSION IN INDIVIGUALS

13. FUSION INHIBITORS @2003
ENTRY INHIBITORS @2007
INTERGRASE INHIBITORS @2007
ANTIVIRAL DRUGS
HIV
Nucleoside
&
Non nucleoside
inhibitors of viral
enzyme
Inhibitors of viral
“PROTEASE
ENZYME”

23. HAART
HIGHLIGHTES:
• It often can suppress viral replication below the limits of detection in
plasma
• Decreases the viral load in lymphoid tissues
• Allow the recovery of immune response's
HIV

24. Recommended choices of first-line
regimens
• Principles for selecting the first-line regimen
• 1. Choose 3TC (lamivudine) in all regimens
• 2. Choose one NRTI to combine with 3TC (AZT or d4T)
• 3. Choose one NNRTI (NVP or EFV)
• First choice: AZT + 3TC + NVP
• for patients with Hb > 8 g/d Substitute NVP with EFV, for patients
with TB or toxicity to NVP

25. What to Expect in the First Six Months of Therapy
CD4
recovery
Early ARV
toxicity
IRIS

26. IRIS
• “occurrence or manifestations of new OIs or existing OIs within six
weeks t six months after initiating ART; with an increase in CD4
count”.

27. Drug resistant variants in treatment of naïve patients
A NEW CHALLENGE ???
In 2004 & 2005; patients with newly diagnosed HIV were found to carry
drug resistant mutants 8% and10% of cases in USA & Europe
respectively.
Infants (PI) USA 2002, 19% - Resistant mutants
HIV

28. COMBINATION THERAPY
A BOON!!
CT turned HIV infection in to chronic treatable disease
Highlights:
• Suppression of viral replication can be achieved
• Restoration of immune function
DRAWBACKS
HIV
ZIDOVUDINE + LAMIVUDINE Combivir
ZIDOVUDINE + ABACAVIR Epzicom
ZIDOVUDINE + LAMIVUDINE + ABACAVIR Trizivir
TENOFOVIR + EMTRICITABINE Truveda
TENOFOVIR + EMTRICITABINE + EFAVIRENZ Atripla
STAVUDINE + LAMIVUDINE + NEVIRAPINE Triomune
COMBINATION FORMULATION