HIV treatment

By : Hebatullah Hassan Abass Mohamed Rozza

4th year medical student at faculty of medicine , Alexandria, Egypt.

goal of HIV treatment

Prevent immune system from severe deterioration

Decrease incidence of coinfection

Primary care intervention

-Patients should under go screening for

diabetes, osteoporosis , renal and psychatric illness.

Lipid profiling test.--Blood monitoring for

viral load.

As a result of series 18 prospective cohort studies:

One study of nearly 7000 men with HIV infection

found that annual mortality rates decreased from 7% in

1996 to 1.3% in 2004 as a result of ART

When to initiate

therapy ???

CD4 <500 CD4 >500

-Cost of ART .-Risk of drug

resistance . -Drug

toxicites.

-Decrease HIV transmission

-better immune recovery

-If there is a hepatitis B co infection ,in pregnancy or in children below 5

According to 2013 guidelines

Initiate ART in adults who

are ready or willing to use

July 2014

Fusion inhibitor

HAART

Nucleoside reverse

transcrptase inhibitor

Non Nucleoside

reverse transcrptase

inhibitor

Integrase inhibitor

Protease inhibitor

Fusion inhibitor

Coreceptor blocker CCR5

antagonist

enfuvertide

maraviroc

Nucleoside reverse

transcrptase inhibitor

(lamivudin , zidovidine ,

tenofuvir emtricitapine)

Non Nucleoside

reverse transcrptase

inhibitor

(etravirine , nivirapine ,

delaviridine)

Integrase inhibitor raltegravir

Protease inhibitor Ritonavir

-raltegravir is more effective than

efavierinz

Treatment should include 2 nucleoside analogue combined with non nucleoside or protease inhibitor.

future hopes for HIV treatment

Monoclonal abs against

certain epitope on cd4 that

prevents infectivity of

the virus

future hopes for HIV treatment

Ibalizomab

Future hopes for HIV treatment

Gene therapy

Some people lack both copies of the CCR5 gene and are

naturally resistant to HIV

so introducing stem cells which lack

CCRF gene may be new a modality of

treatment It was done to a perlin patient in

2007

References

http://emedicine.medscape.com/article/211316-treatmenthttps://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdfhttps://aidsinfo.nih.gov/education-materials/glossary/258/fusion-inhibitor

:// . . / - / / /http www washingtonpost com wp dyn content article2011/02/28/ 2011022803737.AR html

https://lookaside.fbsbx.com/file/Monoclonal%20Abs%20against%20Host%20cellular%20receptors.pdf?

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