anti retroviral treatment dr. alap mehta senior medical officer a.r.t. centre
TRANSCRIPT
Anti Retroviral Treatment
Dr. Alap Mehta
Senior Medical officer
A.R.T. Centre
HAART,ART Combination of different classes of
antiretroviral Highly active antiretroviral therapy ART is an ART ART is never an emergency
GOALS OF HAART Clinical goals: Prolongation of life &
improvement in quality of life. Virologic goals: Greatest possible reduction in
viral load for as long as possible to halt disease progression and to prevent or delay resistance.
Immunologic goals: Immune reconstitution that is both quantitative (CD4 within normal range) and qualitative (pathogen specific immune response)
1st Line ARV Name Of the Drugs
1. Zidovudine
2. Stavudine Drugs Supplied
3. Lamivudine By NACO at
4. Nevirepine ART Centre
5. Efavirenz
6. Tenofovir
Combinations of Regime
Zidovidine
or + Lamivudine + Nevirepine
Stavudine
or
Tenofovir
For 1st 15 Days Nevirepine Once a Day
Then twice a day
Combinations of Regime Zidovidine
or + Lamivudine + Efavirenz
Stavudine
or
Tenofovir
Efavirenz is given in Once a daily Dose For the patient who are on AKT Patient had history of Nevirepine induced rash
Benefits of 1st line Drugs Lesser Pill Count Easily Tolerable Free of Cost at ART Centers
Over all Side Effects Nausea For this Side Effects Vomiting patient can Consult
Gastritis Family Physician Itching
Serious Side Effects Skin Rash + Itching For this Severe Headache Patient Will Abdominal Pain Come to ART Severe Oral Ulcers Centre
Individual Side Effects ZI – DO – VU – DI – NE
Most Common:
Nausea , Vomiting, Gastritis, Discoloration of Nails
Most Serious:
Bone Marrow Suppression, Anemia
Least Common:
Pancreatitis
Individual Side Effects ST – VU – DI – NE
Most Common:
Nausea, Vomiting, Itching
Most Serious :
Pancreatitis, Peripheral Neuropthy,
Lactic Acidosis
Individual Side Effects LA – MI – VU – DI – NE
Very Good Tolerability
Most Serious Side Effects
Lactitc Acidosis
Individual Side Effects NE – VI – RE – PI – NE
Most Serious Side Effects
Skin Rash, SJ Syndrome, Hepatitis
( This drug can cause fatal Side Effects )
Individual Side Effects E – FA – VI – REN – Z
Most Common:
Giddiness, Itching,
Most Serious:
SJ syndrome, Hepatitis
Te-no-fo-vir Fanconi’s Syndrome Osteomalacia Bone Marrow Suppression Wasting
Thanks