hiv treatment final
TRANSCRIPT
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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