HIV AIDS medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
===Anti-HIV Medication=== | |||
Anti-HIV medications (also called antiretrovirals) are grouped into six drug classes according to their mechanism of action. | Anti-HIV medications (also called antiretrovirals) are grouped into six drug classes according to their mechanism of action. | ||
The six classes are as follows: | The six classes are as follows: | ||
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Multidrug regimen has proved to be very beneficial because of reduction in progression to AIDS, opportunistic infections, rate of hospitalizations and deaths. <ref name="pmid16054937">{{cite journal |author=Sterne JA, Hernán MA, Ledergerber B, Tilling K, Weber R, Sendi P, Rickenbach M, Robins JM, Egger M |title=Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study |journal=Lancet |volume=366 |issue=9483 |pages=378–84 |year=2005 |pmid=16054937 |doi=10.1016/S0140-6736(05)67022-5 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(05)67022-5 |accessdate=2012-02-15}}</ref> | Multidrug regimen has proved to be very beneficial because of reduction in progression to AIDS, opportunistic infections, rate of hospitalizations and deaths. <ref name="pmid16054937">{{cite journal |author=Sterne JA, Hernán MA, Ledergerber B, Tilling K, Weber R, Sendi P, Rickenbach M, Robins JM, Egger M |title=Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study |journal=Lancet |volume=366 |issue=9483 |pages=378–84 |year=2005 |pmid=16054937 |doi=10.1016/S0140-6736(05)67022-5 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(05)67022-5 |accessdate=2012-02-15}}</ref> | ||
== | ===Goals of Therap=y== | ||
= | |||
DHHS ART Guidelines present the following goals for therapy: | DHHS ART Guidelines present the following goals for therapy: | ||
* Durable suppression of HIV [[viral load]] ( to <50 cells/mL ). | * Durable suppression of HIV [[viral load]] ( to <50 cells/mL ). | ||
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Uncontrolled [[viremia]] causes [[inflammation]] and immune activation, which has an overall effect on [[cardiovascular]], [[renal]] and [[hepatic]] systems. Controlling viremia also controls these effects. | Uncontrolled [[viremia]] causes [[inflammation]] and immune activation, which has an overall effect on [[cardiovascular]], [[renal]] and [[hepatic]] systems. Controlling viremia also controls these effects. | ||
==Anti Retroviral Therapy (ART)== | ===Indications=== | ||
===Anti Retroviral Therapy (ART)=== | |||
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===Guidelines for Initiation of ART=== | ===Guidelines for Initiation of ART=== | ||
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* Counseling to prevent secondary transmission of HIV remains an important aspect of the care of the older HIV infected patient. | * Counseling to prevent secondary transmission of HIV remains an important aspect of the care of the older HIV infected patient. | ||
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==Related Chapters== | ==Related Chapters== | ||
Revision as of 13:36, 1 October 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The primary goal of antiretroviral therapy (ART) is to reduce HIV-associated morbidity and mortality. This goal is best accomplished by using effective ART to maximally inhibit HIV replication, as defined by achieving and maintaining plasma HIV RNA (viral load) below levels detectable by commercially available assays. Durable viral suppression improves immune function and quality of life, lowers the risk of both AIDS-defining and non-AIDS-defining complications, and prolongs life. Based on emerging evidence, additional benefits of ART include a reduction in HIV-associated inflammation and possibly its associated complications.
Medical Therapy
Anti-HIV Medication
Anti-HIV medications (also called antiretrovirals) are grouped into six drug classes according to their mechanism of action. The six classes are as follows:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs).
- Nucleoside reverse transcriptase inhibitors (NRTIs).
- Protease inhibitors (PIs).
- Fusion inhibitors.
- CCR5 antagonists.
- Integrase inhibitors.
Multidrug regimen has proved to be very beneficial because of reduction in progression to AIDS, opportunistic infections, rate of hospitalizations and deaths. [1]
=Goals of Therap=y
DHHS ART Guidelines present the following goals for therapy:
- Durable suppression of HIV viral load ( to <50 cells/mL ).
- Restoration of normal CD4 cell count.
- Prevention of transmission of the disease.
- Prevention of building of drug resistance.
- Improvement in quality of life of the patient.
Uncontrolled viremia causes inflammation and immune activation, which has an overall effect on cardiovascular, renal and hepatic systems. Controlling viremia also controls these effects.
Indications
Anti Retroviral Therapy (ART)
Related Chapters
- HIV Treatment
- Antiretroviral drug
- Antiretroviral therapy in pregnancy
- Immune reconstitution inflammatory syndrome
References
- ↑ Sterne JA, Hernán MA, Ledergerber B, Tilling K, Weber R, Sendi P, Rickenbach M, Robins JM, Egger M (2005). "Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study". Lancet. 366 (9483): 378–84. doi:10.1016/S0140-6736(05)67022-5. PMID 16054937. Retrieved 2012-02-15.