HIV Prevention and Treatment

Treatment

HIV treatment helps to reduce the amount of HIV in the body
One can control HIV with proper medical care
HIV medicines does not prevent the transmission of other sexually transmitted diseases
There is no cure for HIV

What is an antiretroviral therapy?

The medicines that help in the treatment of HIV is known as antiretroviral therapy
The treatment regimen is comprised of a combination of three or more antiretroviral drugs
ART helps in inhibiting the viral replication by several mechanism
ART should be administered in consultation with doctor

What is the mechanism of action of Antiretroviral therapy?

They are the drugs that inhibit HIV replication by several mechanisms so that propagation of a virus with resistance to a single agent is inhibited by the action of the other two agents

Treatment options of ART

1. Nucleoside/Nucleotide reverse transcriptase inhibitors (NRTIs)
Ex: Abacavir, zidovudine, Didanosine, lamivudine, stavudine, tenofovir
What are nucleoside reverse transcriptase inhibitors?
- They are the drug that inhibit viral replication by chain termination after being incorporated into growing DNA strands by HIV-1 reverse transcription
2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Ex: Efavirenz, nevirapine, rilpivirine
What are non nucleoside reverse transcriptase inhibitors?
- They are the drugs same like nucleoside revers transcriptase inhibitors, where they interfere with reverse transcription by binding reverse transcription
3. Protease inhibitors (PIs)
Ex: Atazanavir, darunavir, indinavir
What is the role of protease inhibitors?
- They are the agents that inhibit protease enzyme which play an important role in assembly of new virus particle
4. Integrase strand transfer inhibitors (INSTIs)
Ex: Dolutegravir, elvitegravir, raltegravir
What is the role of integrase strand transfer inhibitors?
- They are the agents that inhibit viral DNA insertion in to the host cellular genome
5. Fusion inhibitors (FIs)
Ex: Enfuvirtide
What are fusion inhibitors?
- They are the agents which blocks the HIV envelope from merging with the host CD4 cell membrane (fusion). This prevents HIV from entering the CD4 cell
6. Chemokine receptor antagonists (CCR5 antagonists)
Ex: Maraviroc
What are chemokine receptor antagonist?
- They are the agents which blocks viral entry via CCR5 co-receptor into host cells, reduces viral load, and increases T-cell counts in CCR5-tropic HIV-1 (i.e., R5 virus)

When to start HIV treatment:
- Start treatment if diagnosed with HIV
- Treatment is recommended for all people with HIV
- Discuss with doctor about administration of other medicines
What if treatment is delayed:
- Immune system is weakened
- The risk of transmitting HIV to others is high
- Progress to develop AIDS
What are the side effects of HIV treatment:
- The common side effects of HIV medicines are diarrhea, difficulty in sleeping, dry mouth, headache, rash, dizziness, fatigue, nausea and vomiting

What are the advantages of HIV treatment?

Helps in reducing the amount of viral load in blood

Makes the viral load low which can not be detected

Helps in reducing the viral load low and maintains CD4 cell count

Helps to stay healthy by keeping undetectable viral load

Helps to prevent transmission to others

Having an undetectable viral load may also help prevent transmission from injection drug use, mother to baby

Helps to prevent drug resistance when taken as prescribed

Lifestyle modifications

What are the lifestyle modifications required and how they help in maintaining a healthy life?

Healthy diet has benefits like
- Maintaining proper weight
- Increasing the absorption of medicines
- Providing energy to fight against HIV and other opportunistic infections
Regular exercise has benefits like
- Helps in maintaining good physical and mental health
- The chance of depression is reduced
- Improves immune system
Disadvantages of smoking
- If a person is diagnosed with HIV and continues to smoke regularly then they are more likely to
- Lead only a short span of life
- Response to HIV treatment is not met or very poor
- Progress to third stage of HIV i.e. AIDS
- More prone to develop lung cancer, head and neck cancers, cervical and anal cancers, and other cancers

How to prevent from HIV

Protecting yourself
during sex

Have sex with no risk
Avoid to have contact with body fluids like semen, vaginal fluid or blood

Take PrEP

It is used as medicine to prevent from HIV where it is effective only when taken as prescribed

Doctors prescribe PrEP to people who are at substantial risk of HIV infection

Get tested

Earlier test and treatment for STD can lower the chances of risk for HIV

How a pregnant woman can prevent herself from HIV?

The earlier diagnosis helps in preventing transmission of HIV

to baby. She can prevent HIV to her baby by following few measures like:

She should take HIV test in third trimester if participated in sex with her partner
She should always encourage her partner to get tested for HIV
She should consult to doctor and take medicines as prescribed if she is diagnosed for HIV positive
She should avoid breast feeding after delivery

Using condoms in right way

HIV and other sexually transmitted diseases can be prevented by using condoms

Use water based or silicon based lubricants to prevent from breaking or slipping during sex

Don’t have sex

The best way to prevent from other sexually transmitted diseases is to avoid to have sex

Encourage your partner to get tested

This helps your partner to stay healthy

There is no risk of transferring HIV from either partner during sex when he/she takes HIV medicines

What is Pre-exposure prophylaxis

PrEP is a medicine given to people who are at high risk for HIV
This medicine helps to prevent HIV from sex
It reduces the risk of HIV when taken as prescribed
It is less effective when not used as prescribed

To whom PrEP is right for?

PrEP is right

To individuals who were tested negative for HIV
People who had either anal or vaginal sex in the past 6 months
Individuals who have Partners infected with HIV
Individuals who do not use condoms in the right way
Individuals who shared contaminated needles, syringes
Individuals who have been prescribed with post-exposure prophylaxis

When to start and stop PrEP

WHEN TO START

After consulting health care provider before taking PrEP

When HIV test shows negative

Consult to doctor every 3 months for follow-up visits, HIV tests and prescription refills

WHEN TO STOP

When the risk of HIV is very low to infect

When severe side effects were observed

When PrEP reacts the body in unsafe ways

What is Post-exposure prophylaxis

Post exposure prophylaxis is a medicine which is taken after being exposed to virus to prevent from HIV
PEP should be taken within 72 hours after exposure to virus
It has little effect if taken after 72 hours (3 days)
It is not required to people who are frequently exposed to HIV

To whom PEP is right for?

PEP is right

To individuals whose HIV status is negative
To individuals who have been exposed to HIV during sex, through sharing contaminated needles etc, and who have been sexually assaulted

When to start and stop PEP

WHEN TO START

After consulting to health care provider

After having possible exposure to HIV virus

Within 72 hours after being exposed to virus

HOW LONG TO USE

Individuals should take PEP every day for 28 days

Talk to healthcare provider after finishing HIV test

When PrEP reacts the body in unsafe ways

1. Nucleoside/Nucleotide reverse transcriptase inhibitors (NRTIs)

2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

3. Protease inhibitors (PIs)

4. Integrase strand transfer inhibitors (INSTIs)

5. Fusion inhibitors (FIs)

6. Chemokine receptor antagonists (CCR5 antagonists)