Info about ARV


It has been almost 30 years to know the world of HIV and AIDS. But until now, has not yet found a cure or a vaccine to cure the disease. So if we are infected with HIV, the virus that akanterus are in our bodies.

However, although a cure for HIV / AIDS has not been found, there are medications that can slow HIV disease progression towards AIDS stage. Disebutantiretroviral the drug (ARV).

Antiretroviral therapy (ART) has been amended several times. At first, people infected with HIV are encouraged to immediately begin HAART - an approach called "hit hard, hit early" is intended to immediately slow down HIV replication process. Then followed a more conservative approach that recommends ART for PLHIV with CD4 + T cell in between 350 and 500 / mm3. According to the latest WHO recommendations, patients should start treatment before the CD4 + T cell count falls below 350 / mm3.

Today, when to start antiretroviral therapy in general is based on one of the following benchmarks, although the final decision remains with the patient and the doctor who treated him:

  1. The rate of HIV disease that are considered to be at an advanced stage (advanced stage) clinical.
  2. WHO Category IV, regardless of CD4 cell count
  3. Category III WHO taking into account CD4 cell count below 350 / mm3
  4. WHO category I or II with a CD4 cell count below 200 / mm3

 

We know two kinds of classification of HIV infection. The first of the Centers for Disease Control and Prevention (CDC) and the second from the WHO.

Infection classification according to the CDC, which was revised the last time in 1993, aims to evaluate the stage of HIV disease by looking at the count of CD4 + T lymphocytes cells and the presence of certain conditions associated with HIV disease. Commonly used in clinical and epidemiological research is CDC system consisting of three categories (A, B, and C). Clinically, a person is defined to have AIDS when the CD4 + cell count of lymphocytes T

In contrast, according to the WHO classification of HIV infection, which was revised the last time in 2005, can be applied in places with limited facilities, without the need to know how many cell count of CD4 + T lymphocytes or without the use of diagnostic methods or tests in the laboratory. The WHO system is based on clinical manifestations can be recognized and treated by a doctor or medical officer with the level of proficiency in the field of HIV and AIDS different.

The WHO classification systems used in different countries to assess whether a patient undergoing antiretroviral therapy is feasible or not. WHO clinical classification grouped into four categories (I-IV), which reflects the rate of disease from initial HIV infection to advanced stages of HIV / AIDS. These categories are defined by specific clinical condition or symptoms and apply to adults and adolescents over 15 years.

Given that the rate of HIV disease generally runs faster in young children, the treatment (ART) is usually recommended to be more aggressive than adults.

For people who are exposed to HIV (HIV Postexposure Prephylaxis or PEP for short), or in other words, people just do risky behaviors that transmit HIV to her, it is recommended to follow the antiretroviral regimen for 28 days. According to the study, if the treatment is done within 24 hours after the exposure, the success rate was 100%, whereas for those who start antiretroviral regimen within 72 hours after the exposure, the success rate dropped to 52%. This regimen is not recommended for those who are exposed to HIV more than 72 hours earlier.

ARV drugs need to be taken according to doctor's instructions both dose and time. Given that HIV is a virus that mutates, then if we do not obey the rules of the use of antiretroviral drugs, HIV inside the body can become resistant to the drug. In other words, the drugs we consume can no longer slowing HIV disease progression towards AIDS stage, so it needs to be replaced with another drug that may be more expensive or more difficult to obtain.

In Indonesia, HIV treatment generally consists of three types of antiretroviral drugs from two different categories.

In developed countries, patients were given antiretroviral drugs called HAART (Highly Active Antiretroviral Therapy), which is a combination of at least three antiretroviral drugs from three different categories. HAART can suppress the amount of HIV in a way that in many cases, be so low viral load to undetectable in the blood. These conditions are called "undetectable viral load". This means that HIV persists in the blood but can not be detected by testing Viral Load.

Keep in mind that those who are HIV positive, it is very important for a healthy life and maintain a good body by eating nutritious foods, not smoking and doing regular exercise, which could have helped slow the disease progression towards AIDS stage.

ARV drug categories:

  1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  3. Dual-Class Fixed Dose Combination
  4. Protease Inhibitors
  5. Entry Inhibitor
  6. Fusion Inhibitor