ARV Herbals - About HIV

About HIV/AIDS

About HIV

HIV virus is a retro-virus composed of two (2) strands of RNA which accesses the human body via blood, semen, and vaginal secretions and occasionally through body fluids and contaminated sharps. It’s viral protein gp120 locks on with T4 lymphocytes and viral replication starts immediately thereafter and dissemination occurs through circulatory and lymphatic system and results in acute HIV disease within 2-3 weeks and CD4 (T4 lymphocytes) count drops down temporarily but significantly and due to intense immune response to the host, CD4 count bounces back a little later but not up to the previous level. In due course, the CD4 count drops down gradually and viral load (RNA copies) increases correspondingly.

The AIDS and opportunistic infection sets in when the CD4 count drops below 200ul. It is to be appreciated the CD4 (T4 lymphocytes) plays the most and prominent part in the defensive reaction in all types of infections.

Who guidelines on HIV staging without CD4 counts

Stage I ASYMPTOMATIC ONLY LYMPHNODES ENLARGED	Stage II 10% WEIGHT LOSS MINOR MUCOCUTANEOUS LESIONS HERPES ZOSTER RECURRENT URI
Stage III DAIRROHEA 30 DAYS FEVER 30 DAYS THRUSH ORAL HAIRY LECUOPLAKIA PT, PNEUMONIA	Stage IV HIV WASTING PNEUMOCYSTIS CARNIEI LYMPHOMAS KAPOSI SARCOMA HIV ENCEPHALOPATHY MENIGITIS CRYPTOCOCCAL INFECTIONS RESPIRATORY MYCOSIS BASAL CELL CARCINOMA

WHO TREATMENT

2 FIXED LINES FDC (Three drugs combined in a fixed ratio by weight)
2 FLEXIBLE LINES (Three drugs combined)

I Line FDC

d4T (STAVUDINE) NRTI
3TC (LAMIVUDINE) NRTI
NVP (NEVIRAPINE) NRTI

II Line FDC

ZDV (ZID0VUDINE) NRTI
3TC (LAMIVUDINE) NRTI
NVP (NEVIRAPINE) NRTI

NRTI - NEUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR

III Line FDC

d4T (STAVUDINE) NRTI
3TC (LAMIVUDINE) NRTI
EFZ (EFAVIRENZ) NNRTI

IV Line FDC

ZDV (ZID0VUDINE) NRTI
3TC (LAMIVUDINE) NRTI
EFZ (EFAVIRENZ) NNRTI

NNRTI - NON-NEUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR

Treatment failure means CD4 count drops to 50% of the previous count. If treatment failure arises, suitable second line to be chosen 40-50% of patients will not have sustained fall in VIRAL LOAD even in one year of therapy besides poor tolerance and severe toxicity

BASIC TOXICITIES ON NRTI / NNRTI TREATMENT For NRTI

Lacticacidosis

Hepatic steatosis

Peripheral fat wasting

Bone marrow depression

Myopathy

Peripheral Neuropathy

Pancreatitis

For NNRTI

Rashes

Hepatitis

Hyper cholesteriemia

Cost for the above treatment normally Rs 9000 - 12000 per month besides drug failure, intolerance and toxicity and besides costs of lab tests. Treatment costs of opportunistic infections and prophylaxis extra.