HIV / AIDS
What is HIV?
The Human Immunodeficiency Virus (HIV) is a virus that attacks progressively the immune system specifically killing certain cells, called CD4 + T lymphocytes. These cells are critical to the immune system by helping the body to combat diseases, especially infectious diseases.
There are two types of HIV HIV-1 and HIV-2. Different types of monkeys were identified in West Africa as the source of both viruses. In 1986 HIV-2 was isolated in AIDS patients in Africa. Although HIV-2 has transmission paths and cause AIDS manner similar to HIV-1 infected persons with HIV-2 immune deficiency usually develops more slowly.
There are two types of HIV HIV-1 and HIV-2. Different types of monkeys were identified in West Africa as the source of both viruses. In 1986 HIV-2 was isolated in AIDS patients in Africa. Although HIV-2 has transmission paths and cause AIDS manner similar to HIV-1 infected persons with HIV-2 immune deficiency usually develops more slowly.
HIV immune system and
the immune system serves as a defense mechanism against bacteria, viruses or parasites potentially dangerous. The malfunction of the immune system caused by HIV leads to increased susceptibility to other infections and also increases the probability for developing certain cancers. Because of the effectiveness of antiretroviral high power therapy (HAART), developed from the mid-1990s, including the combination of 3 or more different antiretroviral drugs, HIV infection / AIDS is becoming a chronic disease and more easily controllable.
At a later stage, an infection with HIV can lead to AIDS (Acquired Immunodeficiency Syndrome). This syndrome consists of a number of symptoms and disease manifestations that arise due to failure of the immune system.
Because of the effectiveness of antiretroviral high power therapy (HAART), HIV infection / AIDS is becoming a disease chronic and more easily controllable.
the immune system serves as a defense mechanism against bacteria, viruses or parasites potentially dangerous. The malfunction of the immune system caused by HIV leads to increased susceptibility to other infections and also increases the probability for developing certain cancers. Because of the effectiveness of antiretroviral high power therapy (HAART), developed from the mid-1990s, including the combination of 3 or more different antiretroviral drugs, HIV infection / AIDS is becoming a chronic disease and more easily controllable.
At a later stage, an infection with HIV can lead to AIDS (Acquired Immunodeficiency Syndrome). This syndrome consists of a number of symptoms and disease manifestations that arise due to failure of the immune system.
Because of the effectiveness of antiretroviral high power therapy (HAART), HIV infection / AIDS is becoming a disease chronic and more easily controllable.
HIV testing
Your doctor may use several tests to analyze blood, saliva or urine of the patient regarding the presence of HIV. The most common tests detect the presence of antibodies - substances which the body produces in response to the virus - HIV. Other tests detect the presence of the virus itself. In most cases, several tests are used in conjunction to give a reliable result. Depending on the test, there is a "window period" of several days or weeks between the time of infection and the time that the test can detect antibodies to HIV. This "window period" is the period of time that elapses between the moment in which the individual acquired the infection and the period in which the test becomes positive. Currently available tests have a shorter window, a few days to 2-3 weeks, which means that it is possible to diagnose early. HIV / AIDS testing is confidential, voluntary and can not be accomplished without the patient's knowledge.
Your doctor may use several tests to analyze blood, saliva or urine of the patient regarding the presence of HIV. The most common tests detect the presence of antibodies - substances which the body produces in response to the virus - HIV. Other tests detect the presence of the virus itself. In most cases, several tests are used in conjunction to give a reliable result. Depending on the test, there is a "window period" of several days or weeks between the time of infection and the time that the test can detect antibodies to HIV. This "window period" is the period of time that elapses between the moment in which the individual acquired the infection and the period in which the test becomes positive. Currently available tests have a shorter window, a few days to 2-3 weeks, which means that it is possible to diagnose early. HIV / AIDS testing is confidential, voluntary and can not be accomplished without the patient's knowledge.
Progression to AIDS
Many people infected with HIV do not get sick for many years, but as the virus progresses, it can cause serious damage to the immune system. When this happens, the HIV infected person is at risk of developing a life-threatening condition called opportunistic infection.
Many people infected with HIV do not get sick for many years, but as the virus progresses, it can cause serious damage to the immune system. When this happens, the HIV infected person is at risk of developing a life-threatening condition called opportunistic infection.
What are the symptoms of HIV?
Symptoms of HIV vary according to the stage of infection. When a person is infected with HIV, the virus invades a type of white blood cells called CD4 T lymphocytes.There is a type of analysis which measures the number of CD4 cells in blood, being a good indicator of the overall health status of the infected with HIV and of how the infection is progressing. . The lower the CD4 lymphocyte count of a patient with HIV infection, the higher your risk of getting an opportunistic infection
Healthy adults have CD4 cell numbers ranging from 500 to 1450 cells / mm3;Numbers below 500 cells / mm3 means that the immune system is damaged.
Healthy adults have CD4 cell numbers ranging from 500 to 1450 cells / mm3;Numbers below 500 cells / mm3 means that the immune system is damaged.
Opportunistic infections
of AIDS symptoms are primarily the result of diseases that do not normally develop in individuals with healthy immune systems. Most of these diseases are caused by bacteria, viruses, fungi and parasites that are usually controlled by the immune system components which affects HIV. These, so-called "opportunistic infections", and taking advantage of the weakened state of health of patients, are common in people with AIDS. HIV affects almost all body systems.
People with AIDS are also at higher risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system (lymphomas).
In addition, people AIDS often have systemic symptoms of infection such as fever, night sweats, increasing the size of lymph nodes, weakness and weight loss.
of AIDS symptoms are primarily the result of diseases that do not normally develop in individuals with healthy immune systems. Most of these diseases are caused by bacteria, viruses, fungi and parasites that are usually controlled by the immune system components which affects HIV. These, so-called "opportunistic infections", and taking advantage of the weakened state of health of patients, are common in people with AIDS. HIV affects almost all body systems.
People with AIDS are also at higher risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system (lymphomas).
In addition, people AIDS often have systemic symptoms of infection such as fever, night sweats, increasing the size of lymph nodes, weakness and weight loss.
Examples of opportunistic infections:
- Pneumocystis jiroveci (formerly known as Pneumocystis carinii)
- Tuberculosis
- Esophagitis fungal infection (eg. Candida) or viral (eg. Herpes simplex or Cytomegalovirus)
- Chronic diarrhea following infection with bacteria or parasites
- Meningitis caused by fungi (e.g., Cryptococcus neoformans)
What causes HIV?
Like all viruses, HIV needs of the cells of the "host" (ie, human body) to multiply. HIV uses CD4, a type of white blood cell that is part of the immune system. HIV penetrates the CD4 cell (referred to as host cell of the virus). Inside the cell, the genetic material of the virus enters into the cell of the CD4 DNA. For this step to occur it is necessary that from the virus genome RNA is formed a DNA strand complementary to the RNA of the HIV (pro-viral DNA). In this step, HIV requires a specific enzyme, reverse transcriptase. When the host cell DNA is copied, the genetic material of the virus is copied simultaneously giving subsequently lead to the formation of proteins which will be the constituent of the virus. These HIV proteins are secreted as long chain molecules, and then cleaved by another enzyme, a protease.The resulting smaller proteins are assembled to form new copies of the original virus, which is spread to and infect new cells successively repeating this replication cycle.
Transmission of HIV
HIV is transmitted through body fluids, in particular blood, semen, vaginal secretions and breast milk. There are 3 different modes of HIV transmission:
HIV is transmitted through body fluids, in particular blood, semen, vaginal secretions and breast milk. There are 3 different modes of HIV transmission:
- Unprotected sexual contact with an infected partner
- From infected mother to child during pregnancy, childbirth or breastfeeding
- Via Blood by exposure to blood or objects contaminated with blood from an infected person (needles, syringes) or administration of contaminated blood or derivatives
There is no transmission through casual physical contact, coughing, sneezing and kissing, by sharing toilets, using eating utensils or consuming food or drink handled by someone infected with HIV. HIV is not spread by mosquitoes or other insect bites.
How is it diagnosed?
HIV is diagnosed with a simple blood test. A blood sample is taken, which is analyzed in a clinical laboratory to detect anti-VIH.Estão antibodies currently available rapid tests that provide results in minutes, with a similar sensitivity to conventional tests.There are other types of tests, searching anti-HIV antibodies in other fluids, in particular saliva and urine.
Anti-HIV antibodies
Antibodies are proteins produced by cells of the immune system to fight infections.The antigens
are particles recognized as "foreign" by the immune system, such as bacteria, viruses and parasites. A specific antibody is specific for a particular antigen. Thus, if found anti-HIV antibodies in a person's blood, it means that that person is infected with HIV and that the body has initiated an immune response against HIV, through the production of specific antibodies. Contrary to what happens with other viral infections, HIV infection in the case of the production of specific antibodies is not followed by curing the infection.
Antibodies are proteins produced by cells of the immune system to fight infections.The antigens
are particles recognized as "foreign" by the immune system, such as bacteria, viruses and parasites. A specific antibody is specific for a particular antigen. Thus, if found anti-HIV antibodies in a person's blood, it means that that person is infected with HIV and that the body has initiated an immune response against HIV, through the production of specific antibodies. Contrary to what happens with other viral infections, HIV infection in the case of the production of specific antibodies is not followed by curing the infection.
Testing HIV
Routine analysis is carried out for HIV by ELISA (enzyme-linked immunosorbent adsorption test). The degree of sensitivity and reliability of this test is high, but can not reach 100%. This means that if there is a positive result, the diagnosis must be confirmed by a second test. It is possible that the ELISA to detect other antibodies, present by chance in the blood sample, that are not related to HIV, which can cause false positive results.
In order to identify antibodies as anti-HIV antibodies "true", it performs a second test with the same blood sample using a technique known as "western blot". This test displays the reaction of the antibody against different HIV structural proteins, allowing confirm whether or not a positive ELISA test.
Routine analysis is carried out for HIV by ELISA (enzyme-linked immunosorbent adsorption test). The degree of sensitivity and reliability of this test is high, but can not reach 100%. This means that if there is a positive result, the diagnosis must be confirmed by a second test. It is possible that the ELISA to detect other antibodies, present by chance in the blood sample, that are not related to HIV, which can cause false positive results.
In order to identify antibodies as anti-HIV antibodies "true", it performs a second test with the same blood sample using a technique known as "western blot". This test displays the reaction of the antibody against different HIV structural proteins, allowing confirm whether or not a positive ELISA test.
HIV infection stages
Determining the HIV / AIDS infection stage is an important step in the medical evaluation of people with a positive analysis for HIV. For this it is necessary to evaluate the degree of alteration of the functions of the immune system caused by the infection. The classification stages is based on the number of CD4 lymphocytes and the presence of certain infections and diseases. These indicate that the HIV infection has already progressed to AIDS.
When it is infected with HIV, the virus invades a type of white blood cell called CD4.The number of lymphocytes is a good indicator of the overall state and health of someone infected with HIV, giving also information on how HIV infection is progressing. The lower the number of CD4 lymphocytes, the greater the risk of infections. Healthy adults have CD4 lymphocyte numbers ranging from 500 to 1450 cells / mm³; a number less than 500 cells / mm³ already indicates some degree of impairment of the immune system.
Determining the HIV / AIDS infection stage is an important step in the medical evaluation of people with a positive analysis for HIV. For this it is necessary to evaluate the degree of alteration of the functions of the immune system caused by the infection. The classification stages is based on the number of CD4 lymphocytes and the presence of certain infections and diseases. These indicate that the HIV infection has already progressed to AIDS.
When it is infected with HIV, the virus invades a type of white blood cell called CD4.The number of lymphocytes is a good indicator of the overall state and health of someone infected with HIV, giving also information on how HIV infection is progressing. The lower the number of CD4 lymphocytes, the greater the risk of infections. Healthy adults have CD4 lymphocyte numbers ranging from 500 to 1450 cells / mm³; a number less than 500 cells / mm³ already indicates some degree of impairment of the immune system.
What treatments are available?
Since the introduction of HAART
(antiretroviral therapy high power) in 1996, the HIV-infected patients started to have improvements in their health and their quality of life. In fact, the average life expectancy of people with HIV has increased significantly in countries where HAART is widely used, and is now close to the general population. .
(antiretroviral therapy high power) in 1996, the HIV-infected patients started to have improvements in their health and their quality of life. In fact, the average life expectancy of people with HIV has increased significantly in countries where HAART is widely used, and is now close to the general population. .
Goals of treatment
Treatment for HIV has four main objectives:
Treatment for HIV has four main objectives:
- Increased life expectancy and quality of life of people with HIV;
- To prevent the progression of HIV disease by reducing viral load to undetectable levels;
- Restore or maintain the function of the immune system;
- Reduce the risk of passing HIV to others.
Anti-HIV drug classes
Currently, there are more than 25 medications available to help people with HIV to have lives longer and healthier. Patients take typically a combination of HIV drugs, known as antiretroviral therapy high power (HAART). These drugs belong to Class 4:
Currently, there are more than 25 medications available to help people with HIV to have lives longer and healthier. Patients take typically a combination of HIV drugs, known as antiretroviral therapy high power (HAART). These drugs belong to Class 4:
- Reverse transcriptase inhibitors nucleoside or nucleotide (NR (T) Is): NRTIs are the oldest class of anti-retroviral drugs. They block the ability of HIV reverse transcriptase to form a complementary DNA strand RNA viral genome. This step is essential for virus replication cycle, it allows you to integrate into the DNA of the host cell genome and then make copies of itself using the structures and mechanisms of the host cell (lymphocyte T CD4).
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs): NNRTIs block the same protein as NRTIs, but are chemically different. The resistance to this class of medications develops quickly if not used in combination with other active drugs on the virus.
- Protease inhibitors (PIs): PIs block protease, an enzyme that HIV needs to replicate. As a group, PIs are very potent.
- Entry inhibitors: Within this class have inhibitors and fusion inhibitors of co-receptor. Both types of entry inhibitors prevent virus entry into the host cell (T lymphocyte CD4).
- Integrase Inhibitors (IIS) inhibit the enzyme integrase, preventing the integration of pro-viral DNA complementary to virus RNA genome into the genome of the host cell and subsequent formation of new infectious virus.
Combination therapy
The HIV therapy is usually composed of three or more anti-HIV drugs belonging to the classes described above. The combination of these anti-HIV medicines intended to prevent the virus from making copies of itself, while minimizing potential side effects and the amount of pills to take. These associations are termed HAART antiretroviral therapy high power.
The EACS (European AIDS Clinical Society) indicates the following combination therapeutic regimens for initial treatment of HIV infection:
The HIV therapy is usually composed of three or more anti-HIV drugs belonging to the classes described above. The combination of these anti-HIV medicines intended to prevent the virus from making copies of itself, while minimizing potential side effects and the amount of pills to take. These associations are termed HAART antiretroviral therapy high power.
The EACS (European AIDS Clinical Society) indicates the following combination therapeutic regimens for initial treatment of HIV infection:
- 2 NRTIs + 1 PI boosted with ritonavir
- 2 NRTIs + 1 NNRTI
- 2 NRTIs + 1 IIS
Factors such as adherence to treatment, viral drug resistance, and side effects may cause the failure of a HAART regimen. If this happens, the doctor will decide how to adjust medication the patient based on their previous treatment regimens, how many drug combinations experienced and is resistant to some antiretroviral drug (ARV).
Treatment Evaluation
The number of T cells is a way of assessing the functional status of the immune system and the degree of immunosuppression associated with HIV infection. The viral load is the amount of HIV in the blood, and is a very important indication of the effectiveness of treatment (the treatment is to be effective if the virus is detectable in blood) and the prognosis of the disease: the higher the load value Faster is viral disease progression to symptomatic stage and AIDS. These two measures are very important because they help the doctor determine the patient's health status and the degree of effectiveness of medication for HIV.
The number of T cells is a way of assessing the functional status of the immune system and the degree of immunosuppression associated with HIV infection. The viral load is the amount of HIV in the blood, and is a very important indication of the effectiveness of treatment (the treatment is to be effective if the virus is detectable in blood) and the prognosis of the disease: the higher the load value Faster is viral disease progression to symptomatic stage and AIDS. These two measures are very important because they help the doctor determine the patient's health status and the degree of effectiveness of medication for HIV.
Undesirable effects
The medicines for HIV or antiretroviral (ARV) drugs, healthful key to improving the health of patients with HIV infection and increase their life expectancy, but occasionally can also make you feel bad because adverse reactions associated that may arise. The patient should always speak with your doctor about any new side effects, side effects that get worse, or side effects that do not disappear.
The medicines for HIV or antiretroviral (ARV) drugs, healthful key to improving the health of patients with HIV infection and increase their life expectancy, but occasionally can also make you feel bad because adverse reactions associated that may arise. The patient should always speak with your doctor about any new side effects, side effects that get worse, or side effects that do not disappear.
Why adherence is important in the treatment for HIV?
Adherence to treatment is the ability to meet the rigorous treatment according to medical indication. It includes the willingness to start treatment and the ability to take medications exactly as directed by your doctor.
Successful treatment
Although there are many drugs and different therapeutic regimens for HIV, studies show that the former regime is what has greater chances of success and to be maintained over time. Take medications correctly (adherence) increases the chances of success of treatment. In addition, researchers determined that optimal suppression of the virus (complete viral suppression or undetectable viral load) required are correctly taken over 90% of the drug doses (accession 90% to 95%). In each query, Patients should talk to your doctor about treatment adherence. If the patient is experiencing undesirable side effects, they may need to be treated or a change to the treatment regimen may be required. The commitment of the patient to adhere to their treatment plan is critical; studies show that patients who take their medicines properly achieve the best results.
Although there are many drugs and different therapeutic regimens for HIV, studies show that the former regime is what has greater chances of success and to be maintained over time. Take medications correctly (adherence) increases the chances of success of treatment. In addition, researchers determined that optimal suppression of the virus (complete viral suppression or undetectable viral load) required are correctly taken over 90% of the drug doses (accession 90% to 95%). In each query, Patients should talk to your doctor about treatment adherence. If the patient is experiencing undesirable side effects, they may need to be treated or a change to the treatment regimen may be required. The commitment of the patient to adhere to their treatment plan is critical; studies show that patients who take their medicines properly achieve the best results.
Accession impact
Adherence is a very important element in HIV treatment for two reasons:
Adherence is a very important element in HIV treatment for two reasons:
- The adhesion has a direct impact on the effectiveness of anti-HIV drugs, reflected as a reduction in viral load. When the patient forgets to take a dose, even just once, the virus has a chance to reproduce faster. It is essential to maintain a minimum of HIV replication (undetectable viral load) to prevent the onset of complications or not related to AIDS and death.
- Adherence to HIV treatment helps prevent the emergence of resistance to anti-retroviral drugs. When the lack of adherence to treatment, HIV can acquire mutations. This can lead to the emergence of HIV mutant viruses that are resistant to medication.
Consequences of non-adherence to treatment
when there are gaps in medication doses, may develop strains of HIV resistant to medicines that you are taking, and even other drugs that never took. This can lead to that has less treatment options, in case you need a change in treatment regimen in the future.
Since the strains of drug-resistant virus can be transmitted to others, the adoption of risk behaviors can in this sense have serious consequences. The transmission of virus strains with drug resistance to other (s) person (s) means that (s) person (s) starting already have (are) lower treatment options, shortly after acquiring the infection.
when there are gaps in medication doses, may develop strains of HIV resistant to medicines that you are taking, and even other drugs that never took. This can lead to that has less treatment options, in case you need a change in treatment regimen in the future.
Since the strains of drug-resistant virus can be transmitted to others, the adoption of risk behaviors can in this sense have serious consequences. The transmission of virus strains with drug resistance to other (s) person (s) means that (s) person (s) starting already have (are) lower treatment options, shortly after acquiring the infection.
Challenges
is now possible to build simple treatment regimens with reduced number of tablets per day in one or two doses per day only. At the same time, there is a concern develop drugs more and more tolerated by patients. The reduction of side effects associated with antiretroviral drugs results in easier and better adherence which, in turn, translates to greater efficiency.
is now possible to build simple treatment regimens with reduced number of tablets per day in one or two doses per day only. At the same time, there is a concern develop drugs more and more tolerated by patients. The reduction of side effects associated with antiretroviral drugs results in easier and better adherence which, in turn, translates to greater efficiency.
Factors that may hinder adherence to a treatment regimen for HIV include:
- Get side effects of medications (such as nausea, diarrhea);
- Very intense rhythm of life
- Travel, particularly for different time zones;
- Doubts about the medication's effectiveness
- Feeling sick or depressed;
- Forgetting to take medications.
Advice about joining
One of the most important things you can do at the beginning of a treatment regimen is to talk to our doctor about our lifestyle. He can then prescribe an optimized scheme for each case. The topics that the patient should talk to your doctor include:
One of the most important things you can do at the beginning of a treatment regimen is to talk to our doctor about our lifestyle. He can then prescribe an optimized scheme for each case. The topics that the patient should talk to your doctor include:
- Their schedules for travel, accommodation and meals;
- Possible side effects of medication;
- Other medicines you are taking and possible interactions with anti-HIV medicines;
- Your level of commitment to follow a treatment regimen for HIV.
Some advice to help the patient with their treatment regimen:
- Get a treatment guide written to indicate each medication, when and how to take it, and should be taken with meals or on an empty stomach.
- Be honest about personal issues that may affect the adhesion. Adherence may be harder for people dealing with drug addiction or alcoholism, unstable housing situation, mental illness or other difficult situations.
- Consider making a "take-placebo". Practice regimen with vitamins or candy. This may help determine the start that the most difficult to take doses correctly.
Many people find it helpful to identify the activities they normally do at times when they will take their medications. People who adjust their schedules taking medication according to their daily routines adhere better to their treatment regimens than those who do not.
Many people adhere well to treatment at first, but over time, find it difficult to continue.To maintain adherence might be useful to follow the following advice:
- Take the drugs at the same time every day.
- At the beginning of each week, putting the medication for a week in a pill box.
- Use timers, alarm clocks or phones to remember when to take the medication.
- Keep medicines in place that are taken. You may want to hold a reservation in the workplace, folder or portfolio.
- Take a daily medication. Write the names of medicines in the daily schedule and check off each dose as you take.
- Plan ahead-a-week, holidays and changes in routine.
- Develop a support network consisting of family, friends and colleagues who can remind the patient to take medication. Some people also find it helpful to get into a support group for people infected by HIV.
- Control the stock of drugs. Contact the doctor or hospital if the medicines are not sufficient to the next appointment.
What to know about drug resistance to HIV?
Drug resistance occurs when HIV is not properly controlled and quickly makes copies of itself. It is considered that is drug-resistant HIV when no longer responds to the medication the patient is taking for HIV.
Why is the medication stops working?
When HIV makes copies of itself, can make copies that have mutations. Mutations happen because HIV reproduces very quickly, occurring errors in the process. Some of the errors, or mutant viruses are harmless since they are too weak to survive and / or unable to reproduce. Other strains can reproduce rapidly, and finally pass represent the most common type of HIV in the body. Once this happens, the medication which the patient is taking longer has effect on HIV.
When there is resistance to antiretroviral drugs, the viral load of a person (amount of HIV in a blood sample) increases and he / she has to change to a new combination of anti-retroviral drugs (ARVs).
One of the main measures to prevent the development of drug resistance is to prevent the virus from making copies of itself. Therefore, the optimal adherence to a treatment regimen is very important - consistent use of ARV medications helps prevent the reproduction of the virus.
When there is resistance to antiretroviral drugs, the viral load of a person (amount of HIV in a blood sample) increases and he / she has to change to a new combination of anti-retroviral drugs (ARVs).
One of the main measures to prevent the development of drug resistance is to prevent the virus from making copies of itself. Therefore, the optimal adherence to a treatment regimen is very important - consistent use of ARV medications helps prevent the reproduction of the virus.
Class resistanceSometimes you need just one mutation for HIV to become resistant to an entire class of anti-retroviral drugs (ARVs). This is the case of first-generation NNRTIs. If the strain of HIV is resistant to one NNRTI, can become resistant to all first generation NNRTIs. This phenomenon is known as cross-resistance, since the resistance to antiretroviral medicament conferring resistance to other ARV.
Moreover, several mutations are necessary for HIV becomes resistant to protease inhibitors (PIs).
Researchers have identified mutations that make the HIV resistant to one or more NRTIs.
Analysis Resistance
The purpose of the analysis resistance is to detect HIV mutant strains and developed mutations affect the activity of one or more of anti-retroviral (ARV) that the patient is taking.
The analysis resistance became standard for anyone with failure of HAART (antiretroviral therapy high power), but is also important in other situations:
The purpose of the analysis resistance is to detect HIV mutant strains and developed mutations affect the activity of one or more of anti-retroviral (ARV) that the patient is taking.
The analysis resistance became standard for anyone with failure of HAART (antiretroviral therapy high power), but is also important in other situations:
- The patient had never taken any ARV medicine. Even if the patient has never taken any ARV drug, the person who infected this patient may have them taken and developed resistance to one or more ARVs. This resistance may have been transmitted to the patient.
- The viral load of the patient during treatment increases. If the patient being treated and his viral load increases, its strain of HIV may have become resistant to one or more of the medications he is taking.
- The patient may need to change your medication. If the patient needs to change one or more of your medications and your viral load is greater than 1000 copies / mL, a resistance analysis will help determine which medication will work best in that particular case .
- In the case of a pregnant patient. If the viral load is detectable (no HIV copies in the blood of patient), resistance analysis can help identify which drugs are not working, so as to reduce the risk of transmitting virus to her baby. The children of a woman with HIV should be fed with artificial milk, taking into account the risk of HIV transmission through breast milk.
What should a patient ask the doctor?
Living with HIV means taking good care of health daily. This also means working closely with the doctor and his team. Together, the patient and the healthcare team, can devise a plan to fight the virus, prevent the occurrence of infections and other complications, including cardiovascular problems and improve the quality of life of the infected person. The patient should go to the query as indicated by your doctor, usually at intervals of 3-6 months for clinical evaluation and the results of recent analyzes.
The doctor asks analysis periodically to assess the general health of the patient verify the progression of the disease and determine the best treatment. These analyzes also allow the identification of risk factors that the patient may have for other diseases.
The doctor asks analysis periodically to assess the general health of the patient verify the progression of the disease and determine the best treatment. These analyzes also allow the identification of risk factors that the patient may have for other diseases.
Common questions
Should start immediately anti-retroviral if they have a positive analysis HIV treatment?
The clinical situation and the results of the analysis that quantifies the number of CD4 and viral load analysis will determine the need for urgent treatment. A lower number of 350 CD4 cells / mm3 requires initiation of treatment even in asymptomatic persons.
Between 350 and 500 lymphocytes / mm3, European guidelines advise the beginning of the treatment in certain situations. On the other hand, when the number is greater than 500 lymphocytes / mm3, the guidelines are less strict. The doctor, after reflection with the patient, decide whether you will immediately prescribe antiretroviral treatment.
Considering the importance of patient adherence to treatment, we must be aware that the treatment is the right decision at this time.
The clinical situation and the results of the analysis that quantifies the number of CD4 and viral load analysis will determine the need for urgent treatment. A lower number of 350 CD4 cells / mm3 requires initiation of treatment even in asymptomatic persons.
Between 350 and 500 lymphocytes / mm3, European guidelines advise the beginning of the treatment in certain situations. On the other hand, when the number is greater than 500 lymphocytes / mm3, the guidelines are less strict. The doctor, after reflection with the patient, decide whether you will immediately prescribe antiretroviral treatment.
Considering the importance of patient adherence to treatment, we must be aware that the treatment is the right decision at this time.
How effective are latex condoms in the prevention of sexual transmission of HIV infection?
Latex condoms, when properly used, are highly effective in the prevention of heterosexual transmission of HIV, the virus that causes AIDS.
However, it should have become aware that the use of a condom does not protect totally HIV. The only way to avoid at all HIV transmission is to abstain from sex, or have a long-term monogamous relationship with a tested and know you're not infected partner.
Latex condoms, when properly used, are highly effective in the prevention of heterosexual transmission of HIV, the virus that causes AIDS.
However, it should have become aware that the use of a condom does not protect totally HIV. The only way to avoid at all HIV transmission is to abstain from sex, or have a long-term monogamous relationship with a tested and know you're not infected partner.
How long it takes HIV to cause AIDS?
Before 1996, scientists estimated that about half of peoplewith HIV develop AIDS within 10 years after the infection.This time varied greatly from person to person and depended on many factors including a person's health status and their behaviors associated with health.
Since 1996, the introduction of antiretroviral therapy high power (HAART) radically changed the time that elapses between the time of acquisition of HIV infection and AIDS development. There are also other medical treatments that can prevent or cure any of the diseases associated with AIDS, although not cure AIDS itself. Due to these advances in drug therapies and other medical treatments, estimates of how many people will develop AIDS and the development time being recalculated, revised or currently under investigation.
As in other diseases, early detection of infection allows more treatment options and preventive health care.
Before 1996, scientists estimated that about half of people
with HIV develop AIDS within 10 years after the infection.This time varied greatly from person to person and depended on many factors including a person's health status and their behaviors associated with health. Since 1996, the introduction of antiretroviral therapy high power (HAART) radically changed the time that elapses between the time of acquisition of HIV infection and AIDS development. There are also other medical treatments that can prevent or cure any of the diseases associated with AIDS, although not cure AIDS itself. Due to these advances in drug therapies and other medical treatments, estimates of how many people will develop AIDS and the development time being recalculated, revised or currently under investigation.
As in other diseases, early detection of infection allows more treatment options and preventive health care.
How can one know if one is infected with HIV?
The only way to know if you are infected is to be tested for HIV. We can not rely on symptoms to know whether we are infected. Many people who are infected with HIV do not have any symptoms for many years.
It is especially important to take a test if you have used intravenous drugs or shared injecting equipment, have had unprotected sex (without a condom) with partners of whom are unaware of the status for HIV, or even if you have been diagnosed with tuberculosis, hepatitis or sexually transmitted diseases (eg syphilis).
It is essential that pregnant or intend to become pregnant also carry out the HIV diagnostic test, for the possible transmission of HIV to child can be prevented.
The only way to know if you are infected is to be tested for HIV. We can not rely on symptoms to know whether we are infected. Many people who are infected with HIV do not have any symptoms for many years.
It is especially important to take a test if you have used intravenous drugs or shared injecting equipment, have had unprotected sex (without a condom) with partners of whom are unaware of the status for HIV, or even if you have been diagnosed with tuberculosis, hepatitis or sexually transmitted diseases (eg syphilis).
It is essential that pregnant or intend to become pregnant also carry out the HIV diagnostic test, for the possible transmission of HIV to child can be prevented.
How long should one wait to get tested after possible exposure?
It may take some time for the immune system to produce enough antibodies to be detected in HIV analysis, and this period varies from person to person. This period is commonly known as the "window period."
Most people have detectable antibodies between 2 to 8 weeks after infection (the average is 25 days). Still, there is the possibility that some individuals take longer to have detectable antibodies. Thus, if the first HIV test is negative and is performed within 3 months of the possible exposure should be considered its repetition over the past three months of exposure. In very rare cases it can take up to 6 months to be producing anti-HIV antibodies.
It may take some time for the immune system to produce enough antibodies to be detected in HIV analysis, and this period varies from person to person. This period is commonly known as the "window period."
Most people have detectable antibodies between 2 to 8 weeks after infection (the average is 25 days). Still, there is the possibility that some individuals take longer to have detectable antibodies. Thus, if the first HIV test is negative and is performed within 3 months of the possible exposure should be considered its repetition over the past three months of exposure. In very rare cases it can take up to 6 months to be producing anti-HIV antibodies.
Is there a connection between HIV and other sexually transmitted diseases?
Yes. Having a sexually transmitted disease (STD) may increase the risk of HIV infection, whether the STD causes sores or breaks in the skin (eg .: syphilis, herpes) or not (ex .: chlamydia, gonorrhea).
If the DST cause irritation , fissures or ulcers on the skin, it may be easier to enter the body HIV during sexual contact. Even when an STD causes no open cracks or ulcers, infection can stimulate an immune response in the genital area that can facilitate transmission of HIV.
Furthermore, if an HIV-infected person is also infected with another STD, has a probability three to five times that of other people infected with HIV transmit the virus through sexual contact.
Yes. Having a sexually transmitted disease (STD) may increase the risk of HIV infection, whether the STD causes sores or breaks in the skin (eg .: syphilis, herpes) or not (ex .: chlamydia, gonorrhea).
If the DST cause irritation , fissures or ulcers on the skin, it may be easier to enter the body HIV during sexual contact. Even when an STD causes no open cracks or ulcers, infection can stimulate an immune response in the genital area that can facilitate transmission of HIV.
Furthermore, if an HIV-infected person is also infected with another STD, has a probability three to five times that of other people infected with HIV transmit the virus through sexual contact.
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| http://www.yeast-infection-in-men.net/ |
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