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HIV/AIDS TreatmentAntiretroviral drugs Antiretroviral drugs are used to treat HIV infection. In the past, the high cost of these drugs meant that they were rarely used in the Caribbean and sub-Saharan Africa. Several agencies are now making funds available for antiretroviral and other therapies. These organisations include the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank Multi-sectoral AIDS Plan (MAP) and the United States President’s Emergency Plan for HIV/AIDS Relief (PEPFAR). There are three classes of first-line antiretroviral drugs:
The regimens recommended for use in the Caribbean include a combination of three antiretroviral drugs. If available, tests for the level of CD4+ cells and plasma viral load (a measure of how much HIV is replicating in the body) can be used to make judgments about when to begin therapy. Treatment will most likely start when patients develop clinical symptoms from their immunodeficiency or reach a CD4+ cell count of fewer than 350 cells per mm3. Preventing and treating opportunistic infections In addition to antiretroviral drugs, the treatment of HIV infection includes diagnosis, prophylaxis (treatment to prevent or suppress infection) and treatment of selected opportunistic infections.
Preventing and treating opportunistic infections, continued New prevention strategies are being explored. Some strategies that are currently undergoing development/research trials include:
The results of some of these studies could be available within the next two years. Additionally, a wide range of promising HIV prevention approaches are in late-stage clinical trials. Male circumcision Researchers have long observed that countries with higher rates of male circumcision have lower rates of HIV infection. In 2005, the first randomised efficacy trial of male circumcision for HIV prevention, conducted in South Africa, showed that circumcised men were 60% less likely than uncircumcised men to become infected with HIV from female partners.
barriers
Researchers hypothesise that cervical barriers such as diaphragms, which are currently used for contraception, may help protect women from HIV and other sexually transmitted diseases. An efficacy trial of the diaphragm for HIV prevention is nearing completion in South Africa and Zimbabwe, and results are expected in 2007. Pre-exposure prophylaxis with antiretrovirals Research in animals suggests that antiretroviral drugs used for HIV treatment may also be effective in preventing infection in HIV-uninfected adults, an approach called pre-exposure prophylaxis, or PrEP. Efficacy trials of this approach are underway in Botswana, Peru and Thailand. Results could be available as early as 2008. Herpes suppression Herpes, which infects up to 70% of people in some parts of sub-Saharan Africa, can triple the risk of HIV acquisition, as well as increasing the risk of transmission to others. The inexpensive, off-patent drug acyclovir is approved for herpes suppression, and two trials are being conducted in Africa, Latin America and the U.S. to test the efficacy of suppressing herpes to lower HIV risk. Results are expected in 2007 and 2008. Microbicides Microbicides are topical substances, such as gels or creams, that can be applied to the vagina or rectum to reduce HIV transmission. In 2007, two phase III studies of one candidate microbicide were stopped prematurely because in one of the studies, there was a higher number of HIV infection in the active group compared with the placebo group. Currently, there are three other phase III microbicide studies underway; results from some of these trials could be available by 2008. In addition, a number of second-generation microbicide candidates—which specifically target HIV or molecules of the cells it infects—are in earlier stages of research, and could complete clinical trials within 10 years. HIV vaccines The best long-term hope for HIV prevention is a vaccine, but developing an effective vaccine has proven to be a highly complex scientific challenge. Most experts predict that it could be 10 years or more before an HIV vaccine candidate is shown to be effective. An effective vaccine will likely need to stimulate two types of immune response, but most of the vaccine candidates developed to date are designed to target only one arm of the immune system. Currently, 30 HIV vaccine candidates are in clinical trials, including two in advanced efficacy or proof-of-concept trials. SummaryHIV is a virus that can be transmitted sexually, parenterally or perinatally. However, there are precautions to prevent each type of transmission, including condom use, needle sterilisation and short-course antiretroviral treatment during pregnancy. Treatment includes antiretroviral drugs and the prevention and treatment of opportunistic infections. Directory: sites -> default -> files -> content content -> Central area committee meeting content -> Released by LimeSurvey on 12/4/15 Partners Healthcare to upgrade on 2/1/2016 LimeSurvey 06+ (Build 151205) Full Release Notes content -> Review of human rights and social inclusion issues content -> Announcements content -> Manchester community college supplemental job description flsa: Exempt eeo-6 code: 2-20 (Faculty) SOC code: 25-1000 classification content -> Society of Women Engineering Bi-weekly Newsletter content -> Information on Deanship with technology of quick response symbol (QR) content -> Government Standard on Information & Communication Technology odg/ 14 Security content -> Byod connection Guide content -> Guide to australia’s counter-terrorism laws Download 1.91 Mb. Share with your friends:
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