Anti Retroviral Treatment

Dr. Alap MehtaSenior Medical officerA.R.T. Centre

HAART,ART Combination of different classes of

antiretroviral Highly active antiretroviral therapy ART is an ART ART is never an emergency

GOALS OF HAART Clinical goals: Prolongation of life &

improvement in quality of life. Virologic goals: Greatest possible reduction in

viral load for as long as possible to halt disease progression and to prevent or delay resistance.

Immunologic goals: Immune reconstitution that is both quantitative (CD4 within normal range) and qualitative (pathogen specific immune response)

1st Line ARV Name Of the Drugs1. Zidovudine2. Stavudine Drugs Supplied

3. Lamivudine By NACO at 4. Nevirepine ART Centre5. Efavirenz6. Tenofovir

Combinations of Regime Zidovidine or + Lamivudine + NevirepineStavudine orTenofovirFor 1st 15 Days Nevirepine Once a Day Then twice a day

Combinations of Regime Zidovidine or + Lamivudine + EfavirenzStavudine

orTenofovir Efavirenz is given in Once a daily Dose For the patient who are on AKT Patient had history of Nevirepine induced rash

Benefits of 1st line Drugs Lesser Pill Count Easily Tolerable Free of Cost at ART Centers

Over all Side Effects Nausea For this Side Effects Vomiting patient can Consult

Gastritis Family Physician Itching

Serious Side Effects Skin Rash + Itching For this Severe Headache Patient Will Abdominal Pain Come to ART Severe Oral Ulcers Centre

Individual Side Effects ZI – DO – VU – DI – NE Most Common: Nausea , Vomiting, Gastritis, Discoloration of Nails Most Serious: Bone Marrow Suppression, Anemia Least Common: Pancreatitis

Individual Side Effects ST – VU – DI – NE Most Common: Nausea, Vomiting, Itching Most Serious : Pancreatitis, Peripheral Neuropthy, Lactic Acidosis

Individual Side Effects LA – MI – VU – DI – NE Very Good Tolerability

Most Serious Side Effects Lactitc Acidosis

Individual Side Effects NE – VI – RE – PI – NE Most Serious Side Effects

Skin Rash, SJ Syndrome, Hepatitis

( This drug can cause fatal Side Effects )

Individual Side Effects E – FA – VI – REN – Z Most Common: Giddiness, Itching, Most Serious: SJ syndrome, Hepatitis

Te-no-fo-vir Fanconi’s Syndrome Osteomalacia Bone Marrow Suppression Wasting

Thanks