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HIV Information

The Next slide has several choices for you You can choose information on such topics as: Understanding HIV Medication STDs Hepatitis Re-infection Are any of these topics areas you would like more information on?. HIV Information. Understanding HIV/AIDS and Its Treatment.

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HIV Information

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  1. The Next slide has several choices for you You can choose information on such topics as: Understanding HIV Medication STDs Hepatitis Re-infection Are any of these topics areas you would like more information on? HIV Information

  2. Understanding HIV/AIDS and Its Treatment The University of Illinois at Chicago Howard Brown Health Center Treatment Advocacy Program These materials provided in part by Abbott Pharmaceuticals

  3. HIV and AIDS • HIV stands for “Human Immunodeficiency Virus” • HIV is a virus (germ) that infects blood and damages your immune system, which helps you fight disease. • AIDS stands for “Acquired Immune Deficiency Syndrome” • AIDS is the disease caused by HIV. People with AIDS lose their ability to fight germs that can make them sick Understanding HIV

  4. How is HIV passed from one person to another? • HIV is passed through body fluid from one person to another • The four bodily fluids that transmit HIV are blood,semen, vaginal secretions and breast milk • Some of the ways HIV can be passed include: • Unprotected Sex • Sharing injection needles • Infected body fluids in contact with • Mucous membranes • Cuts in the skin • Now that you are infected with HIV is it important that you take precautions to not pass it to others. • Avoid being re-infected with another strain of the virus • Avoid co-infection of Hepatitis C Understanding HIV

  5. The basic HIV test tells whether you are infected by detecting antibodies to HIV, a reaction to HIV from your immune system. Other tests measure how much virus is in your blood; this is your viral load. We measure how strong your immune system is by seeing how many helper T cells you have. This is called your CD4 count. If your viral load is high and/or your CD4 count is low, the virus is harming your immune system. Your Doctor will prescribe drug treatments to keep the virus from further harming your immune system. Blood tests measure the effect of HIV on your body Understanding HIV

  6. Your immune system • The immune system works in your body to fight germs and keep you healthy • T cells (CD4) recognize germs in your body, and they work with other cells to destroy them Understanding HIV

  7. How your immune system fights HIV • Killer T cells find and destroy cells infected with HIV • Helper T cells (CD4 cells) order killer T cells to do their job • HIV infects helper T cells (CD4s) • When the helper T cells (CD4s) are destroyed by HIV, the immune system cannot fight germs • That is why the CD4 count is important to you… Understanding HIV

  8. There is a war between your body and HIV • Billions of viruses are created every day • HIV attacks and infects your T cells • Your immune system attacks and kills the T cells that have been infected with HIV Understanding HIV

  9. HIV eventually drains your immune system • When T cells are killed by HIV, they are replaced—but not as quickly as they are being killed • HIV reproduces very fast • Eventually, T cells fall too far behind and then cannot do their job of fighting germs Understanding HIV

  10. Viral load - the number of copies of HIV in a (ML) of blood The lower your viral load the better Some infections your immune system keeps in check also know as opportunistic infections Because you are HIV+ your body sometimes can not keep them from occurring Viral load is different for each person When viral load increases, then you are getting closer to AIDS and severe illness The amount of virus in your blood can predict how well you will do Understanding HIV

  11. When there is more HIV in your blood (higher viral load), the HIV can infect and kill more helper T cells (CD4s) T cells are needed to fight HIV and other germs Eventually, your body cannot produce T cells as fast as they are killed by HIV When viral load goes up, immunity goes down Understanding HIV

  12. Eventually you don’t have enough T cells to fight HIV and other germs that enter your body You may start to get AIDS when the number of helper T cells in your blood (your CD4 count) gets very low (less than 200) Often people with HIV will begin drug treatments when their CD4 count is below 350 or so. Your doctor will help you make an individual decision about treatment, based on your CD4 count, your viral load, and your overall health. When immunity goes down, you get sick Understanding HIV

  13. Untreated HIV infection spreads throughout the body • Untreated HIV is a race most people cannot win • There is time to act before HIV develops into AIDS Understanding HIV

  14. Treatment slows the virus • Treatment slows down the HIV so it can’t replicate as fast • When the HIV replicates slower, your viral load goes down • When viral load is down, you are doing better against HIV Understanding HIV

  15. HIV is a virus that infects blood HIV is passed from one person to another through blood or certain body fluids The four bodily fluids that transmit HIV are blood, semen,vaginal fluid and breast milk HIV reproduces very fast and attacks and kills Helper T cells T cells are needed to fight HIV and other germs Viral load is the amount of HIV in your blood. CD4 cell count is the number of helper T cells in your blood, and generally shows how strong your immune system is. Summary: HIV infection is a disease of the immune system End of Understanding HIV – Return to Main Menu Understanding HIV

  16. In this section you will learn about the four different types of medication. You will learn names of classes of medications. You will also learn how medication works to help with HIV replication. Medication Medication Overview

  17. Medication can reduce viral load When viral load goes down: HIV is not reproducing as fast The number of T cells (CD4s) can go up Damage to the immune system can be less Treatment reduces the chance that HIV will find ways to hide from drugs that can kill it Antiretroviral treatment (ART) can slow down HIV Medication Overview

  18. Sometimes viral load can be reduced so much that the virus cannot be detected Even if your viral load is detectable as long as it is low, you are doing well When this happens, HIV cannot reproduce enough to do damage When there is not a constant attack from HIV, T-cell levels rise and they can do their job Antiretroviral treatment keeps HIV from getting ahead Medication Overview

  19. Even if viral load cannot be detected, HIV is still there and can be transmitted to others This is why sexual safety will always be important Because HIV is always there, you must continue to take all your medications, on time, without stopping IF YOU STOP TAKING YOUR MEDICINE, YOUR VIRAL LOAD CAN QUICKLY GET VERY HIGH! HIV will never be completely removed from your body Medication Overview

  20. Types of Anti-Retrovirals Fuzeon

  21. Understanding the lifecycle of the virus helps you see how the HIV drugs work. Fusion -The HIV virus attaches itself to the CD4+ cell. Transcription - The virus gives instructions to reproduce HIV using an enzyme know as reverse transcriptase. Integration - After the virus successfully reprograms the cell, it makes HIV, by using an enzyme called integrase. Lifecycle of HIV Medication Overview

  22. NNRTIs stop HIV from making copies of itself by interrupting early in the process. NRTIs stop the HIV early in the same place as NNRTIs, but in a different way PIs stop the HIV from making infectious copies by blocking the last step, just before new copies of HIV are assembled Entry Inhibitors/Fusion drugs stop fusion of HIV with host cells before the virus enters the cell and begins replication Medicine interferes at different places Medication Overview

  23. Cleavage - The viral materials produce long chains of the virus. Using a protease, these can be built into a new virus. Packing - The virus is wound tightly to fit inside the virus shell. Budding – The virus then moves through the outer cell to escape. The virus uses part of the cells outer wall to complete its structure. The HIV virus is now ready to move on and infect other CD4+ cells Lifecycle of HIV Medication Overview

  24. Combination therapy • The best way to treat HIV is by using more than one kind of drug at a time. • Some use PIs with NRTIs which brings medication together that works at the beginning and end of the replication of the virus. • Others use NNRTIs with NRTIs that work at the beginning of the assembly of the HIV virus Medication Overview

  25. Viral Load is the amount of virus in ml of blood (about a tablespoon of blood) Example: Viral load before treatment might be 100,000 per ml TreatmentViral load reduced to: One drug class 10,000 Two drugs classes 1,000 Three drugs classes Greater chance of undetectable Different drugs work together to reduce viral load Medication Overview

  26. Your doctor will recommend a treatment plan • Everyone is different, so each person will have a different treatment plan • Your treatment plan will be designed to REDUCE VIRAL LOAD to an undetectable level by stopping the virus from making more copies of itself Medication Overview

  27. How do you know if the drugs are working? Your doctor can do blood tests to measure the two things that show how well you are doing: 1. Viral load should go down 2. T-cell (CD4) count should go up Medicines need time to work, so these things do not happen right away Medication Overview

  28. HIV drugs can cause side effects As with most powerful medicines, side effects can occur, especially soon after starting therapy. The most common side effects include: • Nausea and vomiting • Diarrhea • Dizziness and headache • Fatigue • Weakness • Rash • Fever & Flu-like symptoms These often go away in 4 to 6 weeks, so if your medications are helping stick with them and see if the side effects stop. Medication Overview

  29. Some reasons for changing medicines: If viral load starts to go up, different drugs may be needed The way you respond to side effects can cause you to choose a different drug The schedule for taking some drugs might not work with the way you live You and your doctor may decide to change your treatment plan Medication Overview

  30. Drugstore medications can help relieve diarrhea and nausea A lot of people mistakenly stop medicines because of side effects. Talk with your doctor about your side effects Keep taking you medication Stopping medication can damage your immune system Good nutrition and regular exercise help you stay strong If needed, your doctor can give you stronger prescription medicines to help relieve side effects People with HIV can live well, even with side effects Medication Overview

  31. Adherence is the main ingredient for making HIV drugs work • Your immune system can recover and stay strong only if your viral load stays low • Even missing a few doses can let HIV reproduce • Most drugs work only if people take them exactly as prescribed. This is called drugadherence. • HIV drugs are very sensitive to non-adherence; to keep your viral load down you must take all of your doses, on time Medication Overview

  32. Adherence prevents drug resistance • Drug resistance means that your HIV has become “used to” the drugs, and they no longer stop the virus. • Drug resistance means HIV in your body happens because you miss a few doses of medication • If you develop drug resistance your viral load will go way up, and the number of T cells will drop, even if you keep taking the drugs. • If this happens you will have to change to different drugs you are not resistant to • If you become resistant to HIV drugs it becomes harder and harder for your doctor to treat you. Medication Overview

  33. How often should I take my medicine? What is the right number of pills to take? Do I take my medicines with or without food? How should I store my medicine? What medicines should / should not be taken together? What do I do if I miss a dose? What do I do if I experience side effects? Your Treatment Advocate will work with you in ways to talk to your doctor . Important questions to askyour doctor

  34. Talk about any medicines you take Talk about “street drugs,” if you use them Talk about the way you live Talk about sexuality or intimacy; make sure s/he knows if you get a new sexually transmitted disease Talk about your health history Your doctor can treat you best if s/he knows you well For any topic you are uncomfortable talking to your doctor about, your Treatment Advocate can help you approach these subjects with your doctor. Tell your doctor about yourself Medication Overview

  35. Find a doctor you are comfortable with Educate yourself about your drugs Know your viral load & CD4 Talk to your doctor or advocate about side effects If you are unhappy with your medicines, talk to your doctor about other options Never make changes in your treatment plan without talking with your doctor Use your Treatment Advocate to find resources, such as HIV information, support groups, counseling, etc. Take an active role in your treatment Medication Overview

  36. Eat healthy, nutritious foods Lower your use of “recreational” drugs Practice safer sex (Avoid co-infection with other strains of HIV, Hepatitis C and new STDs) Exercise Join a class or health club Find others to walk or work out with Stay relaxed Join a relaxation or stress management class Get books or readings about relaxation Keep your spirits high Find others to talk to such as support groups Consider spiritual counseling Keep in touch with your advocate! What else can you do? Medication Overview

  37. For complete information about how antiretroviral treatments (ART) work, the latest on different drugs and general treatment issues, go to: http://aidsmeds.com/ Antiretroviral Treatment of HIV End of Medication Overview – Return to Main Menu Medication Overview

  38. In the next few slides you will learn about Hepatitis. The different types of Hepatitis and what you should know about transmission. Hepatitis Overview Hepatitis Overview

  39. Hepatitis is an inflammation of the liver Two types are acute and chronic: Acute can be cured and can go away in a few days Chronic is when the inflammation does not go away. Three most common types of Hepatitis are A,B,& C Hepatitis A is found in the stool of persons with the virus. It is spread by close personal contact and sometimes by eating infected food or drinking water containing (HAV) What is Hepatitis and how is it transmitted ? Hepatitis Overview

  40. Mild “flu-like” illness Jaundice (yellow skin or eyes) Severe stomach pains Diarrhea People with hepatitis A infection often have to be hospitalized Symptoms of Hepatitis A Hepatitis Overview

  41. Hepatitis B virus (HBV) can cause acute and/or chronic illness. Hepatitis B symptoms such as: Loss of appetite Tiredness Pain in muscles,joints and stomach Diarrhea and vomiting Jaundice (yellow skin or eyes) Hepatitis B Hepatitis Overview

  42. Hepatitis B • Hepatitis B is spread through contact with blood and body fluids of an infected person • It can be spread by: • Unprotected sex • shared needles • stick from used needle Hepatitis Overview

  43. About 1/3 of people who have hepatitis B in the U.S. don’t even know that they have it. Vaccinations for hepatitis A and B are available separately and also in a combined formula. People at high risk for hepatitis A and B are: Men who have sex with men People receiving blood products Travelers People who share needles Risky sexual practices Fecal matter (rimming) Hepatitis (cont) Hepatitis Overview

  44. We know that men who have sex with men are at high risk: Vaccination is the single best way to prevent infection. Have an open discussion with your doctor regarding risk to see if a Hepatitis screening is needed. Should I get vaccinated? Hepatitis Overview

  45. Most people don’t even feel sick when they are first infected and don’t have symptoms for years The jaundice caused by the liver not being able to get rid of waste may cause: Itching Nausea Fever Body aches Symptoms of Hepatitis C Hepatitis Overview

  46. Yes once you have Hepatitis C you can give it to someone else The virus may be transmitted through sex with someone who has HCV People living in the same house sharing razors and toothbrushes can transmit Hepatitis C. Can I give Hepatitis C to someone else? Hepatitis Overview

  47. Intense regimen of injections and medicines. Treating Hepatitis C and HIV at the same time is difficult. Decreased liver function makes many HIV Medications less effective and harder to take. Side effects include: Fevers, body aches, headaches, fatigue, irritability, nausea, vomiting, sleep loss or changes in your blood. Treatment for Hepatitis C End of Hepatitis Overview – Return to Main Menu Hepatitis Overview

  48. In the next few slides we will talk about Re-Infection of HIV How it happens and how to protect yourself from re-infection. Re-Infection Overview Re-Infection Overview

  49. There are many strains of the HIV virus. When someone is infected, they are infected with the same strain as their the person who infected them. The strain you are infected with may already be resistant to some medications. Initial HIV infection Re-Infection Overview

  50. In several years there has been much debate if re-infection with a new strain of the HIV virus is possible. This new strain may be resistant to your medication or classes of medication Does it occur? Yes As in much of the study on HIV we continue to learn more everyday. The re-infection debate Re-Infection Overview

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