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Antiretroviral therapy. ARVs cannot cure the HIV virus ARVs prevent the virus from multiplying: - reduce the levels of virus in the blood - immune system has opportunity to recover People on ARVs can remain well for many years . Antiretroviral therapy.
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Antiretroviral therapy • ARVs cannot cure the HIV virus • ARVs prevent the virus from multiplying: - reduce the levels of virus in the blood - immune system has opportunity to recover • People on ARVs can remain well for many years
Antiretroviral therapy • Three classes of antiretroviral drugs: • nucleotide reverse transcriptase inhibitors (NRTIs) • non-nucleotide reverse transcriptase inhibitors (NNRTIs) • Protease inhibitors (PIs) • Life-long triple therapy • HAART: “highly active antiretroviral therapy” • Antiretrovirals are on WHO essential drugs list
Continued impact of HAART on AIDS deaths in some Western European countries, 1998-2002 1400 Italy 1200 Spain Germany 1000 United Kingdom 800 Number of AIDS deaths 600 400 200 0 1998 1999 2000 2001 2002 Year Source: HIV/AIDS surveillance in Europe (2002). End-of-year report. Data compiled by the European Centre for the Epidemiological Monitoring of AIDS
Antiretrovirals - challenges • High costs • Must be taken for life • Must be taken correctly 95% of the time • Potential for side effects • Regular laboratory monitoring required • Resistance
Resistance • Drug resistance = organism is no longer sensitive to the drug • Antiretrovirals, Anti TB drugs, STI drugs • Influenced by: • characteristics of the organism • inadequate dose • incorrect dosage interval • inadequate treatment period • Using combinations of drugs reduces potential for resistance
HIV and TB treatment programs Before starting HIV or TB treatment programs, think about: What factors influence whether people will: • take the right dose at the right time • take the drug for the required period of time (ARVs for life)