Download Anti Retro Viral Therapy

Anti Retroviral Treatment
Dr. Alap Mehta
Senior Medical officer
A.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

1.
2.
3.
4.
5.
6.
Name Of the Drugs
Zidovudine
Stavudine
Drugs Supplied
Lamivudine
By NACO at
Nevirepine
ART Centre
Efavirenz
Tenofovir
Combinations of Regime
Zidovidine
or
+ Lamivudine + Nevirepine
Stavudine
or
Tenofovir
For 1st 15 Days Nevirepine Once a Day
Then twice a day
Combinations of Regime
Zidovidine
or
+ Lamivudine + Efavirenz
Stavudine
or
Tenofovir
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
Vomiting
Gastritis
Itching
For this Side Effects
patient can Consult
Family Physician
Serious Side Effects




Skin Rash + Itching
Severe Headache
Abdominal Pain
Severe Oral Ulcers
For this
Patient Will
Come to ART
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