Advances in Antiretroviral Therapy
Antiretrovirals are drugs that are used to treat viral infections like HIVSince their introduction in 1987, antiretrovirals have shown significant advancementsExperts like Best Sexologist in Islamabad now use the Highly Active Antiretroviral Therapy (HAART) to treat HIV-1 infectionIn fact, healthcare professionals now manage it as a chronic disease.
What is the new HAART for HIV Patients?
The Highly Active Antiretroviral Therapy (HAART) options for both treatment-naïvetreatment-experienced patients of HIV include: nucleoside reverse transcriptase inhibitors (NRTIs), Entry inhibitors, Non-nucleoside reverse transcriptase inhibitors (NNRTIs), chemokine receptor antagonists (CCR5 antagonists), Protease inhibitors (PIs), Fusion inhibitorsIntegrase Inhibitors (INSTs).
Single pill Regimens
In the early days of Anti-retroviral therapy, the high pill-burden made compliance of the patient, poorThis in turn endangered the effectiveness of treatmentalso increased the chances of resistance developmentToday, the US department of healthhuman services (DHHS) recommends the single tablet regimens for HIV patients, especially for the initial phase, to ensure complianceadherence to treatment.
What is the Goal of Haart?
The goal of therapy in HAART is to reduce the morbiditymortality associated with HIV, to improve the quality of life of patientsto reduce the transmission of HIV-1 to othersAdditionally, healthcare providers aim to prevent drugs resistance, improve the immune functionreduce the viral RNA load with the right therapeutic approach.
A combination of HAART is also recommended for those who engage in high-risk behavior, as well as in pregnant mothers with HIV, to decrease the vertical transmission of infection.
What are the Contraindications for Haart?
All healthcare providers put the HIV positive patients on HAART, immediately, regardless of their CD4 countThere are no outright contraindications to HAART, but certain medications in the regimen can be contraindicated or some reasonIn this situation doctors find an alternate HAART combination but do not stop the medicationSome specific contraindications include:
Avoidance of efavirenz in patients with hepatic dysfunctionpsychiatric illnessEfavirenz and abacavir should also be avoided in patients with cardiovascular disease with history of torsade de pointesAbacavir should also be avoided in patients with history of delayed hypersensitivity reaction.
Monitoring of Haart
HAART has improved patient outcomesreduced the transmission of virus in HIV positive patientsMonitoring of medication, overseeing for side-effectsproper adherence to HAART is necessary for therapeutic response.
Prior to treatment initiation, healthcare professionals need to maintain historyscreen for risk factors such as osteoporosis, renal dysfunction, cardiovascular disease, hepatitis BCtuberculosisHealthcare providers need to be vigilant when the patients are considered high risk such as those with history of psychiatric illness, those with history of substance abusethose living in resource-limited settingSuch patients are considered high risk for noncompliance.
HIV Guidelines for Pediatric Population
HIV positive women who are pregnant or trying to conceive should be put on dolutegravirTenofovir is an alternative antiretroviral that may be usedDirect acting antiviral treatment can be initiated in pregnant women who are co-infected with hepatitis CFor more tailored treatment, its best to seek help of professionals like Best Sexologist in Lahore
