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Done By: Hasan Faeq Hasan
HIV UPDATE TREATMENT
 HIV~ (Human ImmunodeficiencyVirus) The virus
compromises the body’s ability to handle disease and
causesAIDS.
 AIDS~ (Acquired Immune Deficiency Syndrome) It is
related to HIV, but they are not one in the same. A
person has AIDS only in the final stages of HIV, after
the immune system becomes unable to defend itself
against foreign invaders like bacteria, other
viruses, and allows the development of certain
cancers.
• Since 1981 1.7 million people in the
U.S. are estimated to have been
infected with HIV.
• 1 in 5 of those infected are unaware.
• MSM (Men who have sex with men )
accounted for 61% of all new HIV
infections in the U.S. in 2009.
• Over 619,000 with HIV have already
died since the epidemic began.
STATISTICS
•The world first became aware of AIDS in the
early 1980’s.
• Researchers aren’t sure exactly when and how
HIV developed.
•The most likely theories assume that HIV-1
was transmitted to humans from chimpanzees
sometime in the early 20th century.
When HIV emerges from latency (the period
when someone with HIV shows no signs of it)
symptoms can include:
Dry, flaky skin (Xeroderma)
Chronic fatigue
Fever that comes and goes (Pyrexia)
Diarrhea that lasts more than a week
Heavy night sweats (Hyperhidrosis)
Rapid weight loss
Swollen lymph nodes
White spots on tongue, mouth & throat
To be tested for HIV you usually give a sample of blood, urine or a swab of
fluids from your mouth.
It is recommended that if you are sexually active or have multiple partners you
should be tested every 6 months.
There is no cure for HIV. Antiretroviral therapy can reduce the presence of the
virus in the body, but can not eliminate it.
FDA-Approved HIV Medicines
DrugClass
Non-Nucleoside
ReverseTranscriptase
Inhibitors (NNRTIs)
Protease Inhibitors
(PIs)
Generic Name
(Other names and
acronyms)
etravirine
(ETR)
rilpivirine
(rilpivirine
hydrochloride, RPV)
darunavir
(darunavir ethanolate,
DRV)
Brand Name
Intelence
Edurant
Prezista
FDAApproval Date
January 18, 2008
May 20, 2011
June 23, 2006
FDA-Approved HIV Medicines
DrugClass
Entry Inhibitors
Entry inhibitors block
proteins on the CD4 cells that
HIV needs to enter the cells.
Integrase Inhibitors
Integrase inhibitors block HIV
integrase, an enzyme HIV
needs to make copies of itself
Combination HIV Medicines
Combination HIV medicines
contain two or more HIV
medicines from one or more
drug classes
Generic Name
(Other names and
acronyms)
maraviroc
(MVC)
dolutegravir
(DTG)
raltegravir
(RAL)
efavirenz, emtricitabine,
and tenofovir DF
elvitegravir*, cobicistat†,
emtricitabine, and tenofovir
Brand Name
Selzentry
Tivicay
Isentress
Atripla
Stribild
FDAApproval Date
August 6, 2007
August 13, 2013
October 12, 2007
July 12, 2006
August 27, 2012
FDA-Approved HIV Medicines
DrugClass
Combination HIV Medicines
Combination HIV medicines
contain two or more HIV
medicines from one or more
drug classes
Nucleotide Reverse
Transcriptase Inhibitors
Generic Name
(Other names and
acronyms)
emtricitabine, rilpivirine, and
tenofovir DF
tenofovir
lamivudine
zidovudine
stavudine (d4T)
Brand Name
Complera
Viread
Epivir
Retrovir
Zerit
FDAApproval Date
August 10, 2011
26-Oct-2001
17-Nov-1995
19-Mar-1987
24-Jun-94
First-line ART for adults
New recommendations
First-line ART should consist of two nucleoside reverse-
transcriptase inhibitors
(NRTIs) plus a non-nucleoside reverse-transcriptase inhibitor
(NNRTI)
• TDF(Tenofovir) + 3TC(Lamivudine) (or FTC(Emtricitabine)) +
EFV(Efavirenz) as a fixed-dose combination is recommended as the
preferred option to initiate ART
(strong recommendation, moderate-quality evidence).
• If TDF(Tenofovir) + 3TC(Lamivudine) (or FTC(Emtricitabine)) +
EFV(Efavirenz) is contraindicated or not available, one of the
following options is recommended:
• AZT (Zidovudine) + 3TC(Lamivudine) + EFV(Efavirenz)
• AZT + 3TC + NVP
• TDF + 3TC (or FTC) + NVP(Nevirapine)
(strong recommendation, moderate-quality evidence).
Countries should discontinue d4T(Stavudine) use in first-line regimens
because of its well recognized
metabolic toxicities
Transplant drugs replace antiretrovirals in HIV treatment!!
Currently, antiretroviral drugs are used to manage human immunodeficiency
virus (HIV). These drugs prevent the virus from replicating and damage from
occurring to the immune system. But antiretrovirals must be taken for life, and
they are expensive and may have side effects.
Consequently, experimental research is now looking at alternative strategies
to manage, prevent and possibly even cure HIV.
Current therapies fail to cure the disease as they do not attack those viruses
that remain hidden within the immune system,
 These "hidden" viruses seem to be sustained
by inflammation in the body caused by the HIV infection. The
use of immunosuppressant therapy to reduce inflammation and
create an inhospitable environment for the virus. Kidney
transplant patients who have HIV were monitored by the
researchers, Analyzing blood samples from these
patients, the researchers found that HIV was well
controlled during the long-term exposure to
immunosuppressive drugs.
 In particular, the participants who took an immunosuppressant
called sirolimus had fewer blood cells infected with HIV over
time.
 Sirolimus works by modifying the behavior of T cells, and
some T cell functions are implicated in two of the main four
factors that are thought to contribute to HIV persistence.
Gene therapy used to block HIV without drugs
researchers have successfully used gene therapy to boost the immune system
of 12 patients with HIV to resist infection. They removed the patients' white
blood cells to edit a gene in them, then infused them back into the patients.
Some of the patients who showed reduced viral loads were off HIV drugs
completely.
This study shows that we can safely and effectively engineer an HIV patient's
own T cells to mimic a naturally occurring resistance to the virus, infuse those
engineered cells, have them persist in the body, and potentially keep viral
loads at bay without the use of drugs.“
The gene editing method they used is called "zinc-finger nuclease (ZFN)" - a
sort of molecular scissors.
They used ZFN to edit a gene called CCR5 in immune T cells to make it like a
mutation that occurs in 1% of the population. People with the mutation, called
CCR5-delta-32, are naturally resistant to HIV. The mutation effectively blocks
the way the virus enters immune cells.
Each patient received an infusion of 10 billion modified cells
The trial also showed the technique shows promise in ability to suppress
HIV. The viral loads fell in four patients whose treatment was interrupted
for 4 weeks.
Siberian Mushrooms
Scientists from a research lab in Siberia believe a strain of mushroom is capable of
combating HIV.
Its tests found the Chaga mushroom, which grows on the region’s birch trees, to be most
effective in protecting cellular DNA from damaging free radicals. In recent years Chaga
has become a popular dietary supplement in the West; is believed to be the most potent
due to its high concentration of betulinic acid. Laboratory tests show the acid is toxic to
cancer cells and slows the growth of several kinds of tumor cells and HIV, according to
the American Cancer Society.
Nail Fungus
Researchers believe the antifungal drug ciclopirox has unique potential to fight HIV.
Ciclopirox reportedly has a characteristic that prevents the virus from recovering when
the drug is withheld, unlike other antiviral drugs. Researchers say that means it could
end current requirements that people with HIV be on medication for their lifetime.
The drug, which is administered topically for fungal infections, causes HIV-infected cells
to “commit suicide” by interfering with a cell component called mitochondria
•To prevent HIV transmission during sex you need to use a
condom.
• HIV can be spread through vaginal, anal or oral sex.
•Open sores from STDs like herpes & syphilis provide
gateways for HIV to enter the body.
• Gonorrhea & Chlamydia may weaken the skin & mucous
barriers that help prevent infection.
•If you inject drugs, use a new sterile needle each time to
significantly reduce the risk of HIV transmission.
The prognosis for those
with HIV is improving
with the development of
antiretroviral drugs that
help reduce the amount
of HIV in the blood to an
“undetectable viral load”
 The virus first came to Iraq in 1985 via
contaminated blood imported from a French
company. It was detected the following year in
scores of people suffering from haemophilia
 482 cases have been detected since 1986. Of
these, 272 were Iraqis and the rest foreigners.
 In 2005 in 73 percent of recorded cases the source
of infection has been infected blood
transfusions, while 16 percent were through
sexual transmission (heterosexual and
homosexual) and five percent through mother-to-
child transmission during pregnancy.
HIV is not airborne and cannot be caught by touching
skin, sweat or saliva.
You cannot get HIV by holding hands or sharing drinks.
Mosquito's do not inject other peoples blood when they
bite and so can’t spread HIV.
HIV UPDATE TREATMENT
www.aids.gov
www.aidshealth.org
www.aidsmap.com
http://aidsinfo.nih.gov/
http://aidsmeds.com
www.who.int/hiv

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HIV UPDATE TREATMENT

  • 1. Done By: Hasan Faeq Hasan
  • 3.  HIV~ (Human ImmunodeficiencyVirus) The virus compromises the body’s ability to handle disease and causesAIDS.  AIDS~ (Acquired Immune Deficiency Syndrome) It is related to HIV, but they are not one in the same. A person has AIDS only in the final stages of HIV, after the immune system becomes unable to defend itself against foreign invaders like bacteria, other viruses, and allows the development of certain cancers.
  • 4. • Since 1981 1.7 million people in the U.S. are estimated to have been infected with HIV. • 1 in 5 of those infected are unaware. • MSM (Men who have sex with men ) accounted for 61% of all new HIV infections in the U.S. in 2009. • Over 619,000 with HIV have already died since the epidemic began. STATISTICS
  • 5. •The world first became aware of AIDS in the early 1980’s. • Researchers aren’t sure exactly when and how HIV developed. •The most likely theories assume that HIV-1 was transmitted to humans from chimpanzees sometime in the early 20th century.
  • 6. When HIV emerges from latency (the period when someone with HIV shows no signs of it) symptoms can include: Dry, flaky skin (Xeroderma) Chronic fatigue Fever that comes and goes (Pyrexia) Diarrhea that lasts more than a week Heavy night sweats (Hyperhidrosis) Rapid weight loss Swollen lymph nodes White spots on tongue, mouth & throat
  • 7. To be tested for HIV you usually give a sample of blood, urine or a swab of fluids from your mouth. It is recommended that if you are sexually active or have multiple partners you should be tested every 6 months.
  • 8. There is no cure for HIV. Antiretroviral therapy can reduce the presence of the virus in the body, but can not eliminate it.
  • 9. FDA-Approved HIV Medicines DrugClass Non-Nucleoside ReverseTranscriptase Inhibitors (NNRTIs) Protease Inhibitors (PIs) Generic Name (Other names and acronyms) etravirine (ETR) rilpivirine (rilpivirine hydrochloride, RPV) darunavir (darunavir ethanolate, DRV) Brand Name Intelence Edurant Prezista FDAApproval Date January 18, 2008 May 20, 2011 June 23, 2006
  • 10. FDA-Approved HIV Medicines DrugClass Entry Inhibitors Entry inhibitors block proteins on the CD4 cells that HIV needs to enter the cells. Integrase Inhibitors Integrase inhibitors block HIV integrase, an enzyme HIV needs to make copies of itself Combination HIV Medicines Combination HIV medicines contain two or more HIV medicines from one or more drug classes Generic Name (Other names and acronyms) maraviroc (MVC) dolutegravir (DTG) raltegravir (RAL) efavirenz, emtricitabine, and tenofovir DF elvitegravir*, cobicistat†, emtricitabine, and tenofovir Brand Name Selzentry Tivicay Isentress Atripla Stribild FDAApproval Date August 6, 2007 August 13, 2013 October 12, 2007 July 12, 2006 August 27, 2012
  • 11. FDA-Approved HIV Medicines DrugClass Combination HIV Medicines Combination HIV medicines contain two or more HIV medicines from one or more drug classes Nucleotide Reverse Transcriptase Inhibitors Generic Name (Other names and acronyms) emtricitabine, rilpivirine, and tenofovir DF tenofovir lamivudine zidovudine stavudine (d4T) Brand Name Complera Viread Epivir Retrovir Zerit FDAApproval Date August 10, 2011 26-Oct-2001 17-Nov-1995 19-Mar-1987 24-Jun-94
  • 12. First-line ART for adults New recommendations First-line ART should consist of two nucleoside reverse- transcriptase inhibitors (NRTIs) plus a non-nucleoside reverse-transcriptase inhibitor (NNRTI) • TDF(Tenofovir) + 3TC(Lamivudine) (or FTC(Emtricitabine)) + EFV(Efavirenz) as a fixed-dose combination is recommended as the preferred option to initiate ART (strong recommendation, moderate-quality evidence).
  • 13. • If TDF(Tenofovir) + 3TC(Lamivudine) (or FTC(Emtricitabine)) + EFV(Efavirenz) is contraindicated or not available, one of the following options is recommended: • AZT (Zidovudine) + 3TC(Lamivudine) + EFV(Efavirenz) • AZT + 3TC + NVP • TDF + 3TC (or FTC) + NVP(Nevirapine) (strong recommendation, moderate-quality evidence). Countries should discontinue d4T(Stavudine) use in first-line regimens because of its well recognized metabolic toxicities
  • 14. Transplant drugs replace antiretrovirals in HIV treatment!! Currently, antiretroviral drugs are used to manage human immunodeficiency virus (HIV). These drugs prevent the virus from replicating and damage from occurring to the immune system. But antiretrovirals must be taken for life, and they are expensive and may have side effects. Consequently, experimental research is now looking at alternative strategies to manage, prevent and possibly even cure HIV. Current therapies fail to cure the disease as they do not attack those viruses that remain hidden within the immune system,
  • 15.  These "hidden" viruses seem to be sustained by inflammation in the body caused by the HIV infection. The use of immunosuppressant therapy to reduce inflammation and create an inhospitable environment for the virus. Kidney transplant patients who have HIV were monitored by the researchers, Analyzing blood samples from these patients, the researchers found that HIV was well controlled during the long-term exposure to immunosuppressive drugs.  In particular, the participants who took an immunosuppressant called sirolimus had fewer blood cells infected with HIV over time.  Sirolimus works by modifying the behavior of T cells, and some T cell functions are implicated in two of the main four factors that are thought to contribute to HIV persistence.
  • 16. Gene therapy used to block HIV without drugs researchers have successfully used gene therapy to boost the immune system of 12 patients with HIV to resist infection. They removed the patients' white blood cells to edit a gene in them, then infused them back into the patients. Some of the patients who showed reduced viral loads were off HIV drugs completely. This study shows that we can safely and effectively engineer an HIV patient's own T cells to mimic a naturally occurring resistance to the virus, infuse those engineered cells, have them persist in the body, and potentially keep viral loads at bay without the use of drugs.“
  • 17. The gene editing method they used is called "zinc-finger nuclease (ZFN)" - a sort of molecular scissors. They used ZFN to edit a gene called CCR5 in immune T cells to make it like a mutation that occurs in 1% of the population. People with the mutation, called CCR5-delta-32, are naturally resistant to HIV. The mutation effectively blocks the way the virus enters immune cells. Each patient received an infusion of 10 billion modified cells The trial also showed the technique shows promise in ability to suppress HIV. The viral loads fell in four patients whose treatment was interrupted for 4 weeks.
  • 18. Siberian Mushrooms Scientists from a research lab in Siberia believe a strain of mushroom is capable of combating HIV. Its tests found the Chaga mushroom, which grows on the region’s birch trees, to be most effective in protecting cellular DNA from damaging free radicals. In recent years Chaga has become a popular dietary supplement in the West; is believed to be the most potent due to its high concentration of betulinic acid. Laboratory tests show the acid is toxic to cancer cells and slows the growth of several kinds of tumor cells and HIV, according to the American Cancer Society.
  • 19. Nail Fungus Researchers believe the antifungal drug ciclopirox has unique potential to fight HIV. Ciclopirox reportedly has a characteristic that prevents the virus from recovering when the drug is withheld, unlike other antiviral drugs. Researchers say that means it could end current requirements that people with HIV be on medication for their lifetime. The drug, which is administered topically for fungal infections, causes HIV-infected cells to “commit suicide” by interfering with a cell component called mitochondria
  • 20. •To prevent HIV transmission during sex you need to use a condom. • HIV can be spread through vaginal, anal or oral sex. •Open sores from STDs like herpes & syphilis provide gateways for HIV to enter the body. • Gonorrhea & Chlamydia may weaken the skin & mucous barriers that help prevent infection. •If you inject drugs, use a new sterile needle each time to significantly reduce the risk of HIV transmission.
  • 21. The prognosis for those with HIV is improving with the development of antiretroviral drugs that help reduce the amount of HIV in the blood to an “undetectable viral load”
  • 22.  The virus first came to Iraq in 1985 via contaminated blood imported from a French company. It was detected the following year in scores of people suffering from haemophilia  482 cases have been detected since 1986. Of these, 272 were Iraqis and the rest foreigners.  In 2005 in 73 percent of recorded cases the source of infection has been infected blood transfusions, while 16 percent were through sexual transmission (heterosexual and homosexual) and five percent through mother-to- child transmission during pregnancy.
  • 23. HIV is not airborne and cannot be caught by touching skin, sweat or saliva. You cannot get HIV by holding hands or sharing drinks. Mosquito's do not inject other peoples blood when they bite and so can’t spread HIV.