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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
close this folderCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
View the document12.1 Introduction
Open this folder and view contents12.2 Types of Antiretroviral drugs
Open this folder and view contents12.3 Treatment using ARV drugs in adults and adolescents
Open this folder and view contents12.4 Recommended ARV drugs in Tanzania
Open this folder and view contents12.5 Adherence to Antiretroviral Therapy
Open this folder and view contents12.6 Changing of Antiretroviral Therapy
View the document12.7 Second-Line ARV Regimen
Open this folder and view contents12.8 Monitoring Patients on ARV Therapy.
Open this folder and view contents12.9 Laboratory Monitoring of patients on second line drugs
Open this folder and view contents12.10 Treatment failure with second line regimen
View the document12.11 Contraindications (relative) for initiation of ART
View the document12.12 Discontinuation of ART
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

12.1 Introduction

After a decade of slow progress in the treatment of HIV infection, the last few years have seen dramatic advances in the development of antiretroviral drugs (ARV). This now offers extended patient survival and improved quality of life. Various new medications (such as protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitor (NNRTIs), when combined with older nucleoside reverse transcriptase inhibitors (NRTIs), have the potential to reduce HIV replication.

The concurrent development of new anti-fungal and antibacterial drugs allows clinicians to hold at bay the most common (and once fatal) opportunistic infections. Determination of CD4+ T lymphocyte counts, and more recently the viral load has allowed more accurate monitoring of disease progression and guide targeted therapy. Technologically advanced tests such as HIV genotyping help identify mutations that confer drug resistance and so give a physician the ability to rationally use existing antiretroviral drugs.

Theoretically the multiple steps in replication of HIV provide opportunities for intervention. Therapeutic regimens may be directed at one or several of the following stages essential for viral replication. (See Fig 5):

Attachment of HIV to host cell

Reverse transcription of viral RNA to DNA

Integration of pro-viral DNA into host genome

Expression of the viral gene after it has been integrated into host cell DNA including the process of transcription of more viral RNA and the translation of viral proteins.

Processing and post-translational modification of protein products of the virus.


Figure 4: Sites of Anti-retroviral (ARV) drugs action

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