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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
close this folder12.3 Treatment using ARV drugs in adults and adolescents
View the document12.3.1 Criteria of initiation of ART in Adults and Adolescents Patients
View the document12.3.2 Before initiating therapy
View the document12.3.3 Goals of Therapy
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
 

12.3.3 Goals of Therapy

Eradication of HIV infection cannot be achieved with currently available antiretroviral regimens; this is due to the establishment of a pool of latently infected CD4+ T-lymphocyte cells during the very early stages of acute HIV infection that persists with an extremely long half-life, even with prolonged suppression of plasma viraemia to <50 copies/mL.

Primary goals of antiretroviral therapy therefore are:

Maximal and durable suppression of viral load

Restoration and/or preservation of immunologic function

Improvement of quality of life

Reduction of HIV-related morbidity and mortality

Secondary goals are to decrease the incidence of HIV through;

The increased uptake in voluntary testing and counselling with more people then knowing their status and practicing safer sex,

The reduction of transmission in discordant couples, and

Reducing the risks of HIV transmission from mother to child.

In order to achieve these goals the following strategies should be used:

Adequate counselling and creation of supportive environment for patients to maximize adherence to the antiretroviral regimen

Rational sequencing of drugs for the preservation of future treatment options

Monitoring of drug resistance in selected clinical settings, monitoring of toxicities and adverse drug reactions

Given the existing antiretroviral drugs it is important that prescribers understand when to start antiretroviral drugs as described above. They also need to know:

Which drugs to use and in which order

When to change therapy

Which drugs to use when changing therapy

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