HIV

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Author:
laurajane.price
ID:
60098
Filename:
HIV
Updated:
2011-01-16 17:38:25
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HIV
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Description:
HIV disease management 4th yr
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  1. HAART: Which combinations to use?
    At least 3 antiretrovirals

    Preferred choice;

    2 NRTIs with an NNRTI

    - tenofivir, emtricitabine & efavirenz

    - abacavir, lamivudine & efavirenz

    Alternative choice;

    2 NRTIs with a boosted PI

    - didanosine, lamivudine & lopinavir/ritonavir

    - didanosine, emtricitabine & fosamprenavir/ritonavir

    - zidovudine, lamivudine & aztanavir/ritonavir

    3 NRTIs
  2. NRTI's: mode of action and examples of
    Inhibit viral reverse transcriptase by acting as a substrate

    Abacavir

    Didanosine

    Emtricitabine

    Lamivudine

    Stavudine

    Tenofovir

    Zidovudine
  3. NRTI side effects
    Lactic acidosis: rare but severe

    Hepatic steatosis

    Lipoatrophy and lipodystrophy syndrome: buffalo hump and paunch
  4. NNRTI's: mode of action and examples
    Inhibit viral reverse transcriptase by binding to it's active site

    Efavirenz

    Nevirapine

    Etravirine
  5. NNRTI side effects
    Rash within first 2-6 weeks: treat with antihistamines and emollients

    CNS disturbances: sedation, vivid dreams, worst in first 4 weeks, avoid driving if affected

    Hepatitis: monitor LFTs every 2 week for first two months
  6. PIs: mode of action and examples
    Bind to the active site of the HIV protease enzyme to prevent maturation of the newly produced virions

    Atazanivir

    Darunavir

    Fosamprenavir

    Indinavir

    Lopinavir

    Nelfinavir

    Ritonavir

    Saquinavir

    Tipranavir
  7. PI side effects
    Hyperglycaemia

    Hyperlipidaemia

    Lipodystrophy
  8. Entry inhibitors: mode of action and examples

    Adverse effects?
    • Enfuvirtide: fusion inhibitor - binds to gp41 HIV protein
    • - s/c injection bd

    • Maraviroc: binds to CCR5 a co receptor on CD4 cells
    • - bd tabs

    Insomnia

    Headache

    GI disturbances

    Asthenia

    Injection site reactions and hypersensitivity with enfuvirtide
  9. Integrase inhibitors: mode of actions and examples

    Adverse effects?
    Blocks integrase enzyme - prevents viral incorporation of DNA into host DNA

    Raltegravir

    GI disturbances

    Lipodystrophy syndrome

    Asthenia
  10. What are the goals of therapy in HIV positive pts?
    Prevent/treat opportunistic infection

    Improve quality and quantity of life

    Prevent immune system deterioration

    Restore immune function

    Relieve symptoms where the underlying cause is unknown

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