Best treatment for HIV AIDS positive patients – A combination of two or three medicines is therefore recommended for effective treatment of HIV infection
Best treatment for HIV in the world !
Until recently, most medical practitioners recommended only one medicine called zidovudine for treatment of HIV infection.
However, several studies in recent times have indicated that taking only one medicine increases the risk of the virus developing resistance to it. A combination of two or three medicines is therefore recommended for effective treatment of HIV infection.
Medicines recommended for management of HIV infection can be divided into three groups:
1. Nucleoside Reverse Transcriptase Inhibitors, which are also called NRTI. These medicines interrupt an early stage of virus replication.
These medicines may slow the spread of HIV in the body and delay the onset of opportunistic infections, however they do not prevent transmission of HIV to other individuals.
2. Non-nucleoside Reverse Transcriptase Inhibitors, which are also called NNRTI.
3. Protease Inhibitors, or PI. These medicines interrupt virus replication at a later stage in its life cycle.
Nucleoside Reverse Transcriptase Inhibitors:
There are five Nucleoside Reverse Transcriptase Inhibitors. Detailed below are their doses and side-effects.
Zidovudine (AZT):
This is one of the commonly used medicines for management of HIV infection. Its recommended dose is 200 milligrams three times a day or 300 milligrams twice a day. In recent years, AZT has been recommended in combination with other medicines to control HIV infection.
Common adverse effects include suppression of bone marrow, anaemia and neutropenia. Some people also complain of disturbances in their digestive system, headache, sleeplessness and general weakness.
Diadnosine:
This medicine is recommended in the dose of two hundred milligrams twice a day for people who weigh more than 60 kilograms and one hundred and twenty-five milligrams twice a day for those who weigh less than sixty kilograms.
Common side-effects include nausea, diarrhea, inflammation of the pancreas and abnormalities in the structure or function of the nerves of the limbs.
Zalcitabine:
The recommended dose for this medicine is 0.75 milligrams three times a day. Common side-effects include abnormal structure or function of the nerves of the limbs and swelling of the throat.
Stavudine:
Forty milligrams of this medicine is recommended twice a day for people who weigh sixty kilograms or more. For those who weigh less, thirty milligrams is recommended twice a day. Common side-effects include abnormal structure or function of the nerves of the limbs.
Lamivudine:
This medicine has the least side-effects and is therefore normally recommended in combination with Zidovudine or AZT. One hundred and 50 milligrams of Lamivudine is recommended for people who weigh more than50 kilograms. For those who weight less, the recommended dose is two milligrams per kilogram of body weight.
Abnormal accumulation of lactic acid with an abnormal condition of the liver is a rare but potentially life-threatening side effect with the use of all nucleoside reverse transcriptase inhibitors. Lactic acid is a chemical compound that is produced by respiration without oxygen.
Non Nucleoside Reverse Transcriptase Inhibitors:
There are three main medicines in this group. Detailed below are their recommended doses and their interactions with other medicines.
Nevirapine:
Two hundred milligrams of this medicine is recommended four times a day for the first fourteen days followed by the same dose twice a day. Common side-effects include rash, hepatitis and increased levels of an enzyme called transaminase.
Nevirapine interacts with oral contraceptives, some medicines used for treatment of tuberculosis, protease inhibitors and triazolam.
Delavirdine:
The recommended dose of this medicine is 400 milligrams three times a day. Common side-effects include rashes and headache.
Delavirdine is not recommended with tranquillisers or some medicines used for management of sleep disorders(such as triazolam, midazolam) medicines used for epilepsy(such as phenytoin, phenobarbitol), cisapride ( a medicine used for vomiting, increased acids in the stomach) and amphetamines.
Delavirdine increases the level of some medicine such as dapsone, clarithromycin, quindine and protease inhibitors such as indinavir and saquinavir. Antacids can interact with delavirdine and therefore a gap of about one hour is recommended between taking these two medicines.
Efavirenz:
The recommended dose is six hundred milligrams four times a day. Common side effects include rash, dizziness, sleeplessness, abnormal dreams, confusion, lack of concentration, loss of memory, hallucinations, etc.
Efavirenz interacts with medicines such as cisapride, midazolam and is therefore not recommended with them. It also decreases the level of two protease inhibitors including nelfinaviir and ritonavir.
Efavirenz can interact with some medicines such as rifampicin, phenynytoin and is therefore recommended only under direct supervision by a medical practitioner.
Protease inhibitors:
There are four main types of Protease inhibitors. Detailed below are the recommended dosage, interactions with other medicines and the side-effects of protease inhibitors.
Indinavir: 800 milligrams of this medicine is recommended either one hour before meals or two hours after meals. Common side-effects include disturbances of the digestive system.
Occasionally some people may have headache, blurred vision, rash, dizziness, metallic taste in the mouth and abnormal bleeding or bruising in the body. Indinavir is not recommended with medicines such as rifampicin, cisapride, triazolam and midazolam.
Ritonavir:
The recommended dose of this medicine is six hundred milligrams twice a day to be taken with meals. This dose is reached by gradually increasing it during fourteen days.
The first two days three hundred milligrams of ritonavir is recommended twice day followed by 400 milligram twice a day for the next three days. Ritonavir is often recommended in combination with saquinavir, another protease inhibitor.
Common side-effects include nausea, vomiting, diarrhea, decreased sensation in the limbs, hepatitis and change in the taste sensation. Ritonavir is not recommended with medicines such as cisapride, tranquillisers, quinidine. It can increase the levels of clarithromycin and decrease the levels of zidovudine.
Nelfinavir:
The recommended dose for adults is 750 milligrams three times a day with meals. Common side effects include diarrhea, pain in the abdomen, nausea, rashes and increased gas in the bowels. Medicines such as rifampicin can reduce the levels of nelfinavir.
This medicine is not recommended for use along with cisapride, tranquillisers etc. It increases the level of other protease inhibitors such as indinavir and saquinavir.
Saquinavir:
The recommended dose is 600 milligrams to be taken three times a day. Some preparations may also be recommended in the dose of twelve hundred milligrams three times a day.
Common side effects include disturbances in the digestive system such as nausea, diarrhea, pain in the abdomen, headache and indigestion. The levels of saquinavir and nelfinavir and grapefruit juice.
Their levels are reduced by rifampicin, some medicines used for treatment of epilepsy and steroids. It is not recommended along with rifampicin and some tranquillisers.
Zidovudine is recommended in almost all combinations of medicines recommended for treatment of HIV infection. This is because its benefits have been observed for a long time and it can enter the brain more effectively than other medicines.
More important tips related to the best treatment of HIV AIDS patients worldwide !
HIV not only affects the blood but can also enter the brain. Thus, if a medicine does not enter the brain, it cannot control the infection effectively.
It is important to remember that the above description of medicines is merely a guideline. There are several options for a combination of more than one medicine currently recommended for treatment of HIV infection.
Their use is based on the initial findings of several studies. The medicines and the most effective combination is changing rapidly.
All Medicines must be taken under the direct supervision and guidance of a trained medical practitioner / qualified licenced doctor.
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