Transcript HIV/AIDS Prevention and Treatment in Thailand

HIV/AIDS Prevention
and
Treatment in Thailand
Kittipong Vairojanavong M.D.
Nittaya Vairojanavong M.A.
National Council for Women, Thailand
Avert.org commented
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There are very few developing countries
in the world where public policy has been
effective in preventing the spreads of
HIV/AIDS (human immunodeficiency
virus/acquired immunodeficiency
syndromes) on a national scale but
Thailand is an exception.
History
First case was found in 1984
 Next few years, increase in incidence among
* gay men
* sex workers
* injecting drug users
* tourists
 WHO reported that Thailand had the highest
infected rate of 10 folds within a few years in
FIGO Congress in Montreal 20 years ago.
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HIV/AIDS Situation in Thailand
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In March 2006, Total population = 63 millions
Infected cases= 288,672,
Death cases = 81,584
In 1991, there were 143,000 new cases but in 2003,
there were only 19,000 new cases
Incidence rate declines during the last 7 consecutive
years
Most common among people of 20-39 years of age
Male to female = 2:1
At age 15 – 19 , more among female than male
HIV/AIDS Prevention
No sex without protection
 Condom usage is a “MUST”
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Prevention in General Population
Ministry of Public Health initiated
“ 100 percent Condom Program”
for general population
 Condoms were distributed free of charge,
NGOs provided strong support to this
program
 Raised condom usage had decreased the
prevalence of sexual transmitted
infections dramatically
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Detection of HIV
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In 2 – 3 weeks after infected, acute retroviral
syndrome occurred: fever, sore throat enlarged
lymph nodes, flu like illness, viremia,.
Antigenemia, and later anti-HIV antibody.
Window period is the period prior to detect
antibody, may last from 8 weeks to 6 months
HIV Check Up
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Blood and serum recipient
Homosexual
Unprotect sex
Have sex with HIV case
Sex with drug user
Multiple sexual partners
Sexual transmitted disease patient
Drug addicted
Pregnant women
Diagnosis of HIV/AIDS
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Detection of anti-HIV antibody:
Screening test: ELISA and GPA (gelatin
particle agglutination)
Confirmatory test: immunoblot (western
blot) and immuno fluorescent
Antigen (p24 antigen) assay (IFA)
HIV/AIDS Therapy
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1987 AZT (had been used since)
Drugs used in the developing countries
Anti-infective agents to prevent
opportunistic infections
Palliative drugs for physical and mental
discomfort such as analgesics, tranquilizer.
Antiretrovirals (ARVs): to prevent and kill
HIV prior to invade immune system and
prevent HIV from mother to fetus
HIV/AIDS Therapy
 Right
procedure
 Continuous
 Regular
HIV Transmission from Mother to
Fetus
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During pregnancy, HIV penetrates placenta to
fetus. This is hard to prevent
One to two weeks prior to delivery and intrapartum period are highly sensitive period of
transmission up to 50-60 percentใ Prevention by
cleansing birth canal with antiviral antiseptics,
reduce chance of contact of maternal blood during
labor
HIV from maternal milk, incidence of 20 percent
Prevention of Transmission from
Mother to Fetus
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AZT (zidovidine) therapy at 36 weeks and
during labor reduces the infection down 50
percent
AZT therapy to both mother and fetus reduces
infection rate from 25-30% to 9.2%
AZT plus 3TC (lamivudine) for short period to
mother from 34 weeks reduces infected rate
down to 2.83 %, (three times lower)
HIV/AIDS Therapy
No drug to cure this disease yet but there
are drugs to prevent progression of the
disease
 Side effects of the drugs are anemia,
nausea and vomiting
 Vaccines are in investigational periods ad
may need more than 10 years to confirm
the effectiveness of the vaccine
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GPO-VIR
Local made regimen
 Less expensive but effective
 3 in 1 combination (stavudine +
lamivudine + nevirapine)
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GPO-VIR (Government
Pharmaceutical Organization)
Combination of three antiviral drugs
Stavudine (Zerit) 30-40 mg.
Lamivudine (Epivin) 150 mg.
Nevirapine (Viranme) 200 mg.
 Dosage One tablet twice a day
 Result: increase body weight, increase CD4 Tcell, decrease occurrence, no change of
lipodystrophy (study in 2003-2004)
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