Transcript ARV Therapy Basics in the Context of Family Planning

ARV Therapy Basics in the
Context of Family Planning
ARV Therapy Overview
• Inhibits replication of the virus
• Slows disease progression; improves quality of life
• Different drugs attack virus at different stages of
replication
• Combine three drugs into HAART “cocktail” for
best results
decrease
viral load
improve
immune
function
Classes of ARV Drugs
• NRTIs – Nucleoside reverse transcriptase
inhibitors
• NtRTIs – Nucleotide reverse transcriptase
inhibitors
• NNRTIs – Non-nucleoside reverse
transcriptase inhibitors
• PIs – Protease inhibitors
• Entry inhibitors (other new classes under
development)
HAART Therapy Regimens
NRTI
NRTI
NNRTI
+
OR
PI
=
Standard
HAART
Regimen
ARV therapy is complex and should
only be offered by trained providers.
Source: WHO, 2006.
Use of ARV Drugs for HIV Prophylaxis
• Prevent mother-to-child transmission (PMTCT)
– drug regimen depends on availability, cost,
resistance, possible side effects
– reduces vertical transmission by 34% to 50%
• Postexposure prophylaxis (PEP)
– start as soon as possible; continue 4 weeks
– multidrug therapy is more effective
• Other uses under study
Source: Dabis, 2000; CDC, 2005.
Why ARV Clients Benefit from Contraception
• Reduce stress related to unintended
pregnancy
• Avoid complicated pregnancy
(ARVs can aggravate anemia and insulin resistance,
which are common in pregnancy)
• Have access to wider range of ARV drugs if
not pregnant or at risk of pregnancy (some
ARVs have potential harmful effects on fetus)
EFZ should not be given to women of childbearing potential
unless effective contraception can be assured. – WHO, 2004
Source: Shelton, 2004; Powderly, 2002; WHO, 2004.