Modern antiviral drugs for the treatment of HIV AIDS. Treatment of HIV and AIDS: modern medicines Medicines for HIV infection

Tablets for HIV infection give a sick person the opportunity to lead a normal lifestyle, maintaining the normal state of the body. The main goal of highly active antiretroviral therapy (HAART) is to reduce the level of viral load that the cells of the immune system receive. The prescription of HAART drugs is carried out by the doctor, depending on the test results of the infected patient. The treatment regimen includes simultaneous administration of at least three medications. So, what pills do you take for HIV? Let's look at some of the most frequently prescribed ones.

An antiviral drug used as part of HAART. The active component of the drug is zidovudine.

Azidotimidine is indicated for use:

These anti-HIV pills can be prescribed to prevent a person from becoming infected while working with materials contaminated with the virus.

The initial dosage depends on the patient's weight. So, for a patient whose weight falls within the range of 70…80 kilograms, the daily dose will be 1200 micrograms. The dose of medication is divided into six doses.

The dosage should be calculated by the leading doctor depending on the individual characteristics of the course of HIV in the patient.

Side effects of the drug include the development of an anemic state, as well as leukopenia and neutropenia. The reason for the formation of undesirable effects is the prescription of too high daily doses. Also possible:

The use of the drug is prohibited by low levels of neutrophils and hemoglobin (below 7.5 g/dl).

If we talk about which HIV pills are allowed during pregnancy and breastfeeding, Azidotimidine is not one of them.

Heptavir -150 is an effective direct-acting antiviral tablet against HIV. They are a nucleoside reverse transcriptase inhibitor. The active ingredient is lamivudine (each pill contains 150 micrograms of the substance).

These HIV pills - the drug name Heptavir-150 - are part of antiretroviral therapy. Prescribed for use in adult patients. Dosage - 150 micrograms per dose twice a day.

Among the side effects during drug therapy, it is worth noting the development of anemia, pain in the epigastric region, nausea ending with vomiting, the development of paresthesia, diarrhea, etc.

These tablets for HIV-infected patients are contraindicated in case of individual intolerance to the component composition and during breastfeeding. Prescription during pregnancy is justified only if absolutely necessary.

Another pill for HIV infection. The name of the active component is durunavir (each tablet contains 300 micrograms of the substance). The drug prevents the formation of virus cells. The medicine is indicated for use in adult patients, as part of HAART.

Prezista is prescribed in combination with the drug Ritonavir. The scheme could be as follows:

• Prezista 800 micrograms in combination with Ritonavir (100 micrograms). Take once every twenty-four hours strictly with meals.
• 600 micrograms of Prezista in combination with 100 micrograms of Ritonavir twice daily with meals.

The doctor will prescribe a treatment regimen.

Side effects that can develop during therapy include:

• dyspeptic symptoms;
• hives;
• myalgia;
• absence of menstruation;
• formation of anemia, etc.

A contraindication to prescribing the drug will be individual intolerance to the component composition of the drug. You cannot take the drug during treatment with tablets Astemizole, Terfenadine, Midazolam, etc.

These, of course, are not all the names of HIV pills that can be used as part of HAART. Drugs such as Intelence, Stag (the drug is especially often used as a component of HAART), Ziagen and some others may also be prescribed.

If an HIV-infected person takes pills according to the prescribed regimen without violating the recommendations, then the treatment not only prolongs the person’s life, but also prevents the development of the final stage of the disease - AIDS. The drugs considered help reduce the viral load and increase the total number of CD4+ lymphocytes in the patient’s body.

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Tablets for the treatment of HIV

Tablets for the treatment of HIV allow you to maintain the normal state of the patient’s body and improve his quality of life. HIV infection is a sexually transmitted disease. When the virus accumulates in nerve cells and macrophages, the human immune system is damaged. As a result, the patient dies from secondary infections and diseases. The last stage of HIV is acquired immunodeficiency syndrome. A progressive decrease in immunity leads to the development of infectious and oncological diseases, leading, in turn, to the death of the patient.

How do you know if you have HIV?

The danger of HIV infection lies in the fact that in the early stages it is asymptomatic, while viruses actively multiply and invade the cells of the human body. An HIV test is the only reliable way to detect the disease. During the acute phase of HIV, the patient may experience some symptoms. They are rarely pronounced, so the sick person does not pay attention to them. HIV can be suspected if a person has a low-grade fever for a long time, there is a sharp loss of weight, pain when swallowing and signs of stomatitis, bruising and redness on the skin, and persistent diarrhea.

Skin manifestations depend on the disease that occurs against the background of weakened immunity. With fungal infections of the skin, there are blisters and spots covered with a white film, which can be removed with a cotton swab. Seborrheic dermatitis is a skin lesion in which numerous scales form. With pityriasis versicolor, brownish spots of various sizes appear on the skin, gradually covering the entire body. Pyoderma vegetans is another symptom of HIV infection. It occurs when a staphylococcal infection is attached and has the appearance of pustular rashes. Less common are herpes zoster and Kaposi's sarcoma.

The first symptoms of HIV are similar to the symptoms of a common cold, so the patient simply ignores them. Symptoms disappear quickly and are not observed in all infected people. If these signs arose precisely because of HIV infection, their disappearance indicates that the viruses have successfully entered the cells. The disease can be asymptomatic for 10-15 years after infection. If left untreated during this time, the person develops AIDS.

In some cases, HIV manifests itself as a slight enlargement of the lymph nodes in the armpits, collarbones, groin, and neck. In this case, the patient should be tested not only for cancer and diseases of the lymphatic system, but also for HIV.

What contributes to the development of immunodeficiency?

HIV belongs to the lentivirus genus of the retrovirus family. Thus, this virus belongs to the class of viruses and has a low and uneven rate of spread of the infectious process in a multicellular organism. This type of virus is characterized by a long incubation period. HIV primarily attacks cells of the immune system. Infected cells are destroyed over time. This is due to several factors: programmed cell death, cell destruction under the influence of viral waste products, and destruction of infected cells by T-lymphocytes. The number of immune cells decreases over time; with a critical decrease in the number of T-lymphocytes, the body becomes unable to resist opportunistic microorganisms.

An HIV-infected person can transmit the infection at any stage of the disease. The virus is found in large quantities in the blood, breast milk, seminal fluid and vaginal secretions. This determines the routes of infection.

What drugs are used to treat HIV infection?

Treatment of HIV infection includes constant monitoring of the patient’s health status, timely detection and elimination of secondary infections, psychological assistance, antiretroviral therapy, and rehabilitation measures. Psychological assistance consists of preparing the patient for ART and adapting to a new lifestyle. The doctor prescribing antiretroviral therapy must be highly qualified and regularly update his knowledge. An individual course of treatment is prescribed for each patient.

The main goal of ART is to reduce the viral load on cells to a certain level, which is determined by examining the patient for a long time. Antiretroviral therapy is prescribed taking into account the immunological criteria established by WHO standards. Drugs that act on immunodeficiency viruses and suppress their reproduction are called HIV inhibitors. Modern ART regimens include a combination of at least 3 drugs.

The drugs must be taken in the dose prescribed by the doctor at a certain time.

Such treatment can significantly prolong the patient’s life and prevent the development of AIDS. These medications help reduce the viral load and increase the number of CD4+ lymphocytes in the human body. The combination of three antiretroviral drugs provides a longer-lasting effect than taking one or two drugs. Therefore, this treatment regimen has become standard throughout the world.

There are 2 types of antiretroviral drugs. The first type includes viral reverse transcriptase inhibitors, the second type includes protease inhibitors. The standard treatment regimen includes 1 type 2 drug and 2 type 1 drugs. What medications are taken for HIV?

The following medications are used to suppress the replication of the virus: type 1 nucleoside inhibitors (Epivir, Retrovir, Ziagen); combined forms of reverse transcriptase inhibitors (Trizivir, Combivir); class 1 nucleotide inhibitors (Truvada, Viread); non-nucleoside transcriptase inhibitors (Stocrin, Etravirine), fusion inhibitors, protease inhibitors (Norvir, Ritonavir, Invirase).

The patient must be prepared for long-term, and sometimes lifelong, antiretroviral therapy. Achieving high effectiveness of treatment is possible only with proper use of drugs.

The patient must follow a special diet. In parallel with ART, treatment of secondary infections is carried out. For this, various antiviral, antibacterial and antifungal agents are used. The administration of chemotherapy drugs for tumors contributes to the further development of immunodeficiency. Taking immunomodulators is not recommended: it can contribute to the rapid proliferation of viruses.

A diagnosis such as HIV can cause severe emotional distress, so the patient needs psychological help and support from loved ones. The doctor must tell the patient in detail about what medications to treat HIV and what consequences the lack of treatment entails. The prescription of any antiretroviral drugs is carried out only with the consent of the patient.

What are the possible problems with HIV treatment?

With long-term use of HIV inhibitors, the virus can develop resistance to them, which significantly reduces the effectiveness of therapy. The process of changing the genetic code of a virus so that it becomes resistant to a drug is called resistance. The drug does not suppress the growth of viruses, which contributes to the further spread of infection. Incorrectly selected medications for the treatment of HIV lead to the development of virus resistance and its active reproduction. It is the combined treatment regimen that prevents the development of resistance.

If the virus develops resistance to one of the drugs, the other 2 act on it, suppressing reproduction. The slower the virus multiplies, the less likely it is to develop resistance to the drug. However, resistance also develops when taking 3 antiretroviral drugs. Most often this happens when the medication regimen is violated. In this case, the doctor replaces the previously taken medications with others. The range of antiretroviral drugs is not wide enough, so the virus may be resistant to the new drug. This phenomenon is called cross-resistance and occurs quite often.

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The drug Cycloferon and how to take it correctly in tablets

Viral diseases in our time belong to the category of the most common, especially often they are suffered during a seasonal decrease in immunity - during wet or cold periods, characterized by an increase in epidemics. In addition, the body’s resistance to viruses becomes worse under the influence of environmental factors, because most large cities cannot be called environmentally friendly zones.

Therefore, in order to protect themselves from viruses, as well as, if necessary, to get rid of viral diseases, children and adults should take antiviral and immunomodulatory drugs. These include Cycloferon.

Description and composition of Cycloferon

The drug Cycloferon contains inducers of high molecular weight elements endogenous interferon, that is, a protein that is released by cells as a response to the invasion of viruses. Interferon has a wide spectrum of bioactivity. This product has the following pronounced properties:

• antiviral;
• anti-inflammatory;
• antitumor;
• antiproliferative;
• immunomodulatory.

When taking the drug, the maximum amount of interferon is received by the organs and tissues that contain the most lymphoid elements. Such bodies include:

Cycloferon is in the form of tablets; it is sold in pharmacies in packages of 10, 20 and 50 tablets, each of which is enteric-coated.

There are several active ingredients in Cycloferon:

The auxiliary components of the tablet include the following:

Cycloferon for certain diseases is prescribed not only to drink in the form of tablets, they are also taken as injections intramuscularly and intravenously, as well as as a liniment in the form of a tube.

For what diseases should you take Cycloferon?

Taking Cycloferon in tablets is allowed for both adults and children for the treatment or prevention of colds and other viral diseases, for example:

In addition to viral colds, these tablets are also taken for complex therapy of diseases such as:

• viral acute and chronic hepatitis B and C;
• tick-borne encephalitis;
• neuroinfections;
• cytomenalovirus;
• secondary immunodeficiency in chronic fungal, bacterial and intestinal infections;
• prevention of the formation of neoplasms of various types.

Contraindications to taking pills

Cycloferon should not be taken for the following diseases, syndromes and periods:

• impaired liver function or severe liver diseases such as cirrhosis;
• individual tolerance of the drug or its components;
• age up to 4 years;
• pregnancy or breastfeeding.

You should take the drug extremely carefully and strictly according to the dosage for diseases of the gastrointestinal tract and thyroid gland.

Regimens for taking Cycloferon for various diseases

The regimen for taking Cycloferon tablets depends on the disease and the patient’s age. The dosage for an adult patient will be different from the pediatric dosage. According to the instructions, you need to take one tablet per day. half an hour before meals and without chewing, drink plenty of water.

Colds

For a cold, flu or ARVI The reception scheme will be like this:

• 2-4 tablets at a time on the first day;
• Days 2, 4 and 6 of treatment – ​​2 tablets respectively.

This applies to both the treatment itself and cold prevention.

If the patient's condition is severe, then the initial dosage can be increased up to 6 tablets. The use of the drug in the first days of a cold helps alleviate the symptoms of the disease, the time of fever is reduced, peak temperatures and intoxication symptoms are reduced, the expectoration process improves, pain is relieved, and the likelihood of developing complications is minimized.

As a non-specific cold prevention during an epidemic Children and adults can be given Cycloferon according to the following scheme:

• influenza - tablets are taken on days 1, 2, 4, 6 and 8, and then at intervals of 72 hours you need to take the drug five more times;
• ARVI - once a day, observing a daily interval for 5-9 days.

Another regimen for taking Cycloferon tablets will be for infectious herpes. They drink 2-4 pieces on the following days:

• first second;
• fourth to eighth in a day;
• eleventh - seventeenth through 2;
• twentieth;
• twenty-third day of treatment.

It is better to start taking Cycloferon for the prevention of flu and colds at the beginning of winter. It's better to take pills half an hour before meals. The dosage is determined individually depending on age. Thus, the daily dose for an adult is a maximum of 900 mg and varies depending on body weight. Children under 6 years of age are prescribed up to 150 mg, and up to 12 years – 300 mg, respectively.

If you see flu-like symptoms, treatment should be started immediately. But when preventing diseases, the dose needs to be reduced. Recommended to take 6 tablets at once for such symptoms, How:

• headaches of a cold nature;
• aches;
• cold symptoms - cough, runny nose.

For complex therapy infections of intestinal origin The medicine is taken 2 tablets a day for the first two days, then every other day until the eighth and on the eleventh. It is prescribed by a specialist to reduce the number of clinical symptoms of the disease and so that it ends sooner.

Tablet dosage regimen for borreliosis and tick-borne encephalitis looks like that:

• the first three days – 2 tablets once a day;
• from the fifth to the seventeenth day every other day - the same;
• for the next 2 months there is maintenance therapy - 2 tablets once every five days.

Regimen for complex therapy for HIV patients:

• the first 2 days – 4 tablets per day;
• from 4 to 10 days every other day - 4 tablets per day;
• from 13 to 28 days after two days - the same;
• for 4 months – one tablet every 5 days;
• do not take for a month;
• the cycle is repeated again according to the specified scheme.

This treatment regimen helps restore immune system parameters in patients in the early stages of the disease.

For the treatment of herpes Cycloferon is also given for a week, 2 tablets per day, then treatment is stopped for a month and the course is repeated again.

For herpes and HIV, in these regimens Cycloferon can be combined with Acyclovir, which helps prevent relapses of herpes.

The treatment regimen with Cycloferon for this disease of groups B and C depends on the origin.

So, if we are talking about acute infection, then you should take 3 tablets once a day for 22 days. Then take 3 tablets a day every two days for three months.

But in the case chronic infection The intake scheme is as follows:

• 22 days – 3 tablets once a day;
• for 3 months – 3 pieces per day every two days;
• for six months - 3 pieces once a day every three days;
• then, while maintaining the replicative activity of the virus, take 3 pieces once a day, once every 5 days.

Cycloferon in the form of a solution

This drug can be administered to prevent a number of diseases. intramuscularly or intravenously. Most often this is done if a person has had contact with a sick person. The product can be administered once. If infection has already been detected, the dosage is determined by a specialist depending on the characteristics of the patient and the form of the disease.

For the flu Cycloferon is most often administered intramuscularly once every 2 days for 10 days. And when herpetic infection as many. The daily dosage is 250 mg. Cycloferon in the form of a solution can be a component of complex therapy for viral acute hepatitis, the course of therapy lasts in this case 2 weeks, and the daily dose is 500 mg.

Use of Cycloferon in children and pregnant women

The instructions for the tablets suggest the use of the product in children from four years of age in such doses;

• 4-6 years - 1 tablet per day;
• 6-11 years – 2 pieces per day;
• from 12 years old and adults – 3 tablets, respectively.

A second course of treatment should begin at least 2 weeks after the end of the previous one.

During pregnancy and breastfeeding Cycloferon cannot be accepted with the exception of topical application of liniment.

In terms of effects on the human body, drugs such as:

Some experts often tell patients that Cycloferon is the best way to protect the body from colds in winter and that only vaccination is more effective. However, you should not prescribe the drug yourself; it is better consult with a specialist, also do not forget to strictly follow the instructions in the instructions to avoid side effects.

Biseptol: can it be used for colds?

Biseptol is one of the most famous and controversial domestic drugs. In the 80-90s of the 20th century, Biseptol was at the peak of its popularity. It was prescribed by doctors of many specializations, from pediatricians to urologists. The drug was literally considered a panacea for all ills, and it could be bought without the recommendation of a specialist. Many took it uncontrollably, for any reason, including for a common cold. What is the current attitude towards the drug Biseptol? Can it be used to treat a cold?

Biseptol is a combination medicine from the sulfonamide group. It contains sulfamethoxazole and trimethoprim. The name itself implies the composition and effect of the drug. The particle “bi” means that the composition includes two components. The second part of the name - "septol" - probably comes from the Latin "septicus", literally meaning "rotting". In pharmaceuticals, preparations with the septol root belong to the group of antiseptics. Biseptol is a bactericidal drug with a wide spectrum of action. It causes the death of the microbial cell by blocking the synthesis of folic acid, without which the microbial cell cannot divide. Sulfamethoxazole and trimethoprim complement and enhance each other's action in this mechanism.

The pharmaceutical industry produces 4 main forms of the drug:

• Biseptol 480 mg - tablets for adults;
• Biseptol 120 mg - tablets for children;
• Biseptol 240 mg - suspension for children.
• Biseptol 480 mg in ampoules containing concentrate, on the basis of which solutions are prepared for infusions - intravenous drip injections.

Biseptol in ampoules is indicated for use exclusively in a hospital setting.

The most popular forms of release are Biseptol 480 mg in the form of tablets and Biseptol 240 mg - suspension for children.

Pharmacological action and group

The main component of Biseptol, sulfamethoxazole, has a strong bactericidal effect: it disrupts the synthesis of dihydrofolic acid, which is necessary for microorganisms to function. Trimethoprim enhances the effect of sulfomethoxazole. The ratio in which the components are combined is precisely adjusted. If in a Biseptol 480 mg tablet it is approximately 1:5, then when absorbed into the blood, the ratio of sulfamethoxazole and trimethoprim drops to a ratio of 1:20. These concentrations are necessary for maximum synergistic effect of the components.

Is the drug an antibiotic?

This question often worries patients, so it is necessary to put everything in its place.

An antibiotic is a medicinal substance of natural (animal, plant or microbial) origin that has an antibacterial effect that completely suppresses the growth and reproduction of bacteria.

Upon careful reading of the instructions for Biseptol, it becomes obvious that the components of the drug have nothing to do with antibiotics. Both substances were synthesized in the laboratory. Sulfamethoxazole belongs to the group of sulfonamide drugs, and trimethoprim is used only to enhance the effect of the main component. So, Biseptol is a medicine that has an antimicrobial effect, but is not an antibiotic. At the same time, it is naive to believe that a drug that is not one of the notorious “harmful” antibiotics is as safe as vitamins. Sulfonamides are serious substances, and medications containing them should only be taken under the supervision of a physician. Otherwise, you may experience unpleasant consequences, including the development of drug-resistant microorganisms.

Biseptol, like antibiotics, is a prescription drug. Don't forget about this.

Indications and contraindications for use

Biseptol is used to treat infections caused by microorganisms. This drug is prescribed for the treatment of diseases such as:

• bronchitis in acute and chronic form;
• pneumonia;
• pleural empyema (purulent inflammation of the membranes of the lungs);
• lung abscess;
• bronchiectasis;
• ENT pathologies (otitis media; sinusitis);
• intestinal infections (dysentery, paratyphoid A and B, cholera, typhoid fever);
• genitourinary infections(urethritis - inflammation of the urethra; prostatitis - inflammation of the prostate gland; pyelonephritis - inflammation of the renal pelvis and the kidney tissue itself; salpingitis - inflammation of the uterine appendages);
• gonorrhea;
• soft tissue and skin infections(pyoderma, or pustular skin lesion; acne; boil, or boil);
• meningitis(inflammation of the meninges);
• brain abscess;
• septicemia;
• infectious diseases(brucellosis, malaria, toxoplasmosis, borreliosis, scarlet fever);
• wound infections and osteomyelitis;
• prevention and treatment of Pneumocystis pneumonia in HIV-infected patients.

The drug Biseptol is contraindicated for treatment in the following cases:

• cardiovascular failure;
• diseases of the hematopoietic organs;
• liver failure;
• renal failure;
• pregnancy and lactation;
• deficiency of glucose-6-phosphate dehydrogenase (hereditary disease);
• in the treatment of premature infants and under 3 months of age;
• hypersensitivity to the components included in the drug or to other sulfonamides.

Biseptol should be used with caution if:

• the patient previously had allergies to other drugs;
• the patient suffers from bronchial asthma;
• the patient has a deficiency of folic acid;
• have thyroid disease;
• in early childhood and old age.

Treatment with Biseptol should be carried out under the supervision of a physician and blood tests should be carefully monitored.

In some European countries, Biseptol is used to treat children over 12 years of age. In the CIS countries, the drug is also prescribed to young children, starting from 3 months.

The main condition for treating children is precise dosage compliance.

For children, Biseptol is available in the form of a suspension and syrup. The suspension can be given to children from 3 months of age; syrup - after a year; tablets – after 2 years; injections - after 6 years.

When treating with Biseptol, parents need to ensure their child drinks plenty of fluids. In addition, during the treatment period you should limit your consumption of sweets and confectionery, cabbage and carrots, tomatoes and legumes. It is recommended to give your child vitamin complexes.

This medicine should not be given to children on their own. Treatment should be carried out only as prescribed by a pediatrician and under constant medical supervision.

During pregnancy

During pregnancy, a woman’s immunity decreases, and there is a risk of contracting an infectious disease, so very often at a doctor’s appointment questions are asked about the possibility of treating expectant mothers with Biseptol. Clinical studies show that the active ingredients of this drug penetrate the placenta to the fetus and can cause harm to it.

Taking Biseptol during pregnancy is strictly contraindicated! During lactation, you should also not take this medicine, since the components of the drug pass into breast milk in large quantities. Having penetrated the placenta, Biseptol can cause various developmental disorders of the embryo and even cause miscarriage or premature birth.

Colds and flu are acute viral diseases and are caused by various viruses. Biseptol, like other antimicrobial agents, does not affect viruses.

With a common cold, we will not get any effect from Biseptol. A common cold or acute respiratory viral infection goes away on its own within a week. However, in weakened patients, young children, the elderly - that is, those who have malfunctions of the immune system - the disease can take a protracted course. This leads to complications of the pathology and the addition of a bacterial infection. In such cases, an antibacterial drug is needed, and Biseptol would be quite appropriate here.

How to understand this line between a viral and an already complicated viral-bacterial infection? For a non-professional, this is indeed not easy.

One of the symptoms of a complicated viral disease is a sharp deterioration in the condition. For example, this may be an increase in temperature on the third or fourth day of illness. In this case, the temperature either does not drop at all, or after taking antipyretics it drops very slowly and not for long. A complicated infection may also be indicated by the appearance of a severe cough accompanied by the discharge of sputum.

A cold complicated by a bacterial infection should be treated by a doctor who will select the right antibacterial drug.

Possible complications caused by the drug

Like any other drug, Biseptol can have side effects. This happens very rarely; usually the drug is well tolerated by patients. But in rare cases, the medicine may cause:

• From the digestive system: diarrhea, abdominal pain, loss of appetite, nausea, vomiting;
• Colitis (inflammation of the intestines);
• Reactive inflammation of the liver with stagnation of bile – cholestatic hepatitis;
• Glossitis– inflammation of the tongue;
• Stomatitis– inflammation of the oral mucosa;
• Pancreatitis– inflammation of the pancreas;
• From the nervous system: dizziness, headache, depression, slight tremors of the fingers;
• From the kidneys: increased urine volume;
• Kidney inflammation(nephritis);
• Excretion of blood in the urine;
• From the respiratory system: bronchospasm, cough, suffocation or feeling short of air;
• From the hematopoietic organs: a decrease in the number of leukocytes in the blood, a decrease in the number of neutrophils (a type of white blood cell that protects the body from infections), a decrease in platelets (blood platelets involved in blood clotting), folate deficiency anemia;
• From the skin: urticaria, itching, Lyell's syndrome and Stevens-Johnson syndrome (the most severe types of allergic manifestations on the skin and mucous membranes with necrosis and rejection);
• Quincke's edema.

What bacteria cause sore throat and how they spread is described in this article.

Isolated cases of chills and fever, joint and muscle pain, thrombophlebitis (at the injection site), decreased levels of potassium, sodium and blood sugar have been recorded.

Side effects are usually mild and disappear after discontinuation of the drug.

As you can see, Biseptol is not such a safe drug as many people think, although it does not belong to the group of antibiotics. This medicine should not be taken on its own as it can cause many side effects. It should be given especially carefully to children. The drug is contraindicated for pregnant and lactating women. Biseptol can only be beneficial if prescribed appropriately. And only a doctor can do this. Always remember this.

How to take HIV pills

This article is full of information, so we have divided it into two blocks.

contains general information about combination antiretroviral therapy and the purpose of its use.

provides information on how combination therapy is used in practice.

Strive to obtain information about treatment options on your own.

The drug review in this chapter is based on 1999 data. The development of medical science in the field of HIV treatment is happening very quickly. Newly created drugs are tested in experiments and clinical trials. Thus, it is possible that the information presented here may be significantly supplemented by the time our book is published.

Try to independently learn about the latest treatment methods at the AIDS center at your place of residence, in AIDS service organizations, on the relevant Internet pages (if the Web page address is the abbreviation AIDS or HIV, this is almost always what you need).

Block 1. Combination therapy

Medicines that act on HIV (suppress its reproduction) are called antiretroviral drugs, or HIV inhibitors. Currently, when treating HIV infection, it is recommended to use a combination of HIV inhibitors consisting of at least three drugs. This is called triple therapy, or triple combination. Studies have shown that such combinations can significantly prolong the life of a person with HIV infection and prevent the development of AIDS. While taking these drugs, viral load levels decrease and the number of CD4+ lymphocytes in the blood increases. Basically, the mechanism of action of these drugs has been deciphered. It has been found that using a combination of three drugs, you can achieve a longer lasting positive effect from treatment than using one or two drugs. In this regard, triple combinations of antiretroviral drugs have become an internationally accepted standard of care.

Two classes of antiretroviral drugs

There are currently two classes of HIV inhibitors. The first class consists of HIV reverse transcriptase enzyme inhibitors and the second class consists of HIV protease enzyme inhibitors. A triple combination usually consists of two first-class drugs and one second-class drug.

Resistance of the virus to HIV inhibitors (resistance).

There is a problem with the use of HIV inhibitors. The fact is that with long-term use of antiretroviral drugs, the virus becomes insensitive to them, and therefore the effectiveness of treatment sharply decreases. This condition is called HIV resistance or resistance. Resistance means that the virus, during the process of reproduction, has slightly changed its genetic structure (mutated) and has become insensitive to the drug. The medicine no longer prevents the virus from reproducing, which leads to the progression of the disease. The more actively the virus multiplies (untreated, or when only one antiretroviral drug is used, or when the wrong combination of drugs is used), the higher the likelihood of developing resistance. Conversely, the longer resistance does not develop, the more effective the therapy.

The advantage of combination therapy is that HIV does not become resistant for a long time. This happens for two reasons.

If HIV becomes resistant to one of the drugs, another acts on it and suppresses its vital functions. When you use two or three different HIV inhibitors, you are more likely to stay effective for longer. Combination therapy slows down the replication of the virus. The slower the virus multiplies, the lower the likelihood of mutations and, accordingly, the development of resistance.

However, resistance can also develop with combination therapy (most often this happens if the patient violates the doctor’s recommendations for taking medications). In this case, it remains possible to switch to a combination of other types of inhibitors to which resistance has not yet developed. However, the choice of replacement drugs is extremely limited. The mechanisms of interaction between the human body, the virus and drugs are very complex and have not yet been fully studied. The fact is that with the development of resistance to one type of HIV inhibitors, resistance to another type of antiretroviral drugs may develop, even if these drugs have not yet been used. This phenomenon is called cross-resistance. Unfortunately, cross-resistance is quite common. And a new combination of drugs to which the virus still retains sensitivity is by no means easy to find, despite the fact that at the moment there are many more combinations of HIV inhibitors than before.

When can combination therapy be started?

There are certain indications for starting combination therapy. It should start:

• when symptoms of diseases associated with HIV infection appear, regardless of the viral load and the number of CD4+ lymphocytes;
• if HIV infection occurs in an asymptomatic form, then when the viral load increases above 10 thousand viruses per 1 mm3 or when the number of CD4+ lymphocytes decreases below 400-350 cells per 1 mm3. Science has not yet definitively determined the optimal criteria for starting combination therapy. The recommendations given here are based on world experimental experience and “reasonable suggestions” of scientists. However, early and late administration of combination therapy have their drawbacks.

Disadvantages of early therapy

• Early initiation of therapy means that patients will have to adhere to a rigid hourly schedule of taking medications, drinking and eating for years. In addition, these medications often have side effects; In addition, sufficient data have not yet been accumulated on the delayed side effects of antiretroviral drugs.
• Violation of a clearly defined drug regimen increases the likelihood of developing resistance. In other words: “if you do it, then do it.” Therefore, if you doubt that you can cope with the problems associated with combination therapy, it is better to consult a specialist again and, if possible, postpone it somewhat.
• Only when you are completely confident that you are ready to begin treatment and are able to overcome the difficulties associated with it, can you start it and count on a good result.

Disadvantages of late treatment

• Starting treatment too late occurs against the background of profound changes in the immune system. The more damaged the immune system is, the more difficult it will be to restore it.
• Another disadvantage is that the concentration of HIV in the blood increases, and this makes it more aggressive towards the cells of the human body.

In other words, the choice is difficult. Your doctors and friends with experience in treatment will help with advice, but you will have to make the final decision yourself.

Box 2. Practical information on the use of combination therapy

The longer it takes for resistance to develop, the more successful the treatment.

The first combination of drugs prescribed to a person who has not previously received HIV inhibitors usually gives good results: the virus has not yet encountered antiretroviral drugs, has not acquired resistance to them, and the drugs are working at full strength. But, unfortunately, it is impossible to exclude the development of resistant forms of HIV. If the initial regimen is ineffective, other combinations of drugs are prescribed, but this increases the likelihood of cross-resistance. Since the first “hit” is the most significant, it is necessary to ensure that the most aggressive combination against the virus is selected.

What can you do

The success of treatment largely depends on the patient. There are steps you can take on your own to prevent the development of HIV resistance.

• Each time, take the exact prescribed dose of the drug, without decreasing or increasing it. If side effects occur, consult your doctor.
• The total daily number of tablets taken should also strictly correspond to those prescribed by the doctor. Forgetfulness that causes you to skip medications is unacceptable here. Of course, if a person forgets to take one or two tablets, resistance does not immediately arise. But the less often you miss taking medications, the less likely it is to develop resistance. Do not take a double dose if you missed the previous dose.
• It is very important to correctly distribute the daily dose of drugs over time. For example, take a medicine prescribed twice a day at 8 a.m. and at 8 p.m. Three times a day - respectively, at 8 o'clock, 16 o'clock and 24 o'clock. Try to keep your medication intake consistent with your rhythm of life. This does not mean that you should follow the timing second by second, but it is necessary to adhere to the optimal scheme.
• Some medications need to be taken on an empty stomach, others, on the contrary, after meals. These prescriptions are given to ensure that their effectiveness is higher, and here, too, one cannot deviate from the doctor’s recommendation.
• Try to get more information about each drug you are taking and how to take it. For example, if it says “on an empty stomach,” does this mean that the person should not eat or drink anything, and for how long? What is meant by fatty foods? Is it a sandwich with butter or a spoonful of olive oil? Don't hesitate to ask your doctor questions.

Sometimes it is difficult to stick to the treatment regimen

In practice, it turns out that it is not always easy to meet all the requirements for taking medications. This is quite understandable. It is assumed that the treatment will allow the patient to maintain their previous lifestyle. However, can life be called “normal” when during the day, at different times, after meals or, conversely, before meals, you have to take a full handful of pills?

At the beginning of treatment, if the patient has sufficient motivation, this is usually successful. But over time, difficulties often arise. You begin to feel better on the medications and, accordingly, become less punctual in observing the time of taking them, and sometimes even forget to take them. This entails an increased likelihood of developing HIV resistance. And someday it may happen that you will continue to take medications that no longer have any effect on the virus.

What's the best way to take your medications?

So, all medications included in combination therapy must be taken according to certain rules; time of administration, number of tablets, frequency of administration, connection with food (on a full or empty stomach), etc. These rules are different for each drug and for each combination. They need to be clearly understood (your doctor will help you with this) and strictly followed.

Here are some tips that can make meeting your medication requirements easier. It is useful to draw up a diagram for yourself, which will indicate the exact time of taking the drugs, their quantity and exactly how they should be taken before or after meals). This plan should be designed in such a way that it matches your sleep and eating rhythm as best as possible. You can wear a watch with an alarm that sounds when you need to take your pills.

You can place your medications in a special box so that others do not know what disease you are treating. Doctors may offer you brochures with nutritional advice when taking certain medications.

You need to be careful about side effects

As already mentioned, the medications discussed may have side effects. In addition, certain drugs cannot be combined with certain HIV inhibitors due to the risk of negative interactions. This is called cross action.

You should always consult your doctor

When prescribing HIV inhibitors, your doctor should be informed about all other medications you are currently taking. Don't forget about those medications that you buy without a prescription (for example, aspirin, etc.). All this will avoid side effects and cross-reaction of drugs.

Almost all antiretroviral drugs have the ability to cause side effects. Some of these effects disappear spontaneously after a few weeks, so you should, in contact with your doctor, continue to take the medication for the first weeks, despite the discomfort. However, not all side effects go away on their own.

If you have any complaints, you should immediately consult a doctor. He will examine you and either prescribe medications that will eliminate or reduce the side effects of the drug, change the dose of the drug, or stop the drug and prescribe a new one.

We are not able to describe here all the existing side effects of drugs. Full information about each drug can be obtained from the annotation included in the package. However, it is worth keeping in mind that the annotation lists all side effects, including the rarest of them. It is not at all necessary that you will develop all the unpleasant phenomena that are discussed there. The most common side effects of HIV inhibitors are nausea, vomiting, diarrhea (diarrhea), and insomnia. Other side symptoms are more specific. The sub-chapter “Medicines against VI” describes the most common side effects of this type of medicine. We specifically highlight two side effects that are characteristic of HIV reverse transcriptase inhibitors. This:

• neuropathy is damage to nerve endings, manifested as numbness in the limbs, increased or decreased skin sensitivity, muscle spasms, and pain. These side effects often occur with the use of Zerit (d4T), Videx (ddI) and Hivid (ddC). Complaints usually disappear after stopping the medication;
• pancreatitis - inflammation of the pancreas. This rare but very life-threatening complication is sometimes caused by the drug Hivid (ddC). Pancreatitis is characterized by pain in the upper abdomen spreading to the back (girdling pain), vomiting, fever. If such symptoms appear, you should immediately stop taking the medication and consult a doctor. Drinking alcoholic beverages, especially in large quantities, increases the risk of inflammation of the pancreas.

When used together, two drugs may have cross-effects on each other. One drug may weaken or even neutralize the pharmacological action of another. The interaction of two medications used simultaneously can increase the side effects of each of them. And yet, despite the fact that the cross-effect of drugs is known, their combinations are prescribed to patients for health reasons. In such cases, additional monitoring of vital body functions is usually carried out to prevent side effects.

HIV protease inhibitors often cause cross-reaction when taken in combination with certain other drugs. These effects vary among different protease inhibitors. The list of drugs that should not be used with other drugs or should be used with caution is too long to list here. We advise you to read the annotations and seek advice from your doctor in each case. If a particular drug cannot be used with HIV inhibitors due to the risk of cross-effects, you can almost always choose another drug that can be combined with antiretroviral drugs. Cross-effects may occur when combining HIV protease inhibitors with drug and alcohol use. This phenomenon has not been well studied, but nevertheless, try not to use drugs or alcohol during treatment.

Wrong combination choice

It may turn out that you started treatment with a combination that is not suitable for you due to a large number of side effects. As long as the combination of drugs is effective, one of the drugs can be replaced by another. A positive result of therapy is considered to be a significant reduction in the viral load (the best option is to an undetectable level) during combination therapy. In this case, you can change one of three medications. In other words, if one component turns out to be unsuitable, it is not necessary to replace the entire combination of drugs and expect new side effects.

Replacing one combination with another

If the amount of virus in the blood increases while taking the initially chosen combination, it is recommended to replace the entire combination of drugs. No need to wait too long. The sooner the combination is replaced, the higher the likelihood of a rapid reduction in the amount of virus. Due to the development of cross-resistance with subsequent or late replacements of combinations, it is more difficult to obtain a pronounced positive effect from treatment. However, this does not mean an immediate threat to your life or a sharp worsening of the disease. These drugs work quite well for some time, even if their effect is not determined by the results of the viral load. The main indicator here is your well-being and the absence of complaints and signs associated with the effect of HIV on the body.

Let's repeat it again. In the field of treatment of HIV infection and AIDS, large-scale research is constantly being conducted, as a result of which more and more new antiretroviral drugs are emerging. This increases the chances of each patient in his fight against the disease.

Monitoring the effectiveness of combination therapy

In the first chapter, it was said that there are blood tests that can be used to assess the state of the immune system and the rate of development of HIV infection. This is respectively a determination of the number of CD4+ lymphocytes and viral load.

The effectiveness of combination therapy is determined by the same indicators. In addition, during the treatment process, other studies should be carried out: general and biochemical blood tests, general urine analysis, etc. If possible, the blood can be tested for the concentration of an antiretroviral drug, determining HIV resistance to HIV inhibitors. We provide information about some studies below.

Viral load is a measurement of the number of human immunodeficiency virus (HIV) particles in 1 mm3 of blood. This test allows you to judge the course and prognosis of HIV infection, as well as the effectiveness of antiretroviral therapy. The amount of virus in the blood can be insignificant, sometimes so much that it cannot be determined by currently available methods. This test result is assessed as negative, although this does not mean that there is no HIV in the patient’s body. It’s just that its amount in the blood is negligible, so it’s more correct to talk here about an undetectable level of viral load. The presence of HIV in the body in a number of similar cases is confirmed by additional studies. For example, the virus may be in the lymph nodes. This test result indicates a favorable prognosis for the course of HIV infection.

In some cases, the number of HIV particles can be over a million. With high test results, the likelihood of the appearance of symptoms of the disease increases, and the prognosis for the development of HIV infection is determined as AIDS-unfavorable.

Viral load results and CD4+ lymphocyte counts may be variable. Therefore, dynamic medical supervision of people with HIV infection and regular comprehensive examinations are recommended. The well-being of a person with HIV infection, combined with the assessment of indicators, allows the doctor to most objectively assess his condition and prescribe combination antiretroviral therapy in a timely manner, and subsequently monitor its effectiveness.

If combination therapy is effective, then viral load levels are significantly reduced (by 90-99% within one month after starting to take the drugs). Very often the test results become negative.

Combination therapy is considered ineffective if the viral load begins to increase again after an initial decrease.

There are methods for studying the sensitivity of HIV to certain HIV inhibitors - resistance tests. Resistance tests are very expensive and in Russia are used mainly for research purposes.

Additional information about medications

Each person can get additional information about antiretroviral drugs from their doctor.

Medicines against HIV (antiretroviral drugs)

Here we provide an overview of various antiretroviral drugs, or HIV inhibitors, registered and approved for use in Russia.

Along with the widely used HIV inhibitors (HIV reverse transcriptase inhibitors and HIV protease inhibitors), some drugs that do not belong to these groups, but have an anti-retroviral effect, will be described.

We will also list some of the side effects that may occur while taking these medications.

Medicines will be listed under at least two names. The first is the international name of the drug substance or the active principle of the drug (the abbreviated name is indicated in brackets). The second is the brand names of the drugs under which they are sold (in bold). There are two classes of HIV inhibitors.

First class - HIV reverse transcriptase enzyme inhibitors - in turn is divided into two subclasses:

• HIV nucleoside reverse transcriptase inhibitors (NRTIs);
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs).

The second class is HIV protease inhibitors (PIs).

1. HIV reverse transcriptase inhibitors

A. N cleoside reverse transcriptase inhibitors (NRTIs) Azidotimidine (AZT) - Retrovir, Timazide Release form - tablets, capsules of 100 mg. Directions for use: 200 mg (2 tablets, capsules) 3 times a day. Side effects: anemia (anemia), leukopenia (decreased number of white blood cells) and thrombocytopenia (decreased number of platelets) develop after long-term use of the drug. Nausea, vomiting, muscle pain, muscle weakness, and insomnia are also possible. However, if they do appear, they usually go away within a few weeks after starting treatment. It is known that azidothymidine prevents a decrease in intelligence in AIDS.

Lamivudine (ZTS) - Epivir

Release form: 150 mg tablets.

Side effects are quite rare: headache, fatigue, nausea,

Azidotimidine plus lamivudine - Combivnr

Directions for use: 2 times a day.

Side effects: see azidothymidine and lamivudine.

Stavudine (4dT) - Zerit

Release form: capsules of 30 and 40 mg.

Directions for use: 1 capsule 2 times a day (dosage depending on weight

Side effect: neuropathy.

It is known that stavudine penetrates well into the central nervous system.

and prevents a decrease in intelligence in AIDS.

Due to side effects such as neuropathy, it is not recommended

use in combination with zalcitabine. Usually goes well with

Zalcitabine (ddC) – Hivid

Release form: 750 mg tablets.

Directions for use: 1 tablet 3 times a day.

Side effects: neuropathy, ulceration of the mucous membrane of the cavity

mouth, pain in the stomach or intestines.

It is better not to use zalcitabine in combination with stavudine.

Didanosine (ddI) - Videx Release form: 100 mg tablets.

Directions for use: 1 or 2 times a day. Dosage depending on the patient's weight. Didanosine is taken on an empty stomach. Available in the form of tablets that need to be chewed. If you find chewing the tablets unpleasant, you can crush them and dissolve them in apple juice for 10 minutes. Since didanosine contains a buffering agent that reduces stomach acidity, it can be taken at the same time as other medications.

Side effects: neuropathy, inflammation of the pancreas, complaints of pain in the stomach or intestines.

Due to the side effects of didanosine, it is best not to take it in combination with zalcitabine.

Release form: 300 mg tablets. Directions for use: 1 tablet 2 times a day. Abacavir is much stronger than azidothymidine. The drug also appears to penetrate the brain and may prevent intellectual decline. Significant side effects: headache, skin rashes, nausea.

B. Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Release form; tablets 200 mg.

Directions for use: 1 tablet 2 times a day (during the first two weeks, use 1 time a day, then 2 times a day), Side effects: skin rashes. Sometimes they can be so strong that you have to stop taking the drug. This side effect usually appears two weeks after starting treatment.

Release form: 200 mg capsules. Directions for use: 1 capsule 3 times a day. Side effects: rash, dizziness (disappears two weeks after the start of therapy).

2. HIV protease enzyme inhibitors

Release form: 400 mg capsules.

Directions for use: 2 capsules every 8 hours. The medicine is taken on an empty stomach or during meals, provided that it is not a fatty or high-calorie food.

The recommendation “on an empty stomach” means that the drug should be taken two hours before or one hour after meals. If for some reason this does not work, you can eat something very light, such as a cracker or an apple, before taking the medicine. To reduce the likelihood of developing the disease, the medicine should be taken with a full glass of water. You should drink at least 1.5 liters of additional fluid per day, especially in hot weather or during physical activity. Grapefruit juice should be excluded from the diet as it reduces the effect of indennavir. Indinavir and didanosine must be taken one hour apart. Side effects: headache, nausea, abdominal pain, diarrhea, urolithiasis.

Release form: 250 mg tablets. Directions for use: 3 tablets 3 times a day. To improve the effect of nelfinavir, it is best to take it with food. Side effects: Diarrhea, which usually goes away after the first month of treatment (this can also be treated with anti-diarrhea medications such as Immodium).

Saquinavir - Invirase (saquinavir in hard gelatin capsules)

Release form: 200 mg capsules. Directions for use: 6 capsules 3 times a day (in combination with ritonavir - 2 times a day).

For better absorption, the drug should be taken with fatty foods, such as olive oil, whipped cream, and fatty cheese. Side effects: headache, pain in the stomach or intestines, nausea. This drug is quickly absorbed in the intestines and quickly eliminated from the body. Saquinavir is recommended to be taken in combination with ritonavir.

Saquinavir - Fortovase (saquinavir soft gelatin capsules)

Release form; capsules 200 mg.

Directions for use: 6 capsules 3 times a day (in combination with ritonavir - 2 times a day). For better absorption in the body, the drug should be taken with fatty foods: olive oil, whipped cream, fatty cheese. This drug is quickly absorbed in the intestines and quickly eliminated from the body. Saquinavir is recommended to be taken in combination with ritonavir.

Release form: 100 mg capsules and solution. Directions for use: 6 capsules 2 times a day, preferably with meals. Side effects: feeling tired, metallic taste in the mouth, diarrhea, nausea, vomiting. Food plays an important role in reducing side effects. Experiment with foods that you like and tolerate well. If vomiting does occur (the drug is in the intestines after two hours), you do not need to take an additional dose. In order to reduce side effects, it is best to take ritonavir on an increasing schedule over two weeks.

Along with generally accepted antiretroviral drugs registered abroad or in Russia, there are so-called officially unrecognized drugs, although individual studies have demonstrated their antiretroviral activity. These drugs have yet to be studied regarding side effects and therapeutic properties, and must undergo clinical trials. For now, until clinical trials are completed, they cannot be prescribed to every patient. An example of such drugs is hydroxyurea.

Release form: 500 mg capsules. Directions for use: 1 capsule 2 times a day, in combination with didanosine. This drug is used to treat certain types of blood cancer, but is also very effective in fighting HIV. In combination, it enhances the effect of other HIV inhibitors.

Side effects: leukopenia (decrease in the number of white blood cells), suppression of hematopoiesis, nausea, vomiting, diarrhea, rash.

New types of drugs that inhibit the development of HIV infection

Currently, studies are being conducted on drugs with a different mechanism of action on HIV. Some of them, for example, cause HIV to stick together, others prevent the virus from entering the cell. It can be assumed that new mechanisms of inhibitory effects on HIV will help overcome the problem of resistance. Clinical trials with some of these types of drugs are already gaining momentum; others are still waiting their turn.

• Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs): abacavir, zidovudine, lamivudine, didanosine, stavudine, phosphazide.
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs): efavirenz (efavirenz), nevirapine, etravirine.
• Protease inhibitors (PI): atazanavir, indinavir, lopinavir/ritonavir, nelfinavir, fosamprenavir, saquinavir, ritonavir (practically not used as a PI, used as a booster, mainly from the PI class), darunavir.

Antiretroviral drugs, doses and regimens for their use

Factors taken into account when deciding whether to prescribe antiretroviral drugs.

• Degree of immunodeficiency (assessed based on the number of CD4 lymphocytes).
• Risk of disease progression (determined by measuring viral load).
• The patient's readiness and desire to begin treatment.
• Patient awareness of possible side effects of drugs and changes in quality of life.
• Selecting initial therapy to achieve a sustained virological response and maintaining the maximum selection of drug combinations for subsequent use.
• Pharmacoeconomic feasibility of choosing different HAART regimens.

There are certain indications for starting treatment for HIV infection.

Various drug regimens have been developed (first-, second- and third-line regimens), based on clinical studies of the effectiveness of antiretroviral drugs.

Indications for highly active antiretroviral therapy

Treatment regimens using first-line drugs

Treatment regimens using second-line drugs (after assessing the reasons for the failure of the first treatment regimen and testing for viral resistance)

Third-line drug regimens (subsequent HAART failures)

The principle of the approach to treating patients with HIV infection is lifelong use of antiretroviral drugs.

Pathogenetic therapy and treatment regimens for secondary diseases most often reported in HIV-infected patients

Treatment of HIV infection should be combined with treatment of secondary and concomitant diseases. In most cases, treatment of such diseases has priority before starting HAART, since the severity of the patient’s condition determines the presence of one or another nosology.

Cytomegalovirus infection

Treatment of manifest cytomegalovirus infection.

• Three-week therapy with ganciclovir (cymevene) is carried out at a dose of 5 mg/kg 2 times a day intravenously slowly over an hour.
• Valganciclovir (Valcyte) is prescribed at a dose of 900 mg 2 times a day orally for 3 weeks (less preferable).

Treatment and secondary prevention of active cytomegalovirus infection.

• Cymevene is prescribed at a dose of 1 g 3 times a day for 30 days (enterally).
• Apply Valcyte 900 mg once a day for 30 days (enterally).
• Four-week therapy with cymevene 5 mg/kg 1 time per day intravenously for an hour is carried out (less preferable).

Herpes infection caused by herpes simplex virus type 3 (Varicella Zoster)

• Prescribe acyclovir 800 mg 5 times a day (orally) or 750-1000 mg 3 times a day (intravenously).
• Apply valacyclovir 1 g 3 times a day (orally).
• Use famciclovir 500 mg 3 times a day for 7-10 days (orally).

Pneumocystis pneumonia

Selection scheme.

• Biseptol 120 mg/kg per day in 4 divided doses for 21 days.

Alternative schemes.

• Clindamycin at a dose of 600-900 mg intravenously every 6-8 hours.
• Clindamycin at a dose of 300-450 mg orally every six hours in combination with primaquine (15-30 mg - kg) orally.

Primary and secondary prevention of Pneumocystis pneumonia (when the level of CD4 lymphocytes is less than 200 cells in 1 μl): Biseptol at a dose of 480 mg 2 times a day every other day until the number of CD4 lymphocytes increases to 200 cells in 1 μl or more.

Toxoplasmosis (cerebral form is more often diagnosed)

Treatment of toxoplasmosis begins at the slightest suspicion of this disease, without waiting for examination results.

Selection scheme.

• Prescribe 2 tablets of Fansidar 2 times a day in combination with leucovorin (25 mg) intramuscularly every other day for 6 weeks.

Alternative schemes.

• Biseptol is used at a dose of 60 mg/kg per day (in 2 doses) for 6 weeks.
• Use 5-fluorouracil (at a dose of 1.5 mg/kg per day orally) in combination with clindamycin (1.8-2.4 g 2 times a day orally or intravenously) for 6 weeks.
• Prescribe doxycycline (orally or intravenously 300-400 mg per day) in combination with clarithromycin (orally 500 mg 2 times a day) or sulfadiazine (orally 1000-1500 mg) every six hours for 1.5 months.

Kaposi's sarcoma

HAART is the main method to prevent disease progression and achieve clinical improvement. For severe Kaposi's sarcoma. occurring with the involvement of internal organs in the pathological process, prospidin is prescribed at a dose of 100 mg intramuscularly for 30 days.

Candidal stomatitis

Selection scheme.

• Clotrimazole lozenges (10 mg 5 times a day) until symptoms disappear.

Alternative schemes.

• Fluconazole 100 mg per day until symptoms disappear.
• Nystatin at a dose of 500,000 units 4-5 times a day until symptoms disappear.
• Itraconazole (suspension) 100 mg per day until symptoms disappear.

Candidal esophagitis

Selection scheme.

• Fluconazole at a dose of 200 mg per day orally (up to 800 mg per day) for 2-3 weeks.

Alternative schemes.

• Itraconazole capsules 200 mg per day for 2-3 weeks.
• Rarely, as a rule, when it is impossible to prescribe another regimen, amphotericin B is used (at a dose of 0.6 mg/kg per day intravenously) for 10-14 days.

Cryptoccal meningitis

Selection scheme.

• Amphotericin B (0.7 mg/kg per day intravenously) in combination with 5-flucytosine (orally 100 mg/kg per day) for two weeks. Then fluconazole is prescribed at a dose of 400 mg per day for two months or until the cerebrospinal fluid is sanitized. The final stage is maintenance therapy with fluconazole (200 mg per day) until the number of CD4+ lymphocytes increases to 200 cells per 1 μl or more.

Alternative schemes.

• Amphotericin B (at a dose of 0.7-1.0 mg/kg per day intravenously) for two weeks. Then fluconazole is used (orally 400 mg per day) for 8-10 weeks.
• Fluconazole (orally 400-800 mg per day) in combination with 5-flucytosine (orally 100 mg/kg per day) for 6-10 weeks.
• Ambizome is used (4 mg/kg per day intravenously) for two weeks. Then fluconazole is used (400 mg per day) for 8-10 weeks.

Mycobacterial infection

When treating mycobacteriosis found in HIV-infected patients, standard drugs are prescribed and standard dosing regimens are used.

Features of therapy for mycobacterial infection in HIV-infected patients.

• When the number of CD4+ lymphocytes decreases (less than 100 cells per 1 μl), patients are prescribed rifampicin or rifabutin at least 3 times a week, since less frequent use of drugs leads to the formation of pathogen resistance. The duration of treatment is determined individually.
• With a strong decrease in the number of CD4+ lymphocytes (less than 100 cells in 1 μl), at least four drugs are used for the treatment of tuberculosis for 2 months; then two drugs are left (they are used for 4.5 months). If positive results are obtained from sputum analysis after 2 months of treatment, then therapy is carried out over the next 7 months.
• If extrapulmonary forms of tuberculosis are detected, standard treatment regimens for pulmonary tuberculosis are prescribed. The exceptions are miliary tuberculosis, tuberculosis of bones and joints, tuberculous meningitis (treatment is carried out for 12 months).
• Treatment for tuberculosis and HIV infection should not be started at the same time due to the overlap of side effects of the drugs used, adverse drug interactions, requirements for compliance with the drug regimen, and the likelihood of paradoxical reactions associated with the restoration of the immune system. HAART and anti-tuberculosis treatment can be started simultaneously when CD4+ lymphocytes sharply decrease to 50 cells in 1 μl (if the patient tolerates anti-tuberculosis therapy well).
• It is not recommended to use PIs and NNRTIs during anti-tuberculosis therapy, with the exception of efavirenz, ritonavir and the combination of ritonavir and saquinavir.

Hepatitis

The initial stage of antiviral therapy for chronic hepatitis C in patients with HIV infection is presented in the table.

Initial stages of antiviral therapy for chronic viral hepatitis C in patients with HIV infection

The administration of immunoglobulins to patients with HIV infection can be considered as pathogenetic therapy.

Indications for the use of immunoglobulins.

• Immunodeficiency (for replacement purposes).
• Idiopathic thrombocytopenia with an autoimmune mechanism of development (20 g of protein per day).
• Severe bacterial and viral secondary and concomitant diseases.

Doses of drugs and the course of treatment depend on the degree of immunodeficiency, the severity of the patient’s condition, as well as the drug of the immunoglobulin group.

• Normal human immunoglobulin (Gamimun N), immunoglobulin IG VENA N I.V. A single dose is 25-50 ml (intravenous drip), three to ten infusions are performed. Repeated administration is carried out only after 24 hours (or 48 hours or 72 hours).
• Octagam is prescribed 200-400 mg kg (intravenously) every 3-4 weeks.

Medical and social examination

When conducting a medical and social examination of HIV-infected patients, the severity of clinical signs of the disease (stage of HIV infection) is taken into account. Social reasons - the impossibility of further performance of work (for example, a surgeon, dentist, obstetrician-gynecologist, resuscitator, medical personnel performing parenteral manipulations, employees of a blood transfusion station and biomedical drug factories, whose professional duties include the preparation of drugs for parenteral administration) - the basis for definition of permanent disability. If it is impossible for these persons to reorientate professionally, they may be assigned disability group III.

Issues of temporary disability are resolved strictly individually, based on the severity and duration of various clinical signs, guided by the “Instructions on the Rules for the Examination of Temporary Disability for Insured Persons,” with subsequent additions and corrections.

To determine the degree of persistent disability in patients with HIV infection, the Karnofsky index is used.

• If the Karnofsky index is 100-90%, then the patient’s activity is completely preserved.
• The patient's ability for strenuous physical work is limited (can perform light work) with an index value of 80-70%.
• If the value of the Karnovsky index does not exceed 60-30%. then the patient is able to move and care for himself, but cannot work (lying or sitting for less than 50% of the waking period).
• Limitation of the ability to care for oneself, the patient lies or sits more than 50% of the time he is awake - the index value is 40-30%.
• The Karnovsky index does not exceed 20-10%: in this case, the patient is completely immobilized and cannot care for himself.

During the stage of primary clinical manifestations of HIV infection (stages II and III), the patients’ ability to work is completely preserved (Karnofsky index - 90-100%).

At the stage of secondary diseases (stage IVA), the patients’ ability to work is also completely preserved (Karnofsky index - 90-100%). At the same time, some patients experience the development of persistent asthenic disorders and the formation of a psychoorganic syndrome; this leads to a decrease in the ability to work in full (Karnovsky index - 70-80%). In this case, taking into account the nature of professional activity, it is recommended that the patient be assigned disability group III.

At later stages of HIV infection (stage IVB), an increase in relapses of secondary diseases is noted and there is a need for hospitalization (repeatedly) for most patients, which leads to permanent disability (Karnofsky index - 50-80%). In this case, the patient is transferred to disability group II or III. The exception is persistent lesions of the peripheral nervous system with severe impairment of motor functions (Karnofsky index is 10-40%). The patient is assigned disability group I.

At the stage of secondary diseases (stage IVB), all patients exhibit persistent disability (Karnofsky index - 10-50%). Depending on the nature and severity of the lesions, it is recommended to establish disability group I or II.

Clinical examination

In order to organize medical care for patients with HIV infection and to increase the duration and improve the quality of their lives, as well as to carry out anti-epidemic measures, it is necessary to ensure maximum coverage of HIV-infected patients with dispensary observation.

All examinations of an HIV-infected patient are performed only after obtaining voluntary informed consent. It is recommended to actively invite HIV-infected patients for periodic examinations, but at the same time the rights of people to refuse examination and treatment should not be violated. The patient also has the right to choose a medical institution.

Clinical examination of HIV-infected patients is carried out in accordance with regulatory documents.

Dispensary observation of HIV-infected patients is carried out in an outpatient setting at the place of residence or in a medical facility (for continuous provision of medical care, the patient is assigned, for example, to a clinic or hospital).

When registering an HIV-infected patient with a dispensary, it is necessary to familiarize him with the algorithm and purpose of dispensary observation, the schedule of visits to the attending physician and specialists, and the possibility of performing laboratory and instrumental studies. In this case, the patient’s consent to conduct dispensary observation (or refusal of medical care) in writing is required.

Activities carried out during the initial examination

• Examination by the attending physician (consultation, medical history, complete physical examination).
• Registration of secondary diseases, their dynamics and course.
• Registration of concomitant diseases.
• Assessment of the patient’s quality of life (according to the Karnofsky scale).
• Chest X-ray (if the study has not been performed within the last six months).
• Ultrasound of the abdominal organs (liver, gallbladder, pancreas) and kidneys.
• Consultation with an ophthalmologist (examination of the fundus).
• Consultation with an otorhinolaryngologist (examination of hearing acuity and vestibular function).
• Consultation with a neurologist.
• Dentist consultation.
• Consultation with a gynecologist (for women).
• Testing serum or plasma for antibodies to HIV using the ELISA method.
• Complete blood count (hemoglobin and hematocrit: platelets, erythrocytes and leukocytes, leukocyte formula, ESR).
• Biochemical blood test (creatinine and urea; activity of ALT, AST, alkaline phosphatase, LDH, CPK, amylase or lipase; bilirubin and its fractions; glucose, total protein and fractions).
• General urine analysis.
• Determination of markers of viral hepatitis B. C, delta.
• Serological analysis - to detect markers of syphilis, antibodies to cytomegalovirus. toxoplasma, HSV, P. carinii.
• Examination of stool for eggs of worms and protozoa: culture for the diagnosis of salmonellosis.
• Tuberculin test.
• Immunological examination (immune status).
• Determination of HIV RNA concentration in blood serum.

Repeated scheduled examinations are carried out to timely identify indications for prescribing antiretroviral therapy (or for its correction). The extent of planned re-examination depends on the stage of the disease and the level of CD4 lymphocytes.

Terms of medical examination

Consultations with specialized specialists (dentist, ophthalmologist, neurologist) are recommended to be carried out once every six months, examination by other specialists - according to indications.

A study to detect markers of viral hepatitis B and viral hepatitis C and syphilis is also performed every six months.

X-ray of the chest organs and ultrasound of the abdominal organs are performed once a year (if the number of CD4+ lymphocytes increases to more than 500 cells in 1 μl) or 2 times a year (if the number of CD4+ lymphocytes decreases to 500 cells in 1 μl or less).

Brain examination using CT or MRI is recommended when indicated when there is a sharp decrease in the number of CD4+ lymphocytes (less than 200 cells in 1 μl).

Unscheduled examinations should be carried out if any signs of progression of HIV infection are detected or if concomitant diseases develop. At the discretion of the attending physician, additional studies are performed.

It is important to know!

Each type of virus infects a specific type of cell. The ability of a virus to penetrate a cell is determined by the presence of a receptor for a given virus on the target cell, as well as the ability of the virus genome to integrate into the cell genome. It is known that a cell can have receptors for different types of viruses, and receptors for a particular virus can be on cells of different types.

The human immunodeficiency virus is a pathology that destroys the body's natural defenses. Its danger is that it reduces the body's resistance to various infections, contributing to the development of serious diseases and their complications.

It is completely impossible to cure the disease, since its structure is constantly changing, which does not allow pharmacists to create substances that can destroy it. Treatment for HIV infection is aimed at strengthening the immune system and blocking the activity of the virus.

The disease has four stages, the last of which – AIDS (acquired immunodeficiency syndrome) – is terminal.

HIV infection has a very long incubation period. After entering the body, the virus does not manifest itself for a long time, but continues to destroy the immune system. A person begins to get sick more severely and for a longer period of time, since the immune system is unable to cope even with “harmless” infections, which give complications, worsening health conditions more and more.

At the terminal stage, the immune system is completely destroyed, which gives impetus to the development of oncological tumors, severe damage to the liver, kidneys, heart, respiratory system, etc. The result is the death of the patient from one of the diseases of these organs.

HIV has four types, of which the first two are diagnosed in 95% of cases of infection, the third and fourth are extremely rare.

The virus is not resistant to environmental influences, antiseptics, alcohol solutions, and acetone. It also does not tolerate high temperatures and dies already at 56 degrees within half an hour, and when boiled it is destroyed instantly.

At the same time, its cells remain viable when frozen (they are able to “live” 5-6 days at a temperature of 22 degrees); in solutions of narcotic substances they remain active for about three weeks.

For a long time, HIV was considered a disease of drug addicts, homosexuals and women of easy virtue. Today, among the carriers of the virus there are people with high social status and heterosexual orientation. Neither adults nor children are immune from infection. The main route of transmission is biological body fluids. Pathogenic cells are found in:

• blood;
• lymph;
• sperm;
• cerebrospinal fluid;
• vaginal secretion;
• breast milk.

The risk of infection increases in proportion to the number of pathogenic cells in these fluids, and at least ten thousand viral particles are required to transmit infection.

Methods of infection

The main routes of transmission of the virus are considered to be

• Unprotected sexual intercourse.

According to statistics, infection through this route is diagnosed in 75% of patients, but the risk of transmitting pathogenic cells is the lowest: about 30% of sexual partners become infected during the first vaginal contact, about 50% during anal contact, and less than 5% during oral contact.

The risk of genitourinary pathologies (gonorrhea, syphilis, chlamydia, fungi), trauma and microdamage to the mucous membranes of intimate organs (scratches, ulcers, erosions, anal fissures, etc.), and frequent sexual contact with an infected person increases the risk.

Women are more likely to accept the virus than men, since the area of ​​the vagina and direct contact with pathogenic cells is larger.

• Intravenous injections.

The second most popular way, since more than half of drug addicts suffer from it. The reasons are the use of one syringe or utensils to prepare the solution, as well as unprotected intimate contacts with dubious partners while under the influence of drugs.

• Intrauterine path.

During pregnancy, the risk of the virus entering the placenta does not exceed 25%; natural childbirth and breastfeeding increase it by another 10%.

• Penetrating wounds from non-sterile instruments: infection occurs during surgical operations in dubious clinics, tattooing, manicure procedures, etc.

• Direct blood transfusion, untested organ transplantation.

If the donor is HIV positive, transmission is 100%.

The possibility of infection depends on the strength of the recipient's immunity. If the natural defense is strong, the course of the disease will be weaker and the incubation period itself will be longer.

Manifestations of pathology

Symptoms of HIV infection are a manifestation of treatable diseases caused by a weakened immune system, which makes diagnosis very difficult, since a person takes only the necessary tests, treats the consequences of the disease, without even knowing about his true status. There are slight differences depending on the stages of infection.

There are no symptoms characteristic of the virus: the manifestations of the disease are individual and depend on the general health of the patient and the diseases caused by it.

The first stage is the incubation period. This is the initial stage, developing from the moment pathogenic cells enter the body until one year. In some patients, the first symptoms appear within a couple of weeks, in others - no earlier than several months.

The average incubation period is one and a half to three months. During this period, symptoms are completely absent; even tests do not show the presence of the virus. A dangerous disease can be detected at an early stage only if a person has encountered one of the possible routes of infection.

The second stage is the stage of primary manifestations. They arise as a reaction of the immune system to the active proliferation of harmful cells. Usually occurs 2-3 months after infection, lasting from two weeks to several months.

It can happen in different ways

• Asymptomatic when the body produces antibodies and there are no signs of infection.
• Spicy.

The stage is typical for 15-30% of patients; the manifestations are similar to those of acute infectious pathologies:

• temperature increase;
• fever;
• enlarged lymph nodes;
• skin rashes;
• bowel disorders;
• inflammatory processes of the upper respiratory tract;
• increase in the size of the liver and spleen.

In rare cases, the development of autoimmune pathologies is possible.

• Acute with secondary pathologies – typical for most patients.

Weakened immunity allows existing representatives of opportunistic microflora to actively reproduce, which leads to exacerbation or the emergence of infectious diseases. At this stage, it is not difficult to cure them, but soon their relapses become more frequent.

The third stage is a deterioration in the functioning and condition of the lymphatic system. Lasts from two to 15 years, depending on how the immune system copes with viral cells. Enlargement of lymph nodes occurs in groups (except for the inguinal ones) that are not interconnected.

After three months, their size returns to a healthy state, pain on palpation disappears, elasticity and mobility return. Sometimes relapses occur.

The fourth stage is terminal – the development of AIDS. The immune system is practically destroyed, the virus itself multiplies unhindered. All remaining healthy cells are susceptible to destruction, many of them degenerate into malignant ones, and severe infectious pathologies develop.

AIDS also occurs in four stages

• The first occurs after 6-10 years. It is characterized by a decrease in body weight, rashes on the skin and mucous membranes containing purulent contents, fungal and viral infections, and diseases of the upper respiratory tract. It is possible to cope with infectious processes, but therapy is long-term.
• The second develops after another 2-3 years. Weight loss continues, body temperature rises to 38-39 degrees, weakness and drowsiness occur. Frequent diarrhea, lesions of the oral mucosa, fungal and viral lesions of the skin are observed, the manifestations of all previously diagnosed infectious pathologies intensify, and pulmonary tuberculosis develops.

Conventional medications are unable to cope with the disease; only antiretroviral therapy can alleviate the symptoms.

• The third stage occurs 10-12 years after infection. Symptoms: exhaustion, weakness, lack of appetite. Pneumonia develops, viral infections worsen, and healing of their manifestations does not occur. Pathogenic microflora covers all internal and external organs and their systems, diseases are acute and give new complications.

The duration of HIV infection from the moment of infection until the death of the patient varies from person to person. Some die after 2-3 years, others live 20 years or more. Cases have been recorded of people dying from the virus within a few months. A person’s lifespan depends on his general health and the type of virus that has entered the body.

Features of HIV in adults and children

The clinical picture of the disease in representatives of the stronger sex does not differ from the manifestations that develop when the immune system is weakened. Girls suffer the infection more severely, as they begin to experience menstrual irregularities.

Menstruation occurs with severe pain, becomes heavy, and bleeding is observed in the middle of the cycle. A frequent complication of the virus is malignant formations of the reproductive system. Cases of inflammation of the genitourinary system are becoming more frequent, and their course is more severe and longer.

In babies and newborns, the disease does not manifest itself for a long time; there are no external signs. The only symptom by which one can suspect the presence of pathology is a delay in the mental and physical development of the child.

Diagnosis of the disease

It is difficult to detect HIV at an early stage, since the symptoms are absent or similar to the manifestations of treatable pathologies: inflammatory processes, allergies, infectious diseases. The disease can be detected by chance, during a routine medical examination, admission to a hospital, or registration during pregnancy.

The main diagnostic method is a special test, which can be done both in the clinic and at home.

There are a lot of diagnostic methods. Every year, scientists develop new tests and improve old ones, reducing the number of false positive and false negative results.

The main material for research is human blood, but there are tests that can make a preliminary diagnosis by examining saliva or urine using scrapings from the surface of the oral cavity. They have not yet found widespread use, but are used for home preliminary diagnostics.

HIV testing in adults is carried out in three stages:

• screening test - gives a preliminary result, helps to identify people who have been infected;
• reference – carried out to persons whose screening results are positive;
• confirming – establishes the final diagnosis and duration of presence of the virus in the body.

This phased examination is associated with the high cost of research: each subsequent analysis is more complex and expensive, so it is not economically feasible to carry out a full complex for all citizens. During the study, antigens are identified - cells or particles of the virus, antibodies - leukocytes produced by the immune system to pathogenic cells.

The presence of harmful cells can be determined only after seroconversion is achieved - a state when the number of antibodies is sufficient to be detected by test systems. From the moment of infection until the onset of seroconversion, a “window period” occurs: during this time, transmission of the virus is already possible, but no test can detect it. This period lasts from six to twelve weeks.

If the diagnostic results are positive, you should contact your doctor to prescribe antiretroviral therapy. Which doctor treats HIV infection? An infectious disease specialist who is usually present at the central clinic of a city or regional center.

Treatment of human immunodeficiency virus

Once the virus enters the body, it remains there forever. Although research into the infection has been going on for decades, scientists have not been able to invent drugs that can destroy pathogenic cells. Therefore, almost 100 years after the discovery of the virus, the answer to the question of whether HIV infection can be treated remains a sad “No.”

But medicine is constantly inventing drugs that can slow down the activity of HIV, reduce the risks of developing pathologies, help cope with them faster and prolong the life of the infected person, making it full. Treatment of HIV infection involves taking antiretroviral therapy drugs, prevention and treatment of concomitant inflammatory processes.

Therapy is taking medications, but it is impossible to cure immunodeficiency using traditional medicine. Refusal of pharmaceutical products in favor of unconventional recipes is a direct path to the development of AIDS and the death of the patient.

The effectiveness of treatment depends on many factors, but the most important condition for therapy is the patient’s responsible attitude towards the prescribed treatment. In order for it to produce results, medications should be taken at a strictly defined time, their dosage should be observed, and interruptions in treatment should not be allowed. Diet and healthy lifestyle are also recommended.

If these recommendations are followed, the number of protective cells increases dramatically, the virus is blocked, and even highly sensitive tests often cannot detect it. Otherwise, the disease continues to progress and leads to dysfunction of vital organs: heart, liver, lungs, endocrine system.

For HIV infection, the most effective treatment is antiretroviral therapy (HAART). Its main task is to prevent the development of complications and concomitant pathologies that can shorten the patient’s life. HAART also helps improve the patient’s quality of life and make it full.

If therapy is carried out correctly, the virus goes into remission and secondary pathologies do not develop. Such treatment also has a positive effect on the psychological state of the infected person: feeling supported and knowing that the disease can be “slowed down,” he returns to his usual way of life.

In our country, all antiretroviral drugs are provided to a person free of charge after he receives the status of an HIV-positive patient.

Features of antiretroviral therapy

HAART is prescribed on an individual basis, and the tablets included in it depend on the stage of development of the infection. At the initial stage, specialized treatment is not prescribed; it is recommended to take vitamins and special mineral complexes that help strengthen the body’s natural defenses.

Chemotherapy is indicated as a preventive method, but only for those individuals who have been in contact with an HIV-positive person or a potential carrier of the virus. Such prevention is effective only in the first 72 hours after possible infection.

In the second and subsequent stages, therapy is prescribed based on the results of clinical tests that determine the state of immunity. The terminal stage, that is, the presence of acquired immunodeficiency syndrome, requires mandatory medication. In pediatrics, HAART is always prescribed, regardless of the clinical stage of the child’s disease.

This approach to treatment is determined by the standards of the Ministry of Health. But new research shows that early initiation of antiretroviral therapy produces better treatment results and a more positive effect on the patient's condition and life expectancy.

HAART includes several types of drugs that are combined with each other. Since the virus gradually loses sensitivity to the active substances, the combinations are changed from time to time, which makes it possible to increase the effectiveness of treatment.

Several years ago, scientists introduced a synthetic drug called Quad, which included the main properties of prescribed drugs. A huge advantage of the medicine is taking only one tablet per day, which greatly facilitates treatment. This remedy has virtually no side effects, is easier to tolerate by the body, and solves the problem of loss of sensitivity to active components.

Many patients are interested in whether it is possible to block the activity of the virus using traditional methods and how to treat HIV infection at home? It should be remembered that such treatment is possible, but only if it is auxiliary and agreed with the treating doctor.

Folk recipes are shown to strengthen the body's defenses. This can include decoctions and infusions of medicinal herbs, the use of gifts of nature rich in vitamins, minerals and beneficial microelements.

Preventive actions

The immunodeficiency virus is a disease that can be prevented, but it cannot be cured. Today, developed countries have developed special programs aimed at preventing HIV and AIDS, which are monitored at the state level. Every person should know the basics of preventive measures, since there is no guarantee that infection will not occur.

You can avoid serious pathology if you treat your own intimate life responsibly. You should avoid sexual contact with questionable people, and always use condoms when having sex with a new sexual partner about whose condition there is no reliable information.

It is important that the sex partner is one and permanent, and has medical reports confirming the absence of HIV.

One of the popular myths is that a condom is unable to protect against the virus, since the latex pores are larger than the virus cells. This is wrong. Today, barrier contraception is the only way to prevent infection during sexual intercourse.

If a person suffers from drug addiction and injects drugs, he should always use disposable medical instruments, give injections with sterile gloves, and have individual containers for preparing a narcotic solution. To avoid becoming a victim of direct transmission of the virus through the blood, you should refuse blood transfusions.

To carry out procedures where there is access to blood, choose trusted establishments, ensure that their employees carry out all manipulations with gloves, and that instruments are disinfected in the presence of the client.

If HIV is present in a woman who is preparing to become a mother, the baby’s condition is monitored throughout the pregnancy. Cesarean section and refusal of breastfeeding can reduce the risk of infection of the child. It will be possible to determine the baby’s HIV status no earlier than six months later, when the mother’s antibodies to the virus leave the baby’s body.

Artificial insemination methods can prevent severe infection in a child.

An expectant HIV-positive mother should eliminate all factors that reduce the baby’s immunity: stop smoking, stop drinking alcohol, eat more vitamins, cure all infectious and inflammatory diseases, treat chronic ailments to prevent their recurrence during pregnancy.

By following these rules, you can prevent infection with a dangerous pathology and prevent its transmission to healthy people. Since there is no cure for the disease, the only way to rid the world of the virus is to block its spread.

Human immunodeficiency virus is the virus that causes AIDS. HIV was discovered back in 1983, and since then four types have been discovered.

HIV reduces the body's resistance to various types of diseases. Infection with this virus occurs when it enters the bloodstream of a healthy person. biological fluids infected person.

In the external environment, the virus dies almost instantly, so HIV infection can only be through contact.

Cure for HIV

Until recently, there were no drugs that could cure a person from HIV. There were drugs that alleviated the course of the disease, but they only prolonged the inactive period. stage of HIV without giving complete healing.

Just recently, scientists at the Hebrew University of Jerusalem made a startling discovery. They claim to have identified a protein called Gammora, which can almost completely eradicate HIV in the human body.

At the moment, the drug has already passed the first stage of testing. Outwardly, these are ordinary tablets that contain Gammora protein in concentrated form.

The effectiveness of the drug is stunning. 97% is the rate of productive elimination of HIV in infected organism. No one has ever been able to achieve such indicators.

It is very important that Gammora has no side effects. This means that the medicine will act exclusively on virus, while ignoring healthy cells of the body.

There is a high probability that this drug will appear on the pharmaceutical market within the next year. Moreover, its cost will be significantly lower than that of other drugs aimed at combating HIV.

Researchers hope that the drug will soon become available in the poorest regions of Africa, where HIV infection rates are catastrophically high.

Amazing news, right? This is new hope for millions of people around the world and

Many scientists now dream of finding an effective cure for HIV. The goal of treatment is to inhibit the development of the virus. To do this, several are combined into one medicinal product. Today, the most effective treatment method is antiretroviral therapy. At the moment, only antiviral drugs are the best cure for HIV. But you shouldn't joke with these drugs. These medications require strict discipline from the patient.

Why is the cure for HIV called antiretroviral? Yes, because HIV is a retrovirus. The drugs mentioned above have an effect on the virus. They oppress him and prevent him from reproducing.

But it does not completely cure HIV infection. But it suppresses the virus very strongly. So much so that when conducting sensitive tests on a patient taking antiretroviral drugs, doctors absolutely cannot find the presence of the virus in the blood. Although he is there.

HIV medicine is highly effective when used in combination therapy. This therapy includes several drugs that are antiretroviral. This therapy gives the virus very little chance of developing drug resistance.

Antiretroviral therapy is the best cure for HIV. And it is used strictly as prescribed by the doctor. If the patient does not comply with the medication regimen, then soon the drugs will no longer help him. There may also be side effects. Therefore, only a doctor can choose the right combination of drugs.

Many people hope that scientists will find a drug that will completely cure HIV infection. And when a cure for HIV is found, this disease will be completely destroyed. But so far this has not happened.

The whole world is developing new drugs that are used in medicine. The most promising are substances that do not allow the virus to enter the cell. Substances that block the activity of the virus. And substances that do not allow the virus to integrate its genetic information into the cell nucleus. Immunomodulators are also being developed. These are medications that strengthen the immune system and give it the strength to fight viruses.

The same medications that you buy in pharmacies have several names. These medications may also be sold under different brands. For example, ascorbic acid and vitamin C are the same thing. Namely, there are not very many antiviral drugs, about 20.

But we must not forget that antiretroviral drugs have side effects. They are very toxic. So toxic that they can even lead to the death of the patient.

For example, a drug such as "Zidovudine" is depressing and leads to anemia, thrombocytopenia, fatty liver, headache, allergies, and weakness. The drug "Didanosine" leads to acute pancreatitis, neuropathy, diarrhea, and nausea. "Zalcitabine" - for hepatomegaly, stomatitis, sweating, pharyngitis, leukopenia. "Stavudine" - for peripheral neuritis, asthenia, dyspepsia, insomnia, anorexia. "Lamivudine" - for neuropathy, vomiting, anemia, paresthesia. "Nevirapine" - to allergies, hepatitis, drowsiness, fever. "Abacavir" - to severe anorexia, stomatitis, conjunctivitis. "Phosphazide" - for dyspepsia, vomiting, headache.

Most often, side effects are more pronounced at the initial stage of drug treatment. Long-term use of treatment leads to the emergence of HIV strains that are resistant to antiretroviral drugs.

What needs to be done for antiretroviral therapy to be successful? The most important thing is a timely and effective treatment regimen prescribed by a doctor. This will help HIV-infected patients prolong their life by several years.