HIV Treatment

Here are side effects and follow-ups of HIV treatment

Hi, this is Dr, Ajay. In the previous video, I talked to you about diagnosis of HIV and the various tests that are done. I also spoke briefly about HIV. In this video, I would be talking more about HIV treatment, its side effects and the follow up of the patient.

So once the patient is diagnosed with HIV, we subject the patient for further screening of CD4 viral load. The latest guidelines of DHHS and WHO state that you do nt have t wait for the CD4 count to drop. That means, if the patient is HIV+ , you can straight away start HIV treatment without waiting for the CD4 counts. So, after the patient is prepared for the treatment, the counseling is done where we have to assess the patient whether he is ready to start the treatment. You have to do preparedness counseling. We usually start the 3 Drug Regimen which is very popularly known as Combined Antiretroviral Treatment. Once we start the treatment we also monitor the patient for the side effects of the treatment because not all ART medicines are free of side effects. We choose the regimen which has the least side effect.

So for examples, if the patient is on Ziloudine, we monitor the patient for any signs of anemia, weakness, fatigue or nausea. Some patients develop loss of fat which we call lypotrophy and lypodystrophy. Then there are other side effects like Skinofovea causes renal kidney dysfunction, retardation of kidney function. Like this, we monitor the patient. Some people taking Adesanovith can develop yellowish discoloration of eyes. So, we tailor make the medicine to suit the patient. When we start the patient on antiretroviral treatment, on every follow up we insist the patient to take the medicines regularly because adherence is the most important step in the success of antiretroviral medicine. The tests that we do in the follow up are again the baseline function like the liver function, kidney function and we also assess the CD4 viral load at the end of 6 months.

So, by doing these tests, we will know whether the patient is responding to treatment or not. We will also know whether the patient is developing any side-effects to the treatment or not. By this monitoring at every step, we also counsel the patient for adherence. Taking ART treatment also helps in preventing the HIV transmission. For example, if a patient in a couple in HIV positive that is only husband is positive and wife is negative or vice versa, what we call discarded couple, in them if one of the patients is taking antiretroviral treatment, by decreasing the viral load to undetectable levels, we can also prevent the transmission of HIV from one partner to the other but we also recommend the patient to use condom.

There is an option of taking HIV medicine for preventing HIV, what we call as pre-exposure profile axis and post-exposure of profile axis. Here, if a patient accidentally has a needle exposure through an HIV positive patient or if the patient has any sexual exposure, then immediately after the exposure he can take medicines within 72 hours. By taking these medicines for 28 days, he can prevent HIV transmission. This is what we call as post-exposure profile axis. Then there is another entity called pre-exposure profile axis wherein if the patient is getting involved in high-risk activity like for instance, most of the sexual workers unknowingly meet many partners. So to avoid getting HIV infection, they can take preventive treatment which is again taken for 28 days to prevent HIV transmission.

You can always consult me through lybrate or directly in my clinic at Hyderabad, Narayanguda. Thank you.