About HIV Teaching Tool 2 About HIV A

About HIV: Teaching Tool 2

About HIV: A teaching tool © 2 nd edition 2006 This tool was developed by the François-Xavier Bagnoud Center at the University of Medicine and Dentistry of New Jersey (UMDNJ), with the support of the Pediatric AIDS Clinical Trials Group. Excerpts from this publication may be freely reproduced or adapted with acknowledgement of the source, provided the material reproduced is for non-for-profit educational purposes only. Send comments or questions to: info@fxbcenter. org

Sections § Section 1: Understanding HIV infection § Section 2: Understanding HIV treatment

Section 1 Understanding HIV Infection

Learn about: § HIV § The immune system § CD 4 cells § Checking how the immune system is working § Viral load § Why some people with HIV are well and others are very sick § How you get HIV

Our immune system

HIV is a virus. H: Human I: Immunodeficiency V: Virus © 2002 Boehringer Ingelheim Gmb. H

CD 4 cell © 2002 Boehringer Ingelheim Gmb. H

CD 4 cells § CD 4 cell are destroyed after HIV uses them to make more HIV. § The body’s immune system works hard making more CD 4 cells. © 2002 Boehringer Ingelheim Gmb. H

Low CD 4 cells

Measuring CD 4 cells

Adult CD 4 counts

Normal CD 4 Counts in Children § Normal CD 4 counts in children vary widely by age. § In children less than 5 years of age, instead of measuring the number of CD 4 cells, CD 4 percentage (%) is used to determine how much damage has been done to the immune system

Viral load test § The amount of HIV in an infected patient’s blood can be measured. It is called the viral load. § The viral load test shows how much virus is present in the body.

Understanding viral load § LOW viral load is less than 10, 000 copies. § HIGH viral load is more than 10, 000 copies.

Antibodies signal infection § Antibodies are special proteins in the blood made by the immune system to fight a specific infection. § People with HIV usually develop HIV antibodies 4– 6 weeks after being infected. In some cases, it may take as long as 3 months for antibodies to develop. § To find out if a person has been infected with the virus, an HIV test is done that finds and measures antibodies in blood.

§ A person whose blood test results shows HIV infection is HIV-positive. § A person whose blood test does not show HIV infection is HIV-negative

Early stages of HIV Infection © 2002 Boehringer Ingelheim Gmb. H § HIV enters the cell © 2002 Boehringer Ingelheim Gmb. H § HIV uses parts of the CD 4 cell to make more virus (replicate). During this process the CD 4 cell is destroyed.

Viral load and CD 4 cells § Eventually, the immune system is unable to make enough CD 4 cells to replace the ones killed by HIV. § The immune system gets weaker and disease symptoms may develop (symptomatic HIV infection). § As the viral load goes up, the number of CD 4 cells goes down.

WHO HIV clinical stages

AIDS A Acquired—not inherited I Immuno—attacks the immune system D Deficiency— destroys CD 4 cells S Syndrome—a group of symptoms or illnesses

HIV can be transmitted from one person to another by:

The risk of HIV transmission through sex can be reduced by:

HIV is NOT transmitted by:

Section 2 Understanding Antiretroviral Therapy

Learn about: § Highly active antiretroviral therapy (HAART) § How HAART works § Adherence § Resistance § Side effects § Why HAART sometimes doesn’t work well

What is antiretroviral therapy?

Goals of ARV therapy § Lower the amount of HIV in the blood § Save CD 4 cells and allow the immune system to recover

“Classes”of ARV therapy § NRTIs § NNRTIs § PIs § Fls

HAART

When to start ARVs § Guidelines vary from one country to another

Take all doses §Taking ARV medicines lowers viral load

Missed doses §If doses are missed, medicines may cease to be effective.

Adherence § Doctors, nurses, counsellors, family and friends provide support for taking medicines.

Monitoring treatment

Side effects § Most side effects are mild and temporary, but others are more serious. § If side effects occur —talk to your clinician.

Treatment failure § § § Missed doses Viral resistance Medicines not taken due to side effects Other medicines interfere Advanced HIV disease

For antiretroviral therapy (ART) to succeed… § Keep all clinic appointments so clinicians can check your health § In between appointments, report any changes in health right away. § If a dose of an ARV medicine is missed, take the missed dose as soon as possible. But if it is close to the time when the next dose will be taken, don’t take the dose you missed, Two doses should never be taken at the same time.

For ART to succeed… § If vomiting occurs fewer than 30 minutes after taking a dose, repeat the dose. If the repeat dose is vomited, contact the clinician. § If side effects occur, discuss them with the clinician. § Do not stop taking ARV medicines, and do not start any new medicine or home remedy without first discussing changes with the clinician.

Thank you!