Aug02
Posted by Dr. Dewat Ram Nakipuria on Saturday, 2nd August 2014
PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST profdrram@gmail.com,+917838059592,+919832025033,DELHI –NCR,IND
HIV/ AIDS,CANCER LATEST MEDICINES AVAILABLE AT CHEAP RATE.
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RECENT ADVANCEMENT OF ART THERAPY FOR CONTROL OF HIV/AIDS ARE AS FOLLOWS:---
1.ARV IS THE ONLY THE METHOD OF TREATMENT ALL HERBAL, HOMEO, AYURVEDIC, PLANT AND OTHER MEDICINES LACKS CRDIBILITY AND GOOD STUDIES SO THEY ARE SOLD MOSTLY FOR EARNING MONEY,BETTER BE AWAY FROM THEM.
2.MEDICINES ONCE STARTED SHOULD TAKE IT FOR LIFE TIME AS ONCE CLOSED THEN VIRAL REAPPEARS AND THIS VIRUS BECOME RESISTANT TO THESE DRUGS SO NEW TYPE OF DRUG HAS TO BE STARTED.
3.WHEN TO START TREATMENT IS OPTIONAL IN OUR COUNTRY INDIA ART CENTRES GIVE ARV MEDICICINES IF CD4 COUNT IS BELOW 350 BUT AS PER WHO,UK,USA TRAETMENT IS STARTED AS CD4 COUNT FALLS BELOW 500,BUT AS PER NEW RESEARCH TREATMENT SHOULD BE STARTED AS SOON AS IT IS CONFIRMED AND IT IS IN CHILDREN STARTED SOON AFTER BIRTH AS WHEN IT IS SUSPECTED AS IN NEW BORN CD4 AND VIRAL LOAD IS NOT DAIGNOSTIC BUT MORE FEW ANTIGENS DETECTED AFTER 3RD WK OR AFTER 09 MONTHS ANTIBODIES APPEAR AND TREATMENT STARTED NOT DEPENDANT ON CD4 BUT ON VIRAL LOAD IF IT IS MORE THAN 500-5000 COPIES/ML TREATMENT SHOULD BE STARTED TAKING CONSENT OF PATIENT.
4.USUALLY 03 DRUGS STARTED,TRAIL WITH 02 DRUGS IS NOT SATISFACORY AND TRAIL WITH 04 DRUGS IS NOT REQUIED AS EFFICACY SAME WITH 03 DRUGS,TWO NTIS AND ONE PROTEASE INHIBITOR BOOSTED OR 03 NRTIS.
5,INFUSION INHIBITOR LIKE RALTEGRAVIR DALUTEGRAVIR SHOWING GOOD RESULT WITH OR WITHOUT COBISTAT AND TWO NRTIS BUT IF PROTEASE INHIBITOR USED GOOD RESULT ALSO FOUND.
6.TREATMENT SHOULD BE STARTED BY A COMPETANT HIV SPECIALIST AS THESE DRUGS AR VERY TOXIC MAY CAUSE ANY SIDE EFFECT.
7.TREATMENT SHOULD BE STARTED AFTER THOROUGH CLINICAL EXAMINATION OF PATIENT AND KNOWING STATUS OF COINFECTION OF TB,HEPATITIS B AND C AND OTHER OPPURUNISTIC INFECTION AND KNOWING LIVER,KIDNEY,LIPID FUNCTION OF THE PATIENT INCLDING IRON,HAEMOGLBIN,TOTAL LEUKOCYTE COUNT ETC.
8.TREATMENT SHOULD BE CHANGED IF VIRAL LOAD INCREASE OR CD4 DOWNS OR CLINICALLY PATIENT DETEIORATES THEN DRUG SENSITIVITY CAN BE DONE IF AFFORDABLE AND GENOTYPE STUDY SHOULD BE DONE.
9.NOW A DAYS NO MORE CLSSIFICATION LIKE FIRST GENERATION, 2ND GENERATION,3RD GENERATION DRUG IS DONE IF PATIENT CAN AFFORD OR MEDICINES AVAILABLE THEN ANY GOOD COMBINATION MAY BE STARTED.
10.WHILE ON ARV GOOD FOOD,AVOIDING ALCOHOL,DRUGS,NICOTINE UNSAFE ,UNPROTECTED SEX SHOULD BE DONE,USE CONDOM ALWAYS EVEN WITH A PARTNER EXCEPT 1-2 TIMES TO HAVE PREGNANCY IF BOTH HAVE MINIMUM VIRAL LOAD.
11.TREAT TB HEPATITIS C ,B OR LUNG INFECTION OR DIARRHOEA WITH IT AND IF PERSON CD4 COUNT IS LESS THAN 200 THEN COTRIMAXAZOLE SHOULD BE ADDED AND ALL PROPHYLAXIS FOR FUNGAL,TOXOPLASMA INFECTION MAY BE ADDED.