Presentation on theme: "HIV/AIDS Prevention and Treatment in Thailand"— Presentation transcript:
1HIV/AIDS Prevention and Treatment in Thailand Kittipong Vairojanavong M.D.Nittaya Vairojanavong M.A.National Council for Women, Thailand
2Avert.org commentedThere are very few developing countries in the world where public policy has been effective in preventing the spreads of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndromes) on a national scale but Thailand is an exception.
3History First case was found in 1984 Next few years, increase in incidence among* gay men* sex workers* injecting drug users* touristsWHO reported that Thailand had the highest infected rate of 10 folds within a few years in FIGO Congress in Montreal 20 years ago.
4HIV/AIDS Situation in Thailand In March 2006, Total population = 63 millionsInfected cases= 288,672,Death cases = 81,584In 1991, there were 143,000 new cases but in 2003, there were only 19,000 new casesIncidence rate declines during the last 7 consecutive yearsMost common among people of years of ageMale to female = 2:1At age 15 – 19 , more among female than male
5HIV/AIDS PreventionNo sex without protectionCondom usage is a “MUST”
6Prevention in General Population Ministry of Public Health initiated “ 100 percent Condom Program” for general populationCondoms were distributed free of charge, NGOs provided strong support to this programRaised condom usage had decreased the prevalence of sexual transmitted infections dramatically
7Detection of HIVIn 2 – 3 weeks after infected, acute retroviral syndrome occurred: fever, sore throat enlarged lymph nodes, flu like illness, viremia,. Antigenemia, and later anti-HIV antibody.Window period is the period prior to detect antibody, may last from 8 weeks to 6 months
8HIV Check Up Blood and serum recipient Homosexual Unprotect sex Have sex with HIV caseSex with drug userMultiple sexual partnersSexual transmitted disease patientDrug addictedPregnant women
9Diagnosis of HIV/AIDS Detection of anti-HIV antibody: Screening test: ELISA and GPA (gelatin particle agglutination)Confirmatory test: immunoblot (western blot) and immuno fluorescentAntigen (p24 antigen) assay (IFA)
10HIV/AIDS Therapy 1987 AZT (had been used since) Drugs used in the developing countriesAnti-infective agents to prevent opportunistic infectionsPalliative drugs for physical and mental discomfort such as analgesics, tranquilizer.Antiretrovirals (ARVs): to prevent and kill HIV prior to invade immune system and prevent HIV from mother to fetus
12HIV Transmission from Mother to Fetus During pregnancy, HIV penetrates placenta to fetus. This is hard to preventOne to two weeks prior to delivery and intra-partum period are highly sensitive period of transmission up to percentใ Prevention by cleansing birth canal with antiviral antiseptics, reduce chance of contact of maternal blood during laborHIV from maternal milk, incidence of 20 percent
13Prevention of Transmission from Mother to Fetus AZT (zidovidine) therapy at 36 weeks and during labor reduces the infection down 50 percentAZT therapy to both mother and fetus reduces infection rate from 25-30% to 9.2%AZT plus 3TC (lamivudine) for short period to mother from 34 weeks reduces infected rate down to 2.83 %, (three times lower)
14HIV/AIDS TherapyNo drug to cure this disease yet but there are drugs to prevent progression of the diseaseSide effects of the drugs are anemia, nausea and vomitingVaccines are in investigational periods ad may need more than 10 years to confirm the effectiveness of the vaccine
15GPO-VIR Local made regimen Less expensive but effective 3 in 1 combination (stavudine + lamivudine + nevirapine)
16GPO-VIR (Government Pharmaceutical Organization) Combination of three antiviral drugsStavudine (Zerit) mg.Lamivudine (Epivin) 150 mg.Nevirapine (Viranme) 200 mg.Dosage One tablet twice a dayResult: increase body weight, increase CD4 T-cell, decrease occurrence, no change of lipodystrophy (study in )