1. Anti Retroviral Treatment Dr. Alap Mehta Senior Medical officer A.R.T. Centre

2. HAART,ART Combination of different classes of antiretroviral Highly active antiretroviral therapy ART is an ART ART is never an emergency

3. GOALS OF HAART Clinical goals Clinical goals: Prolongation of life & improvement in quality of life. Virologic goals Virologic goals: Greatest possible reduction in viral load for as long as possible to halt disease progression and to prevent or delay resistance. Immunologic goals Immunologic goals: Immune reconstitution that is both quantitative (CD4 within normal range) and qualitative (pathogen specific immune response)

4. 1 st Line ARV Name Of the Drugs 1. Zidovudine 2. Stavudine Drugs Supplied 3. Lamivudine By NACO at 4. Nevirepine ART Centre 5. Efavirenz 6. Tenofovir

5. Combinations of Regime Zidovidine or + Lamivudine + Nevirepine Stavudine or Tenofovir For 1 st 15 Days Nevirepine Once a Day Then twice a day

6. Combinations of Regime Zidovidine or + Lamivudine + Efavirenz Stavudine or Tenofovir Efavirenz is given in Once a daily Dose For the patient who are on AKT Patient had history of Nevirepine induced rash

7. Benefits of 1 st line Drugs Lesser Pill Count Easily Tolerable Free of Cost at ART Centers

8. Over all Side Effects Nausea For this Side Effects Vomiting patient can Consult Gastritis Family Physician Itching

9. Serious Side Effects Skin Rash + Itching For this Severe Headache Patient Will Abdominal Pain Come to ART Severe Oral Ulcers Centre

10. Individual Side Effects ZI – DO – VU – DI – NE Most Common: Nausea, Vomiting, Gastritis, Discoloration of Nails Most Serious: Bone Marrow Suppression, Anemia Least Common: Pancreatitis

11. Individual Side Effects ST – VU – DI – NE Most Common: Nausea, Vomiting, Itching Most Serious : Pancreatitis, Peripheral Neuropthy, Lactic Acidosis

12. Individual Side Effects LA – MI – VU – DI – NE Very Good Tolerability Most Serious Side Effects Lactitc Acidosis

13. Individual Side Effects NE – VI – RE – PI – NE Most Serious Side Effects Skin Rash, SJ Syndrome, Hepatitis ( This drug can cause fatal Side Effects )

14. Individual Side Effects E – FA – VI – REN – Z Most Common: Giddiness, Itching, Most Serious: SJ syndrome, Hepatitis

15. Te-no-fo-vir Fanconi’s Syndrome Osteomalacia Bone Marrow Suppression Wasting

16. Thanks