Lecture Eight

LECTURE EIGHT
For expected learning outcomes

1. Discuss the WHO clinical staging of HIV disease in adults and
adolescents
2. Describe classes of ARVs
3. Explain eligibility for PreP and PEP
WHO Clinical Staging of HIV Disease in Adults and Adolescents
CLINICAL STAGE 1
 Asymptomatic
 Persistent generalized swelling of of lymph nodes
CLINICAL STAGE 2
 Unexplained moderate weight loss (under 10% of presumed or
Measured body weight)
 Recurrent upper respiratory tract infections (sinusitis, tonsillitis, otitis
 media, pharyngitis)
 Recurrent ulceration
 Dermatitis (skin diseases)
 Fungal infection e.t.c
CLINICAL STAGE 3
 Unexplained severe weight loss (over 10% of presumed or measured
 body weight)
 Unexplained chronic diarrhoea for longer than one month
 Unexplained persistent fever (intermittent or constant for longer than
 one month)
 Persistent oral candidiasis e.t.c
CLINICAL STAGE 4
 HIV wasting syndrome
 Pneumonia
 Cancer
 Central nervous system disorders
 HIV encephalopathy
 Meningitis
Selection of ARV treatment regimens for individual patients usually considers

factors such as;
 Potency
 Frequency of dosage
 Side effects
 Maintenance of future treatment options
 The anticipated adherence of the patient/population to a treatment plan
 Head for storage
 Concurrent conditions/illness
 The potential for emergence of resistance
 Cost and access of the regimen
Starting ARV means making a lifelong commitment to medications and enduring
the most universal initial period of unpleasant side effects.
Types/Classes of ARVs
Each type, or “class”, of ARV drugs attacks HIV in a different way.
1. Nucleoside Reverse Transcriptase Inhibitors (also called NRTIs or

“nukes”.) These drugs block step where the HIV genetic material is used to
create DNA from RNA
2. Non-nucleoside Reverse Transcriptase Inhibitors, also called non-nukes
or NNRTIs, also block creation of DNA from RNA but in a different way
3. Protease Inhibitors or PIs block the step where the raw material for new HIV
virus is cut into specific pieces
4. Entry Inhibitors prevent HIV from entering a cell by blocking step of the life
cycle
5. HIV Integrase Inhibitors prevent HIV from inserting its genetic code into
the human cell's code during the life cycle.
PrEP:
PrEP is a daily pill for HIV-negative people that can help prevent HIV
infection before exposure to the virus. PrEP must be taken for at least 7 days to reach
optimal levels of protection against HIV. PrEP is taken as long as someone is at risk
of HIV infection
Who can take PrEP?

PrEP is for people who are HIV negative but at risk of HIV infection such as:
 Sexual partner with HIV who has not been on effective therapy for the
preceding 6 months,
 Sexual partner/s are of unknown HIV status and are at high-risk for HIV
infection (has multiple sexual partners, has had STIs, engages in transactional
sex, injects drugs, from high HIV burden settings)
 Engaging in transactional sex
 Recent sexually transmitted infection
 Recurrent use of post-exposure prophylaxis
 History of sex whilst under the influence of alcohol or recreational drugs as a
habit
 Inconsistent of no condom use or unable to negotiate use during intercourse
with persons of unknown HIV status
 Injection drug use where injection equipment is shared
 Sero-discordant couples trying to conceive
Post-exposure prophylaxis (PEP)

PEP:
PEP is an emergency medication for HIV-negative people that can help prevent
infection after exposure to HIV. PEP must be started within 72 hours after HIV
exposure and taken for 28 days.
The term post-exposure prophylaxis is generally understood to mean the medical
response given to prevent the transmission of blood-borne pathogens following a
potential exposure to HIV. Drugs for PEP are usually administered as a result of
accidental exposure to HIV as early as 2 hours and within 24 hours of the accidental
exposure and not later than 72 hours.
Eligibility for PEP

Individuals are eligible for HIV PEP if:
 Exposure occurred within the past 72 hours
 The potentially exposed individual is not infected or not known to be infected
with HIV
 Mucous membrane or non-intact skin was significantly exposed to a
potentially infectious body fluid
 The source is HIV-infected or the HIV status is unknown
SUMMARY
In this lecture we have discussed the WHO clinical staging of HIV disease in
adults and adolescents. We have also looked into the classification of ARVs and
Explained eligibility for PreP and PEP in prevention of HIV infection.
Further reading
Refer to the ART Guidelines (2016) Section 6.1: Eligibility for ART
Refer to the ART Guidelines (2016) Section 10: ARVs for PEP
Activity
Visit the Kenya National Aids & STI Control Program (NASCOP), World
Health Organization (WHO) and USAID websites and write short notes
maximum one page on existing guidelines before initiation of Anti-retroviral
therapy.

Lecture Eight

Uploaded by

Copyright:

Available Formats

Lecture Eight

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lecture Eight

Uploaded by

Copyright:

Available Formats

LECTURE EIGHT

For expected learning outcomes

WHO Clinical Staging of HIV Disease in Adults and Adolescents

Selection of ARV treatment regimens for individual patients usually considers

Each type, or “class”, of ARV drugs attacks HIV in a different way.

1. Nucleoside Reverse Transcriptase Inhibitors (also called NRTIs or

Who can take PrEP?

Post-exposure prophylaxis (PEP)

Eligibility for PEP

You might also like