hiv aids part 3[3]
Post on 13-Nov-2014
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HIV/AIDS
Elaine Kauschinger PhD, MS, ARNP, FNP-BC
Assistant Professor of ClinicalLead Faculty, Family Nurse Practitioner Program
University of MiamiSchool of Nursing & Health Studies
Part 3: Clinical Management of HIV Infection
Natural History of HIV Infection
MOST HIGHLY
INFECTIOUS INFECTIOUS
SERO-
EXPOSURE -> CONVERSION-> ASYMPOMATIC-> SYMPOMATIC-> AIDS-> DEATH
0-3 months
2-6 months
8-10 years 2-3 years
10-20 years
Time (in years)
CCR5 Antagonist Mechanism of Action
Fusion Inhibitor Mechanism of Action
Highly Active Antiretroviral Therapy (HAART)
6 classes of HIV medications:Nucleoside/nucleotide analogs (“nukes”)
Nonnucleoside reverse transcriptase inhibitors (NNRTI’s) (“non-nukes”)
Protease inhibitors (“PI’s”)
Fusion entry inhibitors
CCR5 Inhibitors
Integrase Inhibitors
Treatment Key….YNEED THREE!
(Three drugs))
DHHS Guidelines: When to Initiate Medications
All patients with a CD4 counts between 350 & 500 cells/mm3
All patients with a history of an AIDS-defining illness or with a CD4 count <350 cells/mm3
Patients with CD4 counts >500 cells/mm3 • 50% of panel recommendation therapy while
50% view therapy as optional – NA-ACCORD study; ART Cohort Collaboration
Please continue to part 3
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