Of Arihlsen ( I. Al ) ( Arildsen Et Al )

The Acquired Immune Deficiency Syndrome denotes a spectrum of conditions that are caused by the HIV virus. Infection with this disease does not result in the instant occurrence of the related signs and symptoms. However, an individual is likely to experience flu-like symptoms after he or she is infected with it. Eventually, the person experiences a prolonged period of apparent health with no visible signs. On progression, the infection adversely interferes with the immune system of the individual. The weakening of the body’s defense system increases the risk of recurrence of common infections and opportunistic illnesses that

(2011) was a multi-continent, randomized, controlled trial to evaluate the effectiveness of antiretroviral therapy on the speed of the disease process among HIV-1 infected and HIV-1 uninfected partners. In the study, 1,763 HIV mixed status couples were grouped into either early antiretroviral and delayed therapy groups. Inclusion criteria consisted of the HIV-1 infected participant having a CD4 count between 350 and 550 with no previous antiretroviral therapy usage, except to prevent mother-baby transmission. Participants attended three monthly sessions and then quarterly sessions until ill or requiring an additional amount of antiretroviral drugs (Cohen et al, 2011). The uninfected partners were tested each quarter for seroconversion, the period in time in which antibodies become detectable. The research study concluded that early antiretroviral therapy initiation had a greater effect on CD4 count than delayed antiretroviral therapy. The average CD4 count in the early therapy group originated at 400 and increased to 603 after 12 months of ART. A decline of CD4 cells were noted in the delayed group (Cohen et al, 2011). The authors concluded that a higher incidence of HIV transmission was noted in African countries and adverse effects were more likely to occur in the early therapy group. Early therapy had a positive effect on the HIV-1 uninfected and HIV-1 infected

As have been described above, HIV can have a potential effect on immunological cells, which are important to protect the body from additional infections such as Tuberculosis (TB), Cytomegalovirus (CMV) and other viral or bacterial infections. An effective treatment is needed to reconstruct what HIV has damaged. Antiretroviral therapy (ART) is a common treatment to stop the viral replication and decrease the disease progression, which may lead to a vast decline of the morbidity and mortality. The standard treatment involves a combination of at least three drugs; often known as a highly active antiretroviral therapy (HAART) where the most common types are Nucleoside reverse transcriptase

Since the arrival of triple therapy, the challenge of sustained and complete viral suppression has been solved for the majority of patients [1]. The major limiting factors for improving the long-term success of ART are tolerability and convenient pill burden [2]. The latest class of the antiretroviral drug developed are Integrase inhibitors (INI). Dolutegravir (DTG) is an Integrase inhibitor, particularly focused on maintaining a favorable safety profile and a high efficiency rate, within a single-tablet regime (STR), it improves resistance barrier and allowing co-formulation with an NRTI backbone. Dolutegravir has been compared against both other classes of HIV anti-retrovirals as well as other integrase nuclear strand inhibitors. In August 2013, DTG was approved by FDA for its use in both patients who have never taken ART (ART-naïve) and patients who have taken ART (ART-experienced) [3]. It is predicted that very soon a STR containing Dolutegravir (DTG), abacavir (ABC) and lamivudine (3TC) will become

Data from the Medical Monitoring project provided data for patients 18 years old and older, who were engaged in care, received ART prescription and managed to suppress their viral load (Bradley, et al., 2014, p. 1114). Specifically, patient HIV medical data was gathered from medical facilities that took place between January- April 2011 (Bradley, et al., 2014, p. 1114). The rate of ART prescription and viral load was documented within the participant’s medical chart preceding the survey. The authors statistical testing was conducted using the delta method (Bradley, et al., 2014, p. 1114) .

For HIV patients having more than > 2 risk factors based on above table-1, use Framingham Risk assessment tool (available at http://hin.nhlbi.nih.gov/atpiii/calculator.asp) to estimate 10 year risk of cardiovascular event or myocardial infarction(MI). However, it has not validated in patients with HIV, is endorsed by international societies such as IDSA [11]. Framingham risk tool over predicted risk in patients who did not receive ART and under predicted risk in patients on ART [12]. Although the utility of this tool in the HIV population may not be optimal but it is likely a reasonable starting point for assessing cardio vascular risk. The highest risk people are those with established cardiovascular disease and those without established

Due to the emphasis on these three measures supporting the HIV Care Continuum, grantees have seen results with over half of the reported data 80% or above. Among these three measures, 24 out of 38 grantees reported data above 90% for prescribing ART to patients. While a similar number of grantees reported data for these three measures, more grantees were successful in prescribing ART compared to viral

HIV RNA (viral load) and CD4 T lymphocyte (CD4) cell count are the two surrogate markers of antiretroviral treatment (ART) responses and HIV disease progression that are used to manage and monitor HIV infection. The key goal of ART is to achieve and maintain durable viral suppression. If a patient has virologic failure, it means that they are unable to achieve or maintain suppression of viral replication to an HIV RNA level <200 copies/mL. Therefore, they should be assessed for virologic failure which include an assessment of adherence, drug-drug or drug-food interactions, drug tolerability, HIV RNA and CD4 T lymphocyte (CD4) cell count trends over time, treatment history, and prior and current drug-resistance testing results. Moreso, drug-resistance testing should be performed while the patient is taking the failing antiretroviral (ARV) regimen or within 4 weeks of treatment discontinuation.

Although a HIV viral suppression of less than 200 copies/mL of blood is not the gold standard at most sites. the rate is measured via the same definition across HHS agencies and programs. This includes HRSA and its HAB (2015) under which the RWHAP Part C falls, the Centers for Disease Control and Prevention, and CMS through “Medicaid, Medicare Physician Quality Reporting System, Physician Feedback/Quality and Resource Use Reports, [and a] Physician Value-Based Payment Modifier” (National Quality Forum [NQF], n.d.). All 360 RWHAP Part C sites report their HIV viral suppression rates using the endorsed NQF (2013) indicator described in table one below.

Available treatment for HIV infected individuals currently includes HAART (Highly Active Antiretroviral Therapy). This treatment has proven to be effective by extending life of individuals affected by HIV, doing so by decreasing viral load, HIV transmission, disease progression, reducing severity of symptoms and preserved the immune system. Therefore, it is important for the patient to get tested to ensure treatment is no delayed and risk further complication. As the virus progress the illness associated with it becomes more complicated and difficult to treat because without treatment the immunodeficiency rises. “The majority of disease occurs in the advanced stages of HIV infection where immunosuppression is the predominant influence Hogan, C., & Wilkins, E., (2011).” Therefore for patient should seek early treatment and adhere to medication regimen to decrease progression of the infection and prevent further complication. Other issues that need to be address is measures need to be taken for early testing, without being tested many patient are able to transfer the virus from one person to another without even knowing. Early diagnose of the disease will give patient the opportunity to seek medical care and become knowledgeable of the step needed to take to prevent them from infecting other individual. Several states have now implement policies to test newborn babies for the HIV virus without permission of the parents. ----------cite.

La Bounty et al. (2015) conducted a cross-sectional study to compare carotid artery wall thickness between 26 HIV positive individuals on HAART and 20 controls without HIV but with comparable cardiovascular risk factors. Wall thickness was evaluated using a 3.0T non-contrast MRI. Cases were included in the study on the basis of male gender, ages between 35-55 years and continuous ART therapy for ≥ 3 years.

The prospects for effective management of individuals with HIV are early dictation of the disease and identification and implementation of an evidence-based intervention that will slow the advancement of HIV to deleterious outcomes (Vervloet, Linn, Van Weert, de Bakker, Bouvy, & Dijik, 2012). HIV is a pandemic and pervasive disease that is associated with extensive mortality and morbidity. In the 1980s, HIV has claimed the lives of 33 million individuals’ and 35 million individuals are presently living with the disease nationwide. HIV attacks humans’ protective systems, and then replicates itself. As a result of this replication, the body cells thereby overwhelm the T-cells or the CD4

Infection with the Human Immunodeficiency Virus (HIV) results in destruction of the body’s host defenses and immune system leading to the condition called Acquired Immune Deficiency Syndrome (AIDS). HIV-AIDS is one of the world’s greatest public health crises. For many years, because of lack of understanding and effective treatment, it is now considered a rapidly progressing fatal disease. HIV infection in humans is considered pandemic by the World Health Organization (WHO). The Center for Disease Control and Prevention (2003) reported that there are more than 20 million died from HIV-AIDS globally.

Nowadays, there are still no treatments to cure AIDS. However, there is a therapy called ART that can reduce the amount of viruses inside the body/ attacking the immune system. ART stands for antiretroviral virus. This is also known as HAART, which stands for highly active antiretroviral virus. This treatment will prevent the viruses from producing more of it, which will help the immune system gain strength and recover from the HIV infection. Though, this can give complications to the patient or any side effects. These side effects include: weakness, headache, nausea, having general sick feeling, having a collection of fat on the back, and diarrhea. Also, patients need to have a healthy type of diet to avoid any risks such as getting a heart attack. This is perhaps made by the high levels of cholesterol and sugar in the blood.

Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS),[1][2] a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Infection with HIV occurs by the transfer of