HIV vs AIDS

One of the main differences between HIV and AIDS is that, one is a virus, and the other one is a condition. A person who is with HIV may or may not have AIDS. On the other hand a person with AIDS will always have HIV in the blood.

HIV:

• HIV is a virus.
• HIV has no symptoms.
• A person who is HIV positive does not yet have AIDS may seem to be perfectly healthy.
• A person who is HIV positive does not have AIDS may have an effective as well as active immune system.
• An HIV positive person who does not have AIDS can work and support his or her family.
• Although HIV is of two types HIV-1 and HIV-2

AIDS: 

• AIDS is a disease.
• A person with AIDS may have the symptoms of various diseases which he has acquired, such as TB, meningitis, and cancer.
• A person who carried AIDS may be thin and weak. He or she may feel and look sick.
• The immune system of a person who is with AIDS is rapidly decreased and becomes less effective in order to protect his or her body.

What kind of infections does a person get as HIV begins leading to AIDS?

We are surrounded by disease-causing viruses, fungi, bacteria, and other germs. Some of such even present within our bodies, even without causing any illness. For instance, numerous people carry the latent TB germ in their bodies. However, these germs will not be successful in causing a disease in a person with a healthy immune system. It is only when the immune system is weakened by malnutrition, illness, or a condition like HIV infection, that these germs find an opportunity to cause disease. Such infections are called opportunistic infections.
Some OIs (opportunistic infections) that could be occur as HIV progresses to AIDS include:

• Encephalitis (inflammation in the brain)
• Candidiasis (or thrush, a fungal infection of the mouth or vagina)
• Gastroenteritis (a digestive illness)
• Meningitis
• Pneumonia
• Herpes
• Kaposi’s sarcoma ( a kind of skin cancer)
• Tuberculosis

Important Information: 
People with HIV, who pay attention to their nutrition needs and eat a balanced diet are more likely to develop AIDS later, and also such patients die later than those who are malnourished.
A person who is HIV positive should get information on nutrition from many sources, should discuss with others living successfully with HIV, and talk to the healthcare professionals before deciding what would be the best diet for her/him.

Read:- What are the symptoms of HIV and how to control HIV

All you need to know about the combination of Lopinavir and Ritonavir

In the year of 2000, in the United States, the Lopinavir ritonavir was approved as a single medication for use in the medical. This fixed-dose combination medication is on the WHO's (World Health Organization's) List of Essential Medicines, the safest and most effective medicines needed in a health system.

The combination of Lopinavir and Ritonavir, both the medications are HIV protease inhibitors. Where Ritonavir mainly works by slowing down the breakdown of lopinavir.

This fixed-dose combination drug sold under the brand name Kaletra. It is basically recommended for the treatment as well as prevention of HIV/AIDS. In this combined medication, the dose of ritonavir should be low. These HIV protease inhibitors must be used with other antiretrovirals. It could be also used for prevention after a needlestick injury or other potential exposure. Till 2006, lopinavir/ritonavir was the most recommended and also most preferred fixed-dose combination medicine for Human Immunodeficiency Virus (HIV) as a first-line therapy by the U.S Department of Health and Human Services.

Apart from this as like several other Human Immunodeficiency Virus (HIV) protease inhibitors, its blood levels are greatly increased by low doses of ritonavir, a potent inhibitor of intestinal and hepatic CYP3A4, (basically an important enzyme in the body, mainly found in the liver and in the intestine. It oxidizes small foreign organic molecules (xenobiotics), such as toxins or drugs) which would otherwise reduce drug levels through catabolism.

Thus, lopinavir was only formulated and marketed as a fixed-dose combination with ritonavir.

Dosage of Lopinavir Ritonavir: 

The recommended daily dosage should be given as 800/200 mg once or twice daily. Also this combination medication can be given as once daily or twice daily regimen. The increased dose of lopinavir and ritonavir should be used when it  combines with the efavirenz, nevirapine, or nelfinavir. The combined Lopinavir and Ritonavir tablets shouldn't be recommended for once-daily dosing in pediatric patients who are younger than 18 years of age. Lopinavir 100 mg and ritonavir 25 mg tablets should be recommended only in those children who have reliably demonstrated the ability to swallow the intact tablet.

What are the Side Effects of Lopinavir Ritonavir:

The most common side effects observed with lopinavir-ritonavir tablets are as follows:

• Rash
• Diarrhea
• Nausea
• Asthenia
• Headache
• Vomiting
• Abdominal Pain
• Raised liver enzymes
• Hyperlipidemia (hypertriglyceridemia and hypercholesterolemia)

Interactions of Lopinavir and Ritonavir: 

Lopinavir and ritonavir tablets are anticipated to have varying degrees of interaction with other medications that are also CYP3A and/or P-gp substrates.
The fixed-dose combination of Lopinavir and Ritonavir should be used with caution in such patients who are with the preexisting conduction system abnormalities, structural heart disease, ischaemic heart disease, and cardiomyopathies.

Price of Lopinavir Ritonavir: 

The cost of Lopinavir and Ritonavir is quite decent. A respective patient can purchase this fixed-dose combination medication through any authorized and registered pharmaceutical company.

Note: The combination of lopinavir 200 mg and ritonavir 50 mg & lopinavir 100 mg and ritonavir 25 mg is not recommended during breastfeeding. For alternate options, talk to your healthcare provider.

Read:- Atazanavir sulfate uses and its side effects

How Darunavir Ritonavir combination is useful in the treatment of HIV

Darunavir: 

Darunavir (DRV), is an antiretroviral medication, which is sold under the brand name Prezista in order to treat as well as prevent HIV/AIDS.
DRV (Darunavir) is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat with the motive of increasing the levels of darunavir. Darunavir, combines with the ritonavir 100 mg antiretroviral and with some other antiretroviral agents, for the treatment of human immunodeficiency virus (HIV) infection in antiretroviral treatment experienced adult patients, such as those with Human Immunodeficiency Virus-1 (HIV-1) strains resistant to more than one protease inhibitor.

Darunavir comes as the strengths which are as follows:

• Darunavir 75 mg tablets
• Darunavir 150 mg tablets
• Darunavir 400 mg tablets
• Darunavir 600 mg tablets
• Darunavir 800 mg tablets

Side Effects of Darunavir: 

This is a quite well-tolerated medication and sometimes it may leave some adverse reactions, which are as follows:

• Skin rash
• Hepatotoxicity
• Diarrhea
• Nausea
• Headache
• Hyperlipidemia
• Serum transaminase elevation
• Hyperglycemia
• Fat maldistribution

Ritonavir:

Ritonavir (RTV), an antiretroviral medication, which is sold under the trade name Norvir in order to treat HIV/AIDS.
Ritonavir is generally prescribed for use along with other medications. When Ritonavir is used with the other medications, then this combination treatment is called HAART, which stands for highly active antiretroviral therapy. Often a low dose this medication is used with other protease inhibitors. It may also be used in combination with other medications for hepatitis C.

How Does Ritonavir Works: 

Initially, ritonavir was developed as an inhibitor of Human Immunodeficiency Virus (HIV) protease, which is one of a family of pseudo-C2-symmetric small molecule inhibitors.
The role of Ritonavir is as a booster. It is rarely used for its own antiviral activity.  This medication is mostly as well as widely used as a booster of other protease inhibitors.
Most important aspect of ritonavir is that it is used in order to inhibit a particular enzyme, in the liver, intestines, and elsewhere, that normally metabolizes protease inhibitors, cytochrome P450-3A4 (CYP3A4).
The drug binds to and inhibits CYP3A4 so that a low dose can be used in order to enhance the other protease inhibitors.
This medication comes as the strength of Ritonavir 100mg.

Side Effects of Ritonavir: 

Ritonavir most widely used as a lower dose. Its activity is mainly based on a CYP3A4 inhibitor.
The most common side effects of ritonavir are as follows:

• Asthenia, malaise
• Diarrhea
• Nausea and Vomiting
• Abdominal Pain
• Dizziness
• Insomnia
• Sweating
• Taste Abnormality
• Metabolic Effects

How Combination Of Darunavir/Ritonavir is Effective:

The reason behind taking both the protease inhibitors (darunavir, ritonavir) is that ritonavir has the potential that it will boost the level of darunavir and also it increases the effect of darunavir.

The recommended oral dose of darunavir tablets should be taken according to the prescribed by your healthcare provider. This medication should be taken with food. The sort of meal/food may not affect the exposure to darunavir.

Interaction: Darunavir ritonavir are both inhibitors of the CYP3A4 isoform.
Darunavir/Ritonavir should not be used in combination with rifampicin, as this may cause significant decreases in darunavir plasma concentrations. This may result in loss of therapeutic effect to Darunavir.

Read:- Carvedilol uses and its side effects.

Uses of Efavirenz Emtricitabine Tenofovir

What is Efavirenz Emtricitabine Tenofovir: 

The combination of these three medications is indicated for the treatment of (HIV) infection in adults aged 18 years and over who have previously been treated with other class of drugs which inhibit the activity of retroviruses (antiretroviral medicines) and have their HIV-1 infection under control for at least three months. The respective patient should not have experienced the failure of a previous Human Immunodeficiency Virus (HIV) therapy.

Efavirenz: Efavirenz is a non-nucleoside reverse transcriptase inhibitor. This is an active substance, which is also known as antiretroviral medicine, which works by interfering with an enzyme (reverse transcriptase) that is necessary for the virus in order to multiply.

Emtricitabine: Emtricitabine is a nucleoside analog reverse transcriptase inhibitor. Emtricitabine is an active substance, which is also known for its antiretroviral activity. This medicine works by interfering with an enzyme (reverse transcriptase) that is necessary for the virus in order to multiply.

Tenofovir Disoproxil: Tenofovir Disoproxil is a nucleotide analog reverse transcriptase inhibitor. Tenofovir Disoproxil is also an active substance, which is also known as antiretroviral medicine, which works by interfering with an enzyme (reverse transcriptase) that is necessary for the virus in order to multiply.

What are the uses of Efavirenz Emtricitabine Tenofovir Disoproxil Fumarate:

The purpose of combining these three drugs into a single, once-daily pill reduces pill burden and simplifies dosing schedules, and therefore has the potential to increase adherence to antiretroviral therapy.

Efavirenz is an NNRTI (non-nucleoside reverse transcriptase inhibitor) of HIV-1. Emtricitabine is an NRTI (nucleoside reverse transcriptase inhibitor) of Human Immunodeficiency Virus-1 and Tenofovir is a nucleotide reverse transcriptase inhibitor of HIV-1, and it can be classified as a NtRTI. All these three medications work in a combination in order to target the Human Immunodeficiency Virus (HIV) reverse transcriptase protein in three ways, which basically helps in reducing the virus's capacity to mutate.

Coming up to the combinational studies there were synergistic antiviral effects observed in between emtricitabine and efavirenz, efavirenz and tenofovir, and emtricitabine and tenofovir.

In the year of 2006 in the United States, Efavirenz/emtricitabine/tenofovir was approved as a once-daily tablet in order to treat Human Immunodeficiency Virus. The main advantage of this new medication was that it could be taken once daily and reduce the overall stress in an antiretroviral regimen.

Related:- List of HIV Medications

Side Effects of Efavirenz Emtricitabine and Tenofovir: 

Common side effects of efavirenz/emtricitabine/tenofovir could be occur as follows:

• Tiredness
• Dizziness
• Gastrointestinal Distress
• And, Skin Discoloration
• Some more severe side effects could be as:
• Hallucinations
• Sleeplessness
• Abnormal Dreams
• Depression

While on HIV therapy patients may experience an increase in their weight and in levels of glucose and blood lipids. The recommended dosage of efavirenz, emtricitabine and tenofovir should be one tablet at or before bedtime.

In order to reduce the side effects, this medication should be taken on an empty stomach. People with kidney or liver problems can take one tablet by mouth once a day.

Some below-enlisted medications should be avoided while on with Efavirenz, Emtricitabine, Tenofovir include:

• Bepridil
• Midazolam
• Pimozide
• Triazolam or Ergot Derivatives

Additionally, St. John's wort is known to reduce the effectiveness of efavirenz/emtricitabine/tenofovir, resulting in increased viral load and possible resistance to Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate.

Read: What are the symptoms of HIV, and how to control HIV Infection?

All you need to know about Entecavir tablets

What is Entecavir: 

Entecavir 0.5 mg contains Entecavir as an active substance. Entecavir 0.5 & 1mg tablets are anti-viral medicines, used to treat chronic (long term) hepatitis B virus (HBV) infection in adults.

What is the use of Entecavir tablets: 

Entecavir can be used in people whose liver is damaged but still functions properly (compensated liver disease) and in people whose liver is damaged and does not function properly (decompensated liver disease).

This medication (Entecavir) is also used to treat HIV infection, and chronic HBV infection (long term) in children and adolescents aged 2 years to less than 18 years.

Entecavir may also be used in children with the compensated liver disease means whose liver is damaged but still functions properly.

Hepatitis B virus may lead towards the infection which has the potential to damage the liver. Entecavir tablets are effective in order to reduce the amount of virus in the body, and in this way it helps in enhancing the condition of the liver.

Side Effects of Entecavir: 

Like all medicines, this medicine can cause side effects, although not everybody gets them.
Patients with Entecavir have reported some common adverse reactions which are as follows:

• Nausea
• Headache
• Vomiting
• Diarrhoea
• Dizziness
• Insomnia (Inability to sleep)
• Fatigue (Extreme tiredness)
• Somnolence (Sleepiness)
• Dyspepsia (Indigestion)
• Increased blood levels of liver enzymes. 

Uncommon side effects are as: rash, severe allergic reactions, and hair loss.

In case of any adverse reactions talk to your healthcare provider. 

How Entecavir is useful in the treatment of HIV: 

Entecavir is a nucleoside analog, or a deoxyguanosine analogue that mainly belongs to a class of medication named carbocyclic nucleosides. This medication inhibits reverse transcription, DNA replication and transcription in the viral replication process.

This medication is highly potent against HBV, but can select for HIV resistance mutations (M184V). Therefore, entecavir should only be used in HBV/HIV coinfected patients in addition to (and should not replace components of) fully suppressive ART.

Entecavir mainly works by reducing the amount of HBV in the blood by resisting and decreasing its ability to multiply and infect new cells.

The efficacy of entecavir medication has been found good in several clinical trials. Entecavir, when taken by mouth is more effective and also well-tolerated treatment.

• In most cases, you may take Entecavir 0.5mg with or without food. However, if you have had a previous treatment with a medicine containing the active substance lamivudine you should consider the following.
• In case of moving towards the Entecavir 0.5 because the treatment with lamivudine was not successful, you should take Entecavir on an empty stomach once daily.
• If your liver disease is very advanced, your doctor will also instruct you to take Entecavir 1mg on an empty stomach.
• Empty stomach stands as, at least 2 hours after a meal and at least 2 hours before your next meal.
• Children and adolescents (from 2 to less than 18 years of age) can take Entecavir 1mg with or without food.
• The price of Entecavir is affordable which can be purchased by any respective patient from any authorized pharmaceutical company. 

Read:- Symptoms of HIV, and how to control HIV infection?

            

            List of Medications for HIV