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240417 ยาต้านไวรัส HIV

What is HIV Antiretroviral Drugs? (continued)

After we got to know more about HIV and AIDS in the last article, in this article we will learn more about HIV antiretroviral (ARV) drugs. While there is currently no medication that can cure AIDS entirely, there are medications that can be taken to prevent HIV infection and reduce the virus’s multiplication. The medication in question is referred to as “HIV antiretroviral drugs”. These medications are designed to inhibit or counteract the replication of HIV, thereby preventing the virus from destroying T-cell white blood cells. If used appropriately, they can prevent infections by as much as 99%.

Anti-HIV medications, or ARVs, are classified based on how they work, as outlined below.

  1. Nucleoside reverse transcriptase inhibitors (NRTIs) block reverse transcriptase (an HIV enzyme) that convert its RNA into DNA (reverse transcription) that would allow HIV to access host cell. This inhibition mechanism abrupt the connection between HIV genetic material and prevents HIV from replicating. Examples of medicines in this group are Tenofovir disoproxil fumarate (TDF), Emtricitabine (FTC), etc.
  2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) also block reverse transcriptase, similar to those under NRTIs. Examples of medicines in this group are Efavirenz (EFV), Rilpivirine (RVP), etc.
  3. Integrase strand transfer inhibitors (INSTIs) inhibit the integration mechanism of HIV. INSTIs block integrase (an HIV enzyme) that insert/integrate its viral DNA into the DNA of the host CD4 cell. Examples of medicines in this group are Dolutegravir (DTG), Bictegravir (BIC), etc.
  4. Protease Inhibitors (PIs) block protease (an HIV enzyme), inhibit its activity, particularly the break-up of the protein chains, stopping HIV from developing and maturing. Examples of medicines in this group are Lopinavir+Ritonavir (LPV/r), etc.

HIV ARV drugs can be categorized into 2 types, as follows:

  1. Pre-exposure prophylaxis (PrEP) is a medicine that helps reduce the risk of infection, taken to prevent getting HIV. Simply put, if you know you are going to be at risk, such as having sex with an HIV positive person, or if you work with people who are at risk, such as healthcare workers working with HIV patients, you should take PrEP before being exposed to the risk for at least 7 days (depending on the type) and continue to take the medicine as long as you are exposed to such risks. Before taking PrEP, the following test results are needed: Anti-HIV, Hepatitis B, and renal function. However, even if PrEP is utilized, it is still recommended to use a condom for double protection.
  2. Post exposure prophylaxis (PEP), sometime known as emergency medicine (ยาต้านฉุกเฉิน) or HIV prevent medicine (ยาต้านเอชไอวี), people who will utilize PEP are people who have already been at risk, such as having sex with an HIV positive person or healthcare workers who were exposed to a needlestick injury. PEP medications cover NRTIs, NNRTIs, NSTs, or PIs, depending on the doctor’s consideration to use which medications. PEP usage requires more and stricter conditions than PrEP. PEP should only be administered within 72 hours of exposure as it is ineffective in preventing HIV infection after 72 hours of being exposed. Before receiving PEP, the following blood tests are required: anti-HIV, Hepatitis B, Hepatitis C, syphilis, renal function, and liver enzyme levels. PEP must be taken for 28 days.

Side effects, which can occasionally be experienced when using ARV medications, include fatigue, nausea, and dizziness. Nevertheless, after taking ARV medications for a week or so, these symptoms may go away on their own. If patients have been on the medication for six months or more, doctors would advise them to take a test for liver and renal functions as ARV medications impair liver and renal function. Additionally, people living with HIV should also have their CD4 white blood cell count and HIV viral load checked.

Even though we understand the benefits and efficacy of ARV drugs and how to use them to their full potential, Admin believes that not being infected, using effective infection prevention, and avoiding exposing yourself to the risk of infection are still preferable to being infected and having to take ARVs. After all, there is still no drug that completely cures AIDS or kill HIV. Thus, Admin encourages everyone to prioritize their health, both for themselves and for those they care about.

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