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About HIV:About HIV: Teaching ToolTeaching Tool

About HIV:About HIV: A teaching toolA teaching tool©© 2nd edition 2006 2nd edition 2006

This tool was developed by the François-Xavier Bagnoud Center at the University of Medicine and Dentistry of New Jersey (UMDNJ),

with the support of the Pediatric AIDS Clinical Trials Group.

Excerpts from this publication may be freely reproduced or

adapted with acknowledgement of the source, provided the

material reproduced is for non-for-profit educational purposes only.

Send comments or questions to: info@fxbcenter.org

SectionsSections

Section 1: Understanding HIV infection

Section 2: Understanding HIV treatment

Section 1Section 1

Understanding

HIV Infection

Learn about:Learn about:

HIV The immune

system CD4 cells Checking how the

immune system is working

Viral load Why some people

with HIV are well and others are very sick

How you get HIV

Our immune systemOur immune system

HIV is a virus.virus.

©2002 Boehringer Ingelheim GmbH

H:Human

I:Immunodeficiency

V:Virus

CD4 cellCD4 cell

©2002 Boehringer Ingelheim GmbH

CD4 cellsCD4 cells

CD4 cell are destroyed after HIV uses them to make more HIV.

The body’s immune system works hard making more CD4 cells.

©2002 Boehringer Ingelheim GmbH

Low CD4 cellsLow CD4 cells

Measuring CD4 cellsMeasuring CD4 cells

Adult CD4 countsAdult CD4 counts

Normal CD4 Counts in ChildrenNormal CD4 Counts in Children

Normal CD4 counts in children vary widely by age.

In children less than 5 years of age, instead of measuring the number of CD4 cells,CD4 percentage (%) is used to determine how much damage has been done to the immune system

Viral load testViral load test

The amount of HIV in an infected patient’s blood can be measured. It is called the viral load.

The viral load testshows how muchvirus is present in

the body.

Understanding Understanding viral loadviral load

LOW viral load is less than 10,000 copies.

HIGH viral load is more than 10,000 copies.

Antibodies signal infectionAntibodies signal infection

Antibodies are special proteins in the blood made by the immune system to fight a specific infection.

People with HIV usually develop HIV antibodies 4–6 weeks after being infected. In some cases, it may take as long as 3 months for antibodies to develop.

To find out if a person has been infected with the virus, an HIV test is done that finds and measures antibodies in blood.

A person whose blood test results shows HIV infection is HIV-positive.

A person whose bloodtest does not show HIV infection is HIV-negative

Early stages of HIV InfectionEarly stages of HIV Infection

HIV enters the cell

©2002 Boehringer Ingelheim GmbH©2002 Boehringer Ingelheim GmbH

HIV uses parts of the CD4 cell to make more virus (replicate). During this process the CD4 cell is destroyed.

Viral load and CD4 cellsViral load and CD4 cells

Eventually, the immune systemis unable to make enough CD4 cells to replace the ones killedby HIV.

The immune system getsweaker and disease symptoms may develop (symptomatic HIV infection).

As the viral load goes up,the number of CD4 cellsgoes down.

WHO HIV clinical stagesWHO HIV clinical stages

A Acquired—not inheritedIImmuno—attacks the immune systemD Deficiency— destroys CD4 cellsS Syndrome—a group of symptoms or illnesses

AIDSAIDS

HIV can be transmitted fromHIV can be transmitted fromone person to another by:one person to another by:

The risk of HIV transmission The risk of HIV transmission through sex can be reduced by:through sex can be reduced by:

HIV is HIV is NOTNOT transmitted transmitted by: by:

Section 2Section 2

Understanding

Antiretroviral Therapy

Learn about:Learn about:

Highly active antiretroviral therapy (HAART)

How HAART works Adherence Resistance Side effects Why HAART sometimes doesn’t work well

What is antiretroviral therapy? What is antiretroviral therapy?

Goals of ARV therapyGoals of ARV therapy

Lower the amount of HIV in the blood

Save CD4 cells and allow the immune system to recover

““Classes”of Classes”of ARV therapyARV therapy

NRTIsNNRTIsPIsFls

HAARTHAART

When to start ARVsWhen to start ARVs

Guidelines vary from one country to another

Take all dosesTake all doses

Taking ARV medicines lowers viral load

Missed dosesMissed doses

If doses are missed, medicines may cease to be effective.

AdherenceAdherence

Doctors, nurses,counsellors, family andfriendsprovidesupport fortaking medicines.

Monitoring treatmentMonitoring treatment

Side effectsSide effects

Most side effects are mild and temporary, but others are more serious.

If side effects occur—talk to your clinician.

Treatment failureTreatment failure

Missed doses Viral resistance Medicines not taken due to side effects Other medicines interfere Advanced HIV disease

For antiretroviral therapy (ART) For antiretroviral therapy (ART) to succeed…to succeed… Keep all clinic appointments so clinicians can

check your health In between appointments, report any changes in

health right away. If a dose of an ARV medicine is missed, take the

missed dose as soon as possible. But if it is close to the time when the next dose will be taken, don’t take the dose you missed, Two doses should never be taken at the same time.

For ART to succeed…For ART to succeed…

If vomiting occurs fewer than 30 minutes after taking a dose, repeat the dose. If the repeat dose is vomited, contact the clinician.

If side effects occur, discuss them with the clinician.

Do not stop taking ARV medicines, and do not start any new medicine or home remedy without first discussing changes with the clinician.

Thank you!Thank you!