Treatment and vaccination for people living with HIV/AIDS

Posted by Doctor CKII Pham Thi Van Hanh - Pediatric Center - Vinmec Times City International Hospital

HIV/AIDS is a chronic infection caused by infection with the human immunodeficiency virus (HIV). The disease has a long asymptomatic latent phase. Severe manifestation in the final stage is Acquired Immune Deficiency Syndrome - AIDS (Acquired Immune Deficiency Syndrome).

Etiology HIV-1 and HIV-2 viruses, belong to the RETROVIRIDAE family.
HIV transmission route: Blood, sexual and mother-to-child transmission.
Epidemiology: Vietnam detected the first HIV infection in 1990. By September 2017, there were 208, 371 people infected with HIV, of which 90,493 AIDS patients. Number of deaths since the beginning of the epidemic: 91,840 people. In the first 9 months of 2017, 6883 new infections were detected, 1260 people died from HIV. 100% of provinces and cities have people infected with HIV.
Pathogenesis: HIV infection destroys TCD4, reduces the cell life from 180 days to 2-3 days, weakens the immune system. If left untreated, people with HIV are susceptible to opportunistic infections or cancers that can lead to death.

HIV testing is very important, helping to diagnose and treat people with HIV early, increasing the effectiveness of treatment and prevention. During treatment, 5 principles must be followed: consent, confidentiality, consultation, accuracy, and connection to care and treatment.
2.1 Need HIV testing counseling for people at risk of HIV infection: Drugs, prostitution, unsafe sex. People with tuberculosis , sexually transmitted diseases , hepatitis C . Patients with no known cause or symptoms suggestive of HIV infection Pregnant women Infected spouse/child; siblings of HIV-infected, HIV-exposed children. Other cases in need
2.2 Diagnostic test for HIV infection in adults and children over 18 months Screening test negative: Return results, note window period (test after 6 months) Test positive screening test: Do a test to confirm the diagnosis at a laboratory licensed by the Ministry of Health to test for HIV infection).

2.3 Testing for early diagnosis of HIV infection in children under 18 months of age PCR testing with DNA - HIV to confirm HIV infection for children born to HIV-infected mothers and children <18 months of age with suspected HIV infection or having a test positive anti-HIV antibodies. Get tested as soon as your baby is exposed at 4-6 weeks of age or during the first visit at an HIV care and treatment facility.

2.4 Diagnosis of the clinical stage of advanced HIV disease (AIDS) Adults and children with HIV ≥ 5 years of age: When CD4 is < 200 or when the patient is at clinical stage 3 or 4. HIV-infected children < 5 years of age: all both considered advanced HIV disease

Purpose: Maximum and long-term inhibition of HIV replication in the body and restoration of immune function.
Benefits of ART: Reduced risk of HIV-related morbidity and mortality. Prevention of HIV transmission from an infected person to another person (partner/injector)
Prevention of mother-to-child transmission of HIV;

3.1 Preparing for ART It is necessary to choose an ART regimen according to clinical stage, opportunistic infections, co-infections (TB, hepatitis), nutrition, routine test results, drug interactions.
Need advice on the benefits of ART, regimen selection, the need for adherence, follow-up visits, medication receipts, drug side effects, tests to monitor.
Counseling on measures to prevent HIV infection and HIV testing for relatives.
Counseling on prevention of mother-to-child HIV transmission if an HIV-infected person becomes pregnant.
3.2 Principles of treatment Treatment as soon as the patient is diagnosed with HIV Proper combination of at least 3 ARV drugs Ensure daily, continuous treatment adherence for life 3.2 Specific treatment First-line ARV regimens one

Note: If the regimens in the Table cannot be used: use alternative regimens
For people with HIV co-infected with TB Treat TB early and do not delay TB treatment when infected with HIV. Start ART after 2 weeks to 8 weeks of starting TB treatment. Assess the interaction between ARV drugs with anti-TB drugs, side effects of the drug, immune reconstitution inflammatory syndrome, do necessary tests and support treatment adherence.
Vinmec International General Hospital offers a Package of Examination and Screening for social diseases to help customers detect diseases early and have effective treatment and prevent dangerous complications. The screening package for social diseases at Vinmec is for all ages, both men and women.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.

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