SIDE EFFECTS ARV

Like most medicines, antiretroviral drugs can cause side effects. These unwanted effects are often mild, but
sometimes they are more serious and can have a major impact on health or quality of life. On rare occasions,
side effects can be life threatening.
Once started, antiretroviral treatment must be taken every day for life. Every missed dose increases the risk that
the drugs will stop working. It is therefore vital that people receiving antiretroviral treatment get all the help
they need to minimise the impact of side effects. Often there are several ways to lessen the harm, either byOther
side effectsAbacavir hypersensitivity reaction
Variation in side effects
Antiretroviral drugs differ in how commonly they cause particular side effects. For example, efavirenz is the
drug most associated with psychiatric symptoms, while protease inhibitors are more likely to raise levels of
cholesterol and triglycerides. This should be considered when deciding which drugs to take.
Side effects vary from person to person and it is impossible to predict exactly how each individual will be
affected. Some people take antiretroviral treatment for years with few problems, while others find the same
drugs intolerable. Nevertheless some characteristics and pre-existing conditions (such as high blood pressure or
hepatitis infection) are known to increase the risk from certain side effects. Doctors should assess these factors
before advising patients on which drugs to choose.
Duration of side effects
Some side effects appear shortly after starting an antiretroviral drug and disappear within a few weeks as the
body gets used to the new chemicals. This is often the case with nausea, diarrhoea and headache, for example.
Unfortunately other side effects such as peripheral neuropathy (nerve damage) and lipodystrophy (fat
redistribution) tend to worsen over time and may never go away. Also some problems may not emerge until
months or even years after treatment is started.
Preparing to start treatment
Those preparing to take antiretroviral treatment for the first time, or about to switch drugs, are well advised to
learn a little about the most commonly associated side effects. This should help them deal with problems as
soon as they arise.
Patients should also know how to spot the warning signs of more serious side effects that may require
immediate intervention.

Reporting side effects

Because side effects are unpredictable, may occur at any time, and can be very serious, it is essential that all
symptoms be reported during appointments with a doctor. Severe or unexpected events should be reported
immediately.
Keeping a side effects diary is a good way to keep track of when symptoms occur, how often and how
severely. If side effects are affecting quality of life or treatment adherence then this too should be reported.
Identifying the cause
Most side effects are not uniquely associated with a particular drug, and sometimes it can be difficult to identify
the cause. HIV itself is capable of producing many of the symptoms that also occur as drug side effects. Other
possible causes include opportunistic infections, stress, diet, and non-HIV drugs.
Patients should make sure their doctors are aware of all drugs they are taking. This means not only
pharmaceuticals but also recreational drugs and complementary and alternative therapies. It may be that a side
effect is due to one of these other substances, either directly or because of an interaction with the antiretroviral
medication. The more information is shared with a doctor, the better equipped they will be to help.
Older people living with HIV may experience signs of ageing that could resemble certain side effects. For
example, when people get older they might be more susceptible to increased fat in the abdomen, which could
look similar to the changes that are caused by lipodystrophy.
Dealing with side effects
There may be several options for dealing with a particular side effect:
Wait for things to improve especially if in the first few weeks of treatment.Address other possible
contributing factors, such as diet, smoking or exercise. Change how the drug is taken (e.g. time of day, dosage,
with or without food)
Try treating the side effect
Change one or more antiretroviral drugs
Switching drugs is often an effective way to reduce or eliminate a side effect when all other approaches have
failed. If the viral load is undetectable then it is usually possible to switch only one drug without affecting
treatment effectiveness or future treatment options. Otherwise, the entire combination may have to be changed.
Switching drugs is not without risks. As already mentioned, it can be difficult to identify the cause of a
particular set of symptoms, and it may turn out that the rejected drug or drugs werent to blame after all. There
is also a chance that the new medication may cause even worse side effects, perhaps forcing another switch.
Changing drugs repeatedly will narrow future treatment options. It is important to weigh the possible risks and
benefits before deciding on this course of action.

It is never a good idea to stop treatment without first consulting a doctor, as this may cause HIV to develop
drug resistance.
Overview of antiretroviral drug side effects
Some of the side effects of antiretroviral drugs are described below, beginning with five of the most notable.
This is not a complete list.
Diarrhoea
Diarrhoea is a common side effect of many antiretroviral drugs especially protease inhibitors. Other possible
causes include HIV, other infections and antibiotics. Sometimes an antiretroviral drug causes diarrhoea for only
the first few weeks; in other cases this side effect lasts for as long as the drug is taken.
The severity of diarrhoea also varies. While even occasional attacks may be inconvenient and
embarrassing, persistent diarrhoea can also lead to dehydration, poor absorption of nutrients and drugs, weight
loss and fatigue.
Drinking plenty of fluids and replacing electrolytes will reduce the risk of dehydration. Electrolytes
such as potassium, sodium and magnesium ions are essential to health and are depleted by diarrhoea. Ways of
replacing electrolytes include oral rehydration salts (available from pharmacies), sports rehydration drinks
(such as Gatorade or Powerade, though the high sugar may worsen diarrhoea), diluted fruit juices, soups, and
homemade rehydration mixtures (8 level teaspoons of sugar and 1 level teaspoon of table salt per litre of water).
Eating bananas, potatoes, fish or chicken will help to replace potassium.
Although it may not be enough to solve the problem, changing diet may reduce the severity of
diarrhoea. Good advice includes:
1. Eat less insoluble fibre (raw vegetables, fruit skins, wholegrain bread or cereal, seeds and nuts)
2. Eat more soluble fibre (white rice, pasta, oat bran tablets, psyllium/isphagula)
3. Cut down on caffeine, alcohol and the sweetener sorbitol.
4. Avoid greasy, fatty, spicy and sugary foods
5. Consider reducing dairy products in case of lactose intolerance
6. Consult a dietician
Over-the-counter medicines such as Imodium (loperamide), Lomotil (diphenoxylate and atropine) and calcium
supplements are sometimes all that is needed to control diarrhoea. If these fail then doctors can prescribe
stronger treatments, which may have to be injected. Sometimes nothing works, and changing drugs may be the
best option.

Nausea and vomiting

Almost all antiretroviral drugs, as well as many other medications, can cause nausea (feeling sick) and
vomiting, especially during the first few weeks of treatment. Although this side effect can reduce appetite, it is
important to keep eating when possible, and to replace lost fluids and electrolytes (as with diarrhoea). The
following measures may help:
1. Eat several small meals instead of a few large meals
2. Avoid spicy, greasy and rich foods; choose bland foods.
3. Eat cold rather than hot meals.
4. Dont drink with a meal or soon after.
5. Avoid alcohol, aspirin and smoking.
6. Avoid cooking smells
Some antiretroviral drugs can be taken with food, and doing so may lessen their harmful effects. It may also
be possible to alter drug dosage or frequency.
Various treatments, known as anti-emetics, are available for nausea and vomiting, some of which do not
require a prescription. There is some evidence that ginger and peppermint may help against nausea.
If nausea and vomiting are severe, or occur with other symptoms such as dizziness, thirst, fever, muscle
pain, diarrhoea, headache or jaundice, then this may indicate a more serious problem such as lactic acidiosis or
pancreatitis. In this case medical attention should be sought as soon as possible.
Rash
Rashes often appear as a side effect of antiretroviral treatment. These may be itchy but are usually harmless and
short-lived. However, severe rashes can occur with nevirapine, and more rarely with some other drugs. Any
rash occurring during the first few weeks of treatment should be reported to a doctor immediately, as should
any rash accompanied by fever, blistering, facial swelling or aches. A rash occurring with abacavir may indicate
a very dangerous hypersensitivity reaction, as described later in this page.
Tips for coping with rashes include:
1. Avoiding hot showers or baths.
2. Using milder toiletries and laundry detergents.
3. Wearing cool fibres such as cotton, and avoiding wool.
4. Humidifying the air.
5. Trying moisturisers/emollients or calamine lotion
Antihistamine tablets can sooth rashes and are generally available without a prescription. However, because
these may interact with antiretroviral medications, patients should check with their doctors before using them.
More severe skin problems may be treated with steroids.

Lipodystrophy
Lipodystrophy involves losing or gaining body fat, often in ways that can be disfiguring and stigmatising.
Three main patterns are seen:
1. Losing fat on the face, arms, legs and buttocks, resulting in sunken cheeks, prominent veins on the
limbs, and shrunken buttocks.
2. Gaining fat deep within the abdomen, between the shoulder blades, or on the breasts.
3. A mixture of fat gain and fat loss.
Although lipodystrophy sometimes affects people with HIV who have not taken any antiretroviral drugs, it
occurs more often among those receiving treatment. The condition is among the most common long-term side
effects of combinations of drugs from the NRTI and protease inhibitor classes. It is particularly associated with
stavudine, and to a lesser extent zidovudine. The precise causes of lipodystrophy remain unknown.
The treatments for lipodystrophy are sadly limited. Changing diet seems to make no significant difference,
though resistance exercise (such as weight lifting) may improve the appearance of limbs by building muscle to
compensate for lost fat. Any form of exercise will burn fat, which may make some parts of the body look better
and others worse, depending on how fat has been redistributed. Aerobic exercise (such as running or
swimming) tends to have more effect on the fat just below the skin than on the deep fat gained through
lipodystrophy.
Doctors have tried using various medications, including human growth hormone, to treat lipodystrophy, but
few have proved effective, and most have significant side effects. For people who have lost fat from the face,
one option is injections of polylactic acid. This chemical (also known as New Fill or Sculptra) improves facial
appearance by thickening the skin.
Switching antiretroviral treatment should stop the symptoms getting worse, but is unlikely to lead to much
improvement once the condition has advanced.
Lipid abnormalities and the heart
Lipid abnormalities are another common side effect of some antiretroviral drugs particularly protease
inhibitors and are often seen in people who also have lipodystrophy. Lipids are molecules of fat, cholesterol
and related chemicals that have important roles in the body. Many factors including diet, smoking and exercise
can affect the balance of these chemicals in the blood. Abnormal lipid levels can be harmful to health.
HIV positive people taking antiretroviral treatment commonly have high levels of a lipid called LDL
cholesterol, low levels of HDL cholesterol, and high levels of triglyceride in the blood. Among HIV negative
people such lipid abnormalities have been linked to greater risks of heart disease, stroke and diabetes.
The first steps in treating lipid abnormalities should be related to diet and lifestyle. General
recommendations include giving up smoking, taking more exercise, cutting calories, eating less fat, and
consuming more fibre and omega-3 fatty acids (found in oily fish and flaxseed). However, people living with

HIV should seek expert advice on applying these guidelines. For example, cutting calories may jeopardise
attempts to build muscle, while eating less fat is not necessarily a good idea for people taking certain protease
inhibitors that require fatty foods to aid absorption.
Yet although diet and lifestyle changes should always be part of the strategy, they are often inadequate to
correct the problem. Doctors may prescribe medications such as statins and fibrates to improve lipid levels, or
they may advise switching treatment.
September 24th, 2009 Posted by purwa | Uncategorized | no comments
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HIV Related opportunistic infection : prevention and treatment

What are opportunistic infections?
People with advanced HIV infection are vulnerable to infections and malignancies that are called opportunistic
infections because they take advantage of the opportunity offered by a weakened immune system.
A partial list of the worlds most common HIV-related opportunistic infections and diseases includes:
Bacterial diseases such as tuberculosis, MAC, bacterial pneumonia and septicaemia (blood poisoning)
Protozoal diseases such as toxoplasmosis, microsporidiosis, cryptosporidiosis, isopsoriasis and
leishmaniasis
Fungal diseases such as PCP, candidiasis, cryptococcosis and penicilliosis
Viral diseases such as those caused by cytomegalovirus, herpes simplex and herpes zoster virus
HIV-associated malignancies such as Kaposis sarcoma, lymphoma and squamous cell carcinoma.
Different conditions typically occur at different stages of HIV infection. In early HIV disease people can
develop tuberculosis, malaria, bacterial pneumonia, herpes zoster, staphylococcal skin infections and
septicaemia. These are diseases that people with normal immune systems can also get, but with HIV they occur
at a much higher rate. It also takes longer for a person with HIV to recover than it takes for someone with a
healthy immune system.
When the immune system is very weak due to advanced HIV disease or AIDS, opportunistic infections
such as PCP, toxoplasmosis and cryptococcosis develop. Some infections can spread to a number of different
organs, which is known as disseminated or systemic disease. Many of the opportunistic infections that occur
at this late stage can be fatal.
Why is there still a need to prevent and treat opportunistic infections?

Highly Active Antiretroviral Therapy (HAART) can reduce the amount of HIV in someones body and restore
their immune system. The introduction of HAART has dramatically reduced the incidence of opportunistic
infections among HIV-positive people who have received the drugs. Yet the prevention and treatment of
opportunistic infections remains essential.
Around the world, millions of people living with HIV in resource-poor communities have no access to
HAART. And even where the drugs are available, they do not entirely remove the need for preventing and
treating opportunistic infections. Sometimes it is advisable for people with acute opportunistic infections to
begin HAART right away, especially if the infection is difficult to treat. However in certain cases it may be
better to delay beginning HAART and instead only to administer treatment for the opportunistic infection,
especially if there are concerns about drug interactions or overlapping drug toxicities.
Those who have already started taking antiretrovirals may require other drugs in certain circumstances.
In particular, some opportunistic infections may be unmasked shortly after the beginning of HAART as the
immune system starts to recover, and these may require specific treatment. Measures to prevent and treat
opportunistic infections become essential if antiretrovirals stop working because of poor adherence, drug
resistance or other factors.
Providing prevention and treatment of opportunistic infections not only helps HIV-positive people to
live longer, healthier lives, but can also help prevent TB and other transmissible opportunistic infections from
spreading to others.
Prevention of HIV-related opportunistic infections
HIV-positive people can reduce their exposure to some of the germs that threaten their health. They should be
especially careful around uncooked meat, domestic animals, human excrement and lake or river water.
However there is no practical way to reduce exposure to the germs that cause candidiasis, MAC, bacterial
pneumonia and other diseases because they are generally common in the environment.
Several HIV-related infections (including tuberculosis, bacterial pneumonia, malaria, septicaemia and
PCP) can be prevented using drugs. This is known as drug prophylaxis. One particular drug called
cotrimoxazole (also known as septra, bactrim and TMP-SMX) is effective at preventing a number of
opportunistic infections. This drug is both cheap and widely available. The World Health Organisation (WHO)
recommends that, in resource-limited settings, the following groups of people should begin taking
cotrimoxazole:
HIV-exposed infants and children, starting at 4-6 weeks after birth or at first contact with health care,
and continued until HIV infection is excluded
HIV-positive children less than 1 year old
HIV-positive children aged 1-4 years who have mild, advanced or severe symptoms of HIV disease, or a CD4
count below 25%

HIV-positive adults and adolescents who have mild, advanced or severe symptoms of HIV disease, or a CD4
count below 350 cells per ml
HIV-positive people with a history of treated PCP.
According to WHO guidelines, treatment of HIV-positive children should continue until at least age
five. In general treatment of adults and children should continue indefinitely, though it may sometimes be
stopped following successful antiretroviral treatment.
Some of the worst affected countries may choose to treat all infants and children born to mothers
confirmed or suspected of living with HIV, until HIV infection is excluded. They may also choose to treat
everyone who is diagnosed with HIV, regardless of symptoms or CD4 count.
Drug prophylaxis is sometimes recommended even for those who have started HAART if they have
very weak immune systems or are otherwise considered to be especially vulnerable. They may be advised to
stop taking the drugs if their immune system recovers.
For people who have already contracted an opportunistic infection and undergone successful treatment,
secondary prophylaxis may be advisable to prevent recurrence. This applies to diseases such as tuberculosis,
salmonella, cryptococcosis and PCP.
Treatment of HIV-related opportunistic infections
Some opportunistic infections are easier to treat than others. Effective treatment depends on health services
being able to procure, store, select and administer the necessary drugs and to provide related treatment, care and
diagnostic services to monitor health status and treatment response.
A few opportunistic infections and symptoms such as candidiasis of the mouth, throat or vagina
(thrush), herpes zoster (shingles) and herpes simplex can be managed effectively through home-based care. In a
home-based care setting diagnosis is made by observing symptoms.
Some opportunistic infections may be diagnosed by observation or using a microscope, and treated
where there is minimal health infrastructure. Such infections include pulmonary tuberculosis and cryptococcal
meningitis.
In a medium infrastructure setting, the facilities available include X-ray equipment and culture facilities.
Using these, opportunistic infections such as extra-pulmonary tuberculosis, cryptosporidiosis, isopsoriasis, PCP
and Kaposis sarcoma can be diagnosed and treated.
Opportunistic infections such as toxoplasmosis, MAC and cytomegalovirus infection can be diagnosed
and treated in places with advanced infrastructure. Treating these infections is often impossible in resource poor
countries. Many developing countries lack the advanced equipment and infrastructure (such as CT scanning)
needed to treat these more complex infections.
Individual opportunistic infections

The following are just a few of the conditions that particularly affect people living with HIV.
Bacterial pneumonia
Pneumonia can be caused by various bacteria. Symptoms among HIV-positive people are much the same as in
those without HIV infection, and include chills, rigours, chest pain and pus in the sputum. The vaccine PPV can
protect people against some of the more common pneumonia-causing bacteria, and is recommended in the US.
Because other forms of respiratory infection including PCP are common among HIV-infected people,
doctors must be certain of diagnosis before administering antibiotics. This may require a chest radiograph,
blood cultures, a white blood cell count and tests to eliminate other infections. Treatment is usually aimed at the
most commonly identified disease-causing bacteria.
Candidiasis
There are two main types of candidiasis: localised disease (of the mouth and throat or of the vagina) and
systemic disease (of the oesophagus, and disseminated disease). The mouth and throat variant (commonly
known as thrush or OPC) is believed to occur at least once in the lifetime of all HIV-infected patients.
Occurence of the vaginal variant is common among healthy women and is unrelated to HIV status.
While OPC is not a cause of death, it can cause oral pain and make swallowing difficult. The main
symptom is creamy white legions in the mouth that can be scraped away. Oesophageal (gullet) candidiasis is a
more serious condition which can cause pain in the chest that increases with swallowing. Disseminated
candidiasis causes fever and symptoms in the organs affected by the disease (for example, blindness when it
affects the eyes), and can be life threatening.
Localised disease may be treated at first with relatively inexpensive drugs such as nystatin, miconazole
or clotrimazole. Systemic candidiasis requires treatment with systemic antifungal agents such as fluconazole,
ketoconazole, itraconazole or amphotericin.
Cryptococcosis
Cryptococcosis is caused by a fungus that primarily infects the brain. It most often appears as meningitis and
occasionally as pulmonary or disseminated disease. Untreated cryptococcal meningitis is fatal.
Cryptococcosis is relatively easy to diagnose. However, its treatment (either amphotericin B with or
without flucytosine or in mild cases with oral fluconazole) and secondary chemoprophylaxis are often
impossible in developing countries because of high cost and limited availability of the drugs required.
Cryptosporidiosis and isosporiasis
Cryptosporidiosis (crypto) and isosporiasis are both caused by protozoan parasites. These diseases are easily
spread by contaminated food or water, or by direct contact with an infected person or animal. Both crypto and

isosporiasis cause diarrhoea, nausea, vomiting and stomach cramps. In people with healthy immune systems,
these symptoms do not last more than about a week. However, if the immune system is damaged then they can
continue for a long time. Diarrhoea can interfere with the absorption of nutrients and this can lead to serious
weight loss.
To confirm diagnosis of either disease, the stool is normally checked for parasites and their eggs. There is no
cure for crypto, but antiretroviral therapy to restore immunity can effectively clear up the infection. For
isosporiasis, TMP-SMX (trimethoprim-sulfamethoxazole) is often the preferred treatment.
Cytomegalovirus
Cytomegalovirus (CMV) is a virus that infects the whole body. It most commonly appears as retinitis, which
causes blurred vision and can lead to blindness. CMV can also affect other organs, and is capable of causing
fever, diarrhoea, nausea, pneumonia-like symptoms and dementia.
CMV infection may be treated with drugs such as ganciclovir, valganciclovir and forscarnet.
Herpes simplex and Herpes zoster
The usual symptoms of herpes simplex virus infection (HSV, which causes sores around the mouth and
genitals) and herpes zoster virus infection (zonal herpes or shingles) are not life-threatening but can be
extremely painful. Both viruses are also capable of causing retinitis and encephalitis (which can be lifethreatening).
Both herpes simplex and herpes zoster are usually diagnosed by simple examination of the affected area,
and may be treated with drugs such as acyclovir, famciclovir and valacyclovir.
Histoplasmosis is a fungal infection that primarily affects the lungs but may also affect other organs.
Symptoms can include fever, fatigue, weight loss and difficulty in breathing.
Disseminated histoplasmosis infection may be diagnosed using an antigen test, and can be fatal if left
untreated. Treatment usually involves amphotericin B or itraconazole.
Kaposis sarcoma
HIV-associated Kaposis sarcoma causes dark blue lesions, which can occur in a variety of locations including
the skin, mucous membranes, gastrointestinal tract, lungs or lymph nodes. The lesions usually appear early in
the course of HIV infection.
Treatment depends on the lesions symptoms and location. For local lesions, injection therapy with
vinblastine has been used with some success. Radiotherapy can also be used, especially in hard-to reach sites
such as the inner mouth, eyes, face and soles of the feet. For severe widespread disease, systemic chemotherapy
is the preferred treatment.

Leishmaniasis
Leishmaniasis is transmitted by sandflies and possibly through sharing needles. The most serious of its four
forms is visceral leishmaniasis (also know as kala azar) which is characterised by irregular bouts of fever,
substantial weight loss, swelling of the spleen and liver and anaemia (occasionaly serious). In its more common
forms, leishmaniasis can produce disfiguring lesions around the nose, mouth and throat, or skin ulcers leading
to permanent scarring.
Treatment of leishmaniasis with pentavalent antimony is relatively expensive, partly because of the cost of
drugs but also because hospital admission is recommended (in milder cases, trained health workers may
administer the injections or infusions at a patients home). If left untreated, visceral leishmaniasis is usually
fatal.
MAC
The germs of the mycobacterium avium complex (MAC) are related to the germ that causes tuberculosis. MAC
disease generally affects multiple organs, and symptoms include fever, night sweats, weight loss, fatigue,
diarrhoea and abdominal pain.
MAC should be treated using at least two antimycobacterial drugs to prevent or delay the emergence of
resistance. Such drugs include clarithromycin, azithromycin, ethambutol and rifabutin.
PCP
PCP is caused by a fungus, which was formerly called pneumocystis carinii but has now been renamed
pneumocystis jirovecii. PCP is a frequent HIV associated opportunistic infection in industrialised countries but
appears to be less common in Africa. The symptoms are mainly pneumonia along with fever and respiratory
symptoms such as dry cough, chest pain and dyspnoea (difficulty in breathing). Definitive diagnosis requires
microscopy of bodily tissues or fluids.
Severe cases of PCP are initially treated with TMP-SMX or clindamycin and oral primaquine. Mild
cases can be treated with oral TMP-SMX throughout. With both of these regimens, toxicity (notably allergictype reactions) often requires changes in therapy.
Prevention of PCP is strongly recommended for HIV-infected persons with very weak immune systems
wherever PCP is a significant health problem for HIV-infected persons, and also after their first episode of PCP.
The preferred drug is usually TMP-SMX.
Toxoplasmosis

Toxoplasmosis (toxo) is caused by a protozoan found in uncooked meat and cat faeces. This microbe infects the
brain and can cause headache, confusion, motor weakness and fever. In the absence of treatment, disease
progression results in seizures, stupour and coma. Disseminated toxo is less common, but can affect the eyes
and cause pneumonia.
Definitive diagnosis of toxo requires radiographic testing (usually a CT or MRI scan). The infection is
treated with drugs such as pyrimethamine, sulfadiazine and clindamycin. Leucovorin may also be used to
prevent the side-effects of pyrimethamine.
Tuberculosis
Tuberculosis (TB) is a bacterial infection that primarily infects the lungs. Tuberculosis is the leading HIVassociated opportunistic disease in developing countries. For people who are dually infected with HIV and TB,
the risk of developing active tuberculosis is 30-50 fold higher than for people infected with TB alone. And
because mycobacterium can spread through the air, the increase in active TB cases among dually infected
people means:
more transmission of the TB germ
more TB carriers
more TB in the whole population.
Tuberculosis is harder to diagnose in HIV-positive people than in those who are uninfected. The diagnosis of
TB is important because TB progresses faster in HIV-infected people. Also, TB in HIV-positive people is more
likely to be fatal if undiagnosed or left untreated. TB occurs earlier in the course of HIV infection than many
other opportunistic infections.
A proper combination of anti-TB drugs achieves both prevention and cure. Effective treatment quickly
makes the individual non-contagious, which prevents further spread of the TB germ. The DOTS (directly
observed short course) treatment strategy recommended by WHO treats TB in HIV-infected persons as
effectively as it treats those without the virus. A complete cure takes 6 to 8 months and uses a combination of
antibiotics. In addition to curing the individual, it also prevents further spread of the disease to others. This is
why treating infectious cases of TB has important benefits for society as a whole.
Isoniazid preventive therapy is recommended as a health-preserving measure for HIV-infected persons
at risk of TB, as well as for those with latent TB infection.
September 29th, 2009 Posted by purwa | Uncategorized | no comments
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