HIV/AIDS DRUGS

(BIOTECHNOLOGY IN EDUCATION)
SE 6008
SUNDAY/7:30 AM-7:30 PM

Prepared and Presented by

WELFREDO JR. L. YU
Student ,EdD-Science Education

Presented to

DR. JAY P. PICARDAL

Professor

UPV 07-14-18
Objectives:
•Describe the HIV/AIDS
DRUGS.
•Discuss recent advances
on HIV/AIDS DRUGS.
 HIV
•Human Immunodeficiency Virus

•H = Infects only Human beings

•I = Immunodeficiency virus weakens the
immune system and increases the risk of
infection
•V = Virus that attacks the body
 AIDS
•Acquired Immune Deficiency Syndrome
•A = Acquired, not inherited
•I = Weakens the Immune system
•D = Creates a Deficiency of CD4+ cells in the
immune system
•S = Syndrome, or a group of illnesses taking
place at the same time
Causes of mortality

Source : Ford et al, Lancet HIV 2016

SOURCE: https://www.qub.ac.uk/elearning/hiv-and-pregnancy/ElearningResource/Module1-HIVawareness/WhatisHIV/
 HIV and AIDS

• When the immune system becomes

weakened by HIV, the illness progresses to
AIDS

• Some blood tests, symptoms or certain

infections indicate progression of HIV to
AIDS
 HIV-1 and HIV-2
HIV-1 and HIV-2 are :
• Transmitted through the same routes
• Associated with similar opportunistic infections

• HIV-1 is more common worldwide.

• HIV-2 is found in West Africa, Mozambique, and Angola.

 HIV-1 and HIV-2
• HIV-2 is less easily transmitted
• HIV-2 is less pathogenic
• Duration of HIV-2 infection is shorter
• MTCT is relatively rare with HIV-2
Transmission of HIV
•HIV is transmitted by
• Direct contact with infected blood
• Sexual contact: oral, anal, or vaginal
• Direct contact with semen or vaginal and
cervical secretions
• HIV-infected mothers to infants during
pregnancy, delivery, or breastfeeding
Transmission of HIV
HIV is not transmitted by
• Public baths
• Coughing, sneezing
• Handshakes
• Insect bites
• Work or school contact
• Touching, hugging • Using telephones
• Water, food • Sharing cups, glasses,
• Kissing plates, or other utensils
Four Stages of HIV
 Stage 1 - Primary
• Short, flu-like illness - occurs one to six weeks after
infection
• no symptoms at all
• Infected person can infect other people
 Stage 2 - Asymptomatic

• Lasts for an average of ten years

• This stage is free from symptoms
• There may be swollen glands
• The level of HIV in the blood drops to
very low levels
• HIV antibodies are detectable in the
blood
 Stage 3 - Symptomatic

• The symptoms are mild

• The immune system deteriorates
• emergence of opportunistic infections and
cancers
 Stage 4 - HIV  AIDS

• The immune system

weakens

• The illnesses become

more severe leading
to an AIDS diagnosis
 Opportunistic Infections associated
with AIDS
•Bacterial
• Tuberculosis (TB)
• Strep pneumonia

•Viral
• Kaposi Sarcoma
• Herpes
• Influenza (flu)
 Opportunistic Infections associated
with AIDS

•Parasitic
• Pneumocystis carinii

•Fungal
• Candida
• Cryptococcus
Modes of HIV/AIDS Transmission
 Through Bodily Fluids

• Blood products
• Semen
• Vaginal fluids
• Breast Milk
 Through IV Drug Use
• Sharing Needles
• Without sterilization
• Increases the chances of contracting HIV
Through Sex
 Mother-to-Baby

• Before Birth
• During Birth
• Postpartum
• After the
birth
ADVANCES OF HIV/AIDS TREATMENT

Treatment Options
• HIV treatment (antiretroviral therapy or ART)
involves taking medicine as prescribed by a
health care provider. HIV treatment reduces
the amount of HIV in your body and helps you
stay healthy. 
• There is no cure for HIV, but you can control
it with HIV treatment.
1st effective therapy for
HIV was the nucleoside
reverse transcriptase
inhibitor zidovudine but
this drugs or even in
combination of drugs from
same group were unable to
suppress virus for long
periods of time and patient
eventually dies.
Later on the development of other drugs from other anti HIV
class were also combined such as protease inhibitors indinavir.

This concept of three drug therapy was quickly adapted in to

clinical practice this rapidly showed impressive benefit with 60-
80% decline in rates of AIDS, death and hospitalization this is
called HAART(highly active antiretroviral therapy.
 Targets for treatment of HIV (anti-retroviral drugs)

Source: https://www.researchgate.net/figure/Human-Immunodeficiency-Virus-life-cycle-Targets-for-antiretroviral-
intervention_fig1_267686772
 Zidovudine

•Pharmacokinetics
Orally effective
Penetrates CSF(cerebrospinal fluid)
Excreted through kidney
 Side effects

• Bone marrow depression (leukopenia)

• Headache
• Nausea , anorexia
• Myopathy , fatigue
-Can be used in children in low doses ,
during pregnancy & delivery
 Emtricitabine

• Oral formulation should not

be used in a pregnant AIDs
patient because it contains a
propylene glycol which is a
potentially toxic compound
for the fetus.
 Emtricitabine
• Highly absorbed orally , not affected by
food.

• Common adverse effects

GIT (gastrointestinal tract)upset
Hyperpigmentation of palms& soles
 Didanosine

• Oral bioavailability is reduced by food

• Eliminated by the kidney
• Causes acute pancreatitis as a side effect &
retinal damage & Peripheral neuropathy
Therapeutic effects for
all
•Increase T cells partially restoring
immune system

•Reverses AIDS dementia

Pharmacokinetics
• Orally effective
• Metabolized in liver
• Excretion through
kidney
• Inducer of hepatic
cytochrome P450
 Pharmacokinetics
•Very effective for prevention of
transmission of infection as a single dose
at time of labor and continue as an oral
doses for 3 days for the neonates (birth
to one month).
 Side Effects

• Hepatotoxicity
• Skin reaction up to life threating as
Steven-Johnson Syndrome ( mainly
with nevirapine)
• Diarrhea
• Headache
 Protease Inhibitors

• Protease inhibitors

• Ritonavir, Atazanvir
 Mechanism of action

• Block the viral protease enzyme necessary to

produce mature virions

• ( prevent polyprotein cleavage,which is

necessary for the maturation of viral cells )
 Pharmacokinetics

Atazanavir
• oral absorption requires an acid environment
• Excretion via biliary elimination
• Enzyme inhibitors P450
 Pharmacokinetics

Ritonavir
• Should be taken with meals ( its oral
bioavailability increases with food )
• Clearance is mainly via the liver
• Enzyme inhibitors P450
 Side effects for protease inhibitors

• Increased bleeding in hemophilic

patients
• Increased blood sugar level ( worsening
of diabetes)
• Changes in body fat distribution central
obesity, buffalo hump, (gynecomastia)
Entry Inhibitors
• Maraviroc
• Mechanism of action
Blocks certain strains of HIV
from binding to chemokine
receptor type 5 ( CCR5) thus
preventing the virus from
entering target cells.
 RECENT ADVANCES
Cabotegravir is the latest WHO-
recommended drug that protects
against HIV infection. In January
2021, the agency approved the use of
a vaginal ring coated with the anti-HIV
drug dapivirine. It blocks HIV
integrase by attaching to the active
integrase site and inhibiting the
retroviral deoxyribonucleic acid (DNA)
integration stage, which is necessary
for the HIV replication cycle.
•Common Side Effects of
HIV Drugs
• Duque III, together with other PNAC Members, signed today the
Implementing Rules and Regulations of Republic Act 11166,
otherwise known as the Philippine HIV and AIDS Policy Act. This
law, which repealed the old HIV law (RA 8504), aims to effectively
address the growing HIV epidemic in the country.
• The Philippine AIDS Prevention and Control Act of 1998,
Republic Act 8504, criminalizes discrimination against people living
with HIV in the workplace “in any form from pre-employment to post-
employment, including hiring, promotion or assignment, based on the
actual, perceived or suspected HIV status of an individual.”
Fast-Track commitments for 2020
2020 TARGETS MISSED
IMPACT-LEVEL MILESTONES
To reduce new HIV infections to fewer than 500 000 by 2020
To reduce AIDS-related deaths to fewer than 500 000 by 2020
To eliminate HIV-related stigma and discrimination by 2020
10 COMMITMENTS

1 2
Ensure that 30 million people living with HIV
have access to treatment through meeting the
90–90–90 targets by 2020.
Eliminate new HIV infections among children by 2020
while ensuring that 1.6 million children have access
to HIV treatment by 2018 and
1.4 million by 2020.
3 4
Ensure access to combination prevention
options, including preexposure prophylaxis,
voluntary medical male circumcision, harm
reduction and condoms, to at least 90% of people by
2020, especially young women and adolescent girls
in high HIV-prevalence countries and key populations
—gay men and other men who have sex with men,
transgender people, sex workers and their clients,
people who inject drugs and prisoners.
Eliminate gender inequalities and end all forms of
violence and discrimination against women and girls,
people living with HIV and key populations by 2020.
5
Ensure that 90% of young people have the skills,
knowledge and capacity to protect themselves from
HIV and that they access to sexual and reproductive
health services by 2020, in order to reduce the
number of new HIV infections among adolescent
girls
and young women to below 100 000 per year.

6 7 8 9 10
Ensure that 75% of people living with, at risk of and Ensure that at least 30% of all service delivery is Ensure that HIV investments increase to Empower people living with, at risk of and affected Commit to taking AIDS out of isolation through
affected by HIV benefit from HIV-sensitive social community-led by 2020. US$ 26 billion by 2020, including a quarter for by HIV to know their rights and to access justice and people-centred systems to improve universal health
protection by 2020. HIV prevention and 6% for social enablers. legal services to prevent and challenge violations of coverage, including treatment for tuberculosis,
human rights. cervical cancer and hepatitis B and C.

Source :2nd-place---hiv-aids-in-african-americans-2018-hshcp
Source:https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/key-strategies
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Thank You!