ANTI RETRO VIRAL THERAPY.

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ANTI RETRO VIRAL THERAPY.

• PERUNDURAI EXPERIENCE. .

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HOSPITAL STATISTICS.

• OUT PATIENTS 10168.
• IN PATIENTS 1982. ( Up to
  May 2002.) GM.

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SEX RATIO

• MALES 1529.
• FEMALES 453. GM.

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YEAR WISE PROGRESSION.

• STEADY INCREASE IN HIV/AIDS CASES.
  GM.

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MORTALITY DATA.

• Mortality is almost the same in all the
  yrs..
  GM.

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ANTI RETRO VIRAL THERAPY.

• Those who can afford to take ARV is very
  less.
  GM.

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PMCH PROTOCOL.

• COUNSELLING ( Individual,Family Financial)
• ASYMPTOMATIC CASES. Viral load gt55,000
  copies/ml CD4 lt200 cells/c.mm.
• SYMPTOMATIC CASES. GM.

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WHAT DRUGS...

• ZIDO LAMI SAQU. (A) 18
• ZIDO LAMI NEVI. (B) 34
• ZIDO LAMI EFAV. (C) 05
• STAV LAMI NEVI. (D)
  12 GM.

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WHEN ?

• ASYMPTOMATIC STAGE 12
• SYMPTOMATIC 61
  GM.

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INVESTIGATIONS.

• AT THE START. Viral load , CD4 cell
  count, Hb,TC,DC,ESR,Platlet count, Sugar,
  Urea,Creatinine, Lipid profile, and other
  necessary tests(HBs Ag, HCV, Ultra sound
  abdomen,LFT, etc..)
• Repeated after 6 months after 1 Yr, and
  every year. GM.

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OUTCOME.

• Viral load undetectable 15
  Less than 10,000 35 10,000 to
  20,000 10 gt 20,000
  03
• CD4 cells consistent increase in all the
  patients.
• Clinical outcome is good ( opportunistic
  infections 05)

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OPPORTUNISTIC INFECTIONS.

• TUBERCULOSISPULMONARY ( 08 ) LYMPH NODE (02
  ) COLD ABSCESS (01 ) TUBERCULOMA (01) TB
  Meningitis (01 ) LIVER ABSCESS(01).
• ORAL CANDIDIASIS ( 16)
• DIARRHOEAL ILLNESS (13)
• PCP (03) GM.

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VIRAL LOAD(Copies/ml).

• LOWEST 62,994
• HIGHEST 10,40,000 At the start.
• LOWEST Undetectable.
• HIGHEST 28,004. After one year.(33
  cases) GM.

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CD4 CELL COUNT.

• At the start LOWEST 22 HIGHEST
  299
• After one year LOWEST 252 HIGHEST
  916 GM.

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OPPORTUNISTIC INFECTIONS.

• ORAL CANDIDIASIS (02)
• HERPES ZOSTER (02)
• TUBERCULOSIS (01)
  GM.

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QUALITY OF LIFE.

• Weight gain 5 Kgs to 24 Kgs.
• All are living with their families.
• All are going to their jobs.
  GM.

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TOXICITY PROFILE.

• Anemia 10
• Peripheral neuropathy 04
• Nevirapine rash 04
• Lipodystrophy 01
• Severe giddiness 01
• Nephrolithiasis 02
• GM.

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POST EXPOSURE PROPHYLAXIS.

• 3 INCIDENTS. 02 HOUSE SURGEON 01 STAFF
  NURSE
• 2 INCIDENTS OF NEEDLE STICK INJURY NON-HIV
  PATIENTS. GM.

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PMTCT.

• YEAR No. of
  cases 98 01 99 06 00 15 01
  15 02(May) 04
• Total no. of cases 41 GM.

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THANK YOU.