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http://manila.lpu.edu.ph/about.php?test=essay-changer essay changer 4. Recommend appropriate first-line pharmacotherapy interventions for patients with hiv infection. 5. Recommend appropriate second-line pharmacotherapy interventions for patients with hiv infection. 6. Describe the components of a monitoring plan to assess effectiveness and adverse effects of pharmacotherapy for hiv infection. 7. Educate patients about the disease state, appropriate lifestyle modifications, and drug therapy required for effective treatment. Introduction h uman immunodeficiency virus type is the major cause of aids. Hiv primarily targets cd4+ lymphocytes, which are critical to proper immune system function. If left untreated, patients experience a prolonged asymptomatic period followed by rapid, progressive immunodeficiency. Therefore, most complications experienced by patients with aids involve opportunistic infections and cancers. Aids occurs when a patient with hiv has a cd4 cell count below 200 cells/mm3 (200 × 106/l), a cd4 cell percentage of total lymphocytes less than 14% (0. 14), or one of the centers for disease control (cdc) aids defining conditions. 1 epidemiology and etiology hiv is primarily transmitted by sexual contact, by contact with blood or blood products, and from mother to child during gestation, delivery, or breast-feeding. Although the global incidence of hiv has fallen 33% since 2001, hiv prevalence has increased, largely due to life-extending antiretroviral therapy. Combination antiretroviral therapy (cart) has increased both the length and quality of life for hiv-infected patients, however, to date, there are no treatments that eradicate hiv from the body. 2 as of 2012, approximately 35. 3 million people are infected with hiv worldwide. Approximately 70% of these cases are in sub-saharan africa, with a prevalence of approximately 5%. Central asia, eastern europe, north africa, and the middle east are also seeing rapidly rising infection rates. 2 in 2012 alone, approximately 1. 6 million people worldwide died from aids and 2. 3 million people were newly infected with hiv. Most of these infections were acquired through heterosexual transmission. As of december 2012, women accounted for 45.

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http://www.cs.odu.edu/~iat/papers/?autumn=homework-help-in-visual-basic-net homework help in visual basic net The use of antiretrovirals with unique mechanisms of action like enfuvirtide (fusion inhibitor) or maraviroc (ccr5 antagonist) may be warranted as salvage therapy. If patients fail therapy with resistance to only one drug, one or two active agents may be substituted for this drug while retaining the remaining drugs in the regimen. If patients fail therapy with resistance to more than one drug, changing classes of antiretrovirals and/or adding new active drugs is warranted. New nrtis should be selected from resistance testing. If this is not available, the assumption should be made that resistance has developed to all nrtis used in the failing regimen. In general, hiv that is resistant solely to lamivudine and/or emtricitabine will be susceptible to other nrtis. If hiv develops resistance solely to tenofovir, then it may have reduced susceptibility to didanosine and likely abacavir but should remain susceptible to zidovudine, stavudine, lamivudine, and emtricitabine. Cross-resistance occurs between zidovudine and stavudine. 8 if a patient appears to fail an antiretroviral regimen without detectable hiv resistance, adherence should be investigated, and the adequacy of the plasma hiv rna concentration in the resistance sample confirmed. Options include continuing the current regimen or starting a new regimen and repeating the resistance test 2 to 4 weeks after adherence is verified. The availability of new potent antiretrovirals has resulted in a decrease in the number of patients with multiclass drug resistance. Although rare, such patients have very limited treatment options, making it impossible to construct a regimen with two to three active agents.

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