Sustiva is an antiviral drug belonging to non-nucleoside inhibitors of the reverse transcriptase of the immunodeficiency virus. The active substance is Efavirenz. The drug affects the enzyme of the virus, with the help of which it divides. This enzyme is called HIV 1 reverse transcriptase, which does not influence HIV 2 reverse transcriptase. Efavirenz does not cure HIV infection but prevents HIV-infected cells from multiplying in the human body. The drug has a pronounced synergism against nucleoside inhibitors; that is, it enhances their effect. Therefore, a joint prescription is recommended.
Sustiva is an oral medication. Absorption takes place in the small intestine and partially in the stomach. The drug binds to plasma proteins by 99%. It is metabolized in the liver due to the cytochrome P 450 system. The period of maximum concentration is 4-5 hours. Reception in a dose of 200 mg for 10 days promotes the accumulation of the drug from 22% to 42%. The half-life is up to 72 hours, with 10 days of admission, it is shortened. It is excreted in metabolites by the kidneys up to 34%, bile up to 61%.
Sustiva is used in complex therapy for the treatment of HIV-infected people of type 1. The use is allowed in the age category starting from 3 years and weighing from 13 kg.
It is mandatory admission in combination with drugs belonging to nucleoside reverse transcriptase inhibitors. It is prescribed to be taken 2 hours before meals or before bedtime. Food intake increases the concentration of the medication, which can lead to an increase in the occurrence of side symptoms. For better tolerability of the drug and to reduce undesirable effects, it is best to take the medication at bedtime.
Crushing or reducing the daily dose is not recommended.
Do not take with grapefruit or any other citrus.
Treatment for adults consists of taking 600 mg of Sustiva once a day. The medicine is suitable for children, and the dosage depends on the child's weight but not less than 13kg. Nowadays, no studies have been conducted if the bodyweight is below. A child's dosage starts from 200 mg once a day. If the child's weight is over 40 kg, it is recommended to use an adult dose of 600 mg once a day.
According to the studies, while taking Sustiva 600 mg 2 times a day, neurological symptoms were observed: dizziness, drowsiness, gait disturbance, rocking, attention disorder, etc.
In a similar situation, treatment is symptomatic and careful monitoring of the patient and blood test is recommended. There are no antidotes. Gastric lavage is effective for the first 2 hours. Hemodialysis is not effective due to the high binding to albumin and other blood proteins.
The use of activated carbon is acceptable.
Sustiva is contraindicated in severe cases of liver damage, specifically class C according to the Child-Pugh classification; if the child is under 3 years old, or the weight is less than 13 kg, and increased reaction to the medication, or it's component in the composition. And the simultaneous reception with terfenadine, astemizole, midazolam, triazolam, cisapride is also not recommended.
Sufficient studies when taking the drug in pregnant and lactating women have not been conducted. In animal research, the medication had a teratogenic effect and penetrated the breast milk of rats.
When using the medication, strictly barrier contraception is necessary. Studies have not been carried out when taken together with combined oral contraceptives (COCs), a decrease in concentration and a weakening of the effect is possible.
In conducted researches, the following have been detected: nausea, stool disorder, insomnia, sleep disturbances, headaches, and dizziness, hence fatigue, and impaired concentration and movement. Allergic reactions, such as erythema multiforme and Stevens-Johnson syndrome, are rare. Children most often had a maculopapular rash, rarely with a severe course with blisters and ulcers.
When taken simultaneously with the drugs indicated in the contraindications, there is competition for the general enzyme of CYP3A4 metabolism, due to which life-threatening conditions can occur, such as respiratory arrest, severe arrhythmias, and prolonged sedation.
Sustiva reduces the concentration of antifungal treatments, which reduces the effectiveness of medications, the risk of resistance in the treatment increases.
The medication reduces the effectiveness of protease inhibitors such as atazanavir, indinavir, amprenavir, which makes both medications ineffective. Therefore, the risk of resistance increases.
Sustiva is not used as a fundamental and only method against HIV infection. In treatment with only one Efivir (Efavirenz), resistance to the drug develops rapidly and becomes ineffective. It should start in combination with those medications that have not yet been used in treatment. Pay attention when selecting combination therapy for cross-resistance of drugs, which is observed when taken together with some protease inhibitors.
Joint intake with alcohol and psychotropic substances is not recommended since an additive effect is possible.
Control over blood cholesterol and liver enzymes. In the case of an increase in liver transaminases by 5 times or more, consider discontinuing the medication. Compare the risks of hepatotoxicity and the benefits of taking the drug.
If a severe skin reaction with ulcers, the medication should be terminated. If the rash is minor, more often, it disappears on the 8th day of treatment. It can be enhanced by taking corticosteroids or antihistamines.
HIV (human immunodeficiency virus) is a chronic infectious disease characterized by a slowly progressive course that later leads to AIDS (acquired immunodeficiency syndrome). An infection completely disables the human immune system by reducing the level of CD4 + lymphocytes.
HIV infection is scary but opportunistic, i.e., concomitant diseases in a person with immunodeficiency syndrome. HIV is an infection, the reproduction of which occurs only inside a person. The virus replication cells integrate into the human genome, are tropic to the immune system's lymphoid cells, and can cause serious diseases, up to leukemia and lymphoma.
There are 2 types of viruses - HIV 1, which is more common, and HIV 2, which is typical for certain regions of West Africa. They have no difference in the formation. The differences are only at the level of the virulence of the virus, the degree of infectiousness, and some of the nuances of treatment. HIV 1 is more lethal, more contagious, and depletes a person's immune system more quickly. Virulence is the ability of a particular virus strain to infect a specific organism.
• Breastfeeding a baby from an infected woman; • Unprotected intercourse; • Through the blood; • After transplantation from an infected donor
When a person becomes infected, he/she does not experience any symptoms. A week later, a flu-like state may develop - fever, chills, loose stools, swollen lymph nodes, skin rashes are possible.
• Stage 1. The virus does not reveal for several years - this stage is called latent. • Stage 2. Characterized by a sharp weight loss of less than 10%, frequent respiratory infections, an itchy rash, the appearance of seborrheic dermatitis, shingles, and oral ulcers. • Stage 3. Weight loss is already more than 10%, the appearance of diarrhea for a month, fever, which can persist, candida stomatitis, up to necrotizing ulcers. The appearance of pulmonary tuberculosis, hairy leukoplakia of the mouth, severe infectious diseases such as pneumonia, meningitis, purulent myositis, empyema, etc. Decreases are indicative of blood - anemia, thrombocytopenia, neutropenia. • Stage 4. Complete exhaustion, up to cachexia, pneumocystis pneumonia, candidiasis of the lower respiratory tract - trachea, bronchi, lungs. Development of extrapulmonary tuberculosis, Kaposi's sarcoma, toxoplasmosis, cytomegalovirus infection, etc. Damage to the brain, heart, kidneys, the development of sepsis.
The virus gradually destroys the immune system, decreasing the body's resistance to infections. Resistance decreases to such an extent that a person begins to suffer from diseases that are not terrible for an ordinary person because immunity easily fights with them. For the transition from the initial stage to stage 3-4 - acquired immunodeficiency syndrome, tens of years pass.
Preventive measures include: • Protected sexual intercourse, reducing the number of sexual partners, finding out the partner's HIV status before entering an intimate relationship, barrier contraception; • Eliminate the use of drugs and alcohol; • Cover wounds with plaster, wash hands, clean, use latex gloves; • Use of sterile medical instruments.
It should be noted that HIV is NOT transmitted through kisses, hugs, household items, swimming pools, showers, saunas, insect bites, handshakes.
Complications and consequences of HIV infection are the symptoms of the development of acquired immunodeficiency syndrome (AIDS). Immunodeficiency leads to severe related diseases, the appearance of diseases from opportunistic microorganisms, and, ultimately, death.
Opportunistic diseases leading to the death of the patient:
Toxoplasmosis is a parasitic disease leading to damage to the nervous system, eyes, internal organs, and mental retardation.
Cytomegalovirus infection - fever, damage to the respiratory and gastrointestinal tract, decreased visual acuity.
Fungal infection of the whole organism:
• Pneumocystis pneumonia - a lesion of the lungs with a yeast fungus. The development of respiratory and heart failure, leading to death in 50% of cases; • Damage to the brain and membranes; • Damage to the oral cavity.
The vascular tumor that affects the skin, internal organs, and mucous membranes are called Kaposi's sarcoma.
Generalized herpes - the skin becomes covered with blisters with a liquid content with the involvement of internal organs.
Toxic hematite - effects on the liver of drugs, chemicals, alcohol. Over time, it leads to cirrhosis of the liver.
Extrapulmonary tuberculosis and pulmonary tuberculosis, appearing for the first time.
The disease is chronic, and it is impossible to recover from it. However, modern antiretroviral therapy helps to make life easier for the patient and slow down the disease.
The history of HIV infection, like any other, has not yet registered a single case of treatment leading to recovery due to traditional methods. Not a panacea - teas and decoctions, the use of mustard plasters. If the virus is confirmed, specialist advice and antiretroviral therapy are required. If the viral load is high, the medications must be used simultaneously, which reduces the risk of rapid death.
Of the traditional methods for strengthening the immune system, several methods have been passed down to nowadays.
• Tincture of calendula. In the morning, on an empty stomach 2 drops, during the day 1 drop every hour and 2 more before bedtime. Break after every 3 days of taking. The course is half a year. • St. John's wort decoction. 100 grams of St. John's wort per liter of boiling water, boil for an hour. Strain, add sea buckthorn oil. Let stand for 2 days. Drink half a glass 4 times a day. • A decoction of Chinese cucumber. Grind, bring to a boil. Add nettle leaves, simmer for 5 minutes. Strain. Add chamomile. For 2 days, keep in a warm place. Consume half a glass after meals.
You can never entirely trust traditional methods and not use modern medicine because viruses are changing, becoming resistant. Even if we consider the fact that drugs are being developed according to the latest research and observations of viruses, the deliberate methods remain unchanged. Therefore, what helped our grandparents with viral infections will not necessarily help us, no matter how they assure us of this. But the most valuable thing is spent - time.
It is necessary to understand that any alternative treatment methods can help and harm simply because they are not suitable for a particular person. Therefore, you should always consult a doctor, and even more so in such serious diseases. Even if we consider the same course of the disease extremely rare, each person always needs an individual approach.
Without antiretroviral therapy, the average life expectancy is 8-10 years. If AIDS is already diagnosed, the terms are reduced by 1-1.5 years. In the regions that introduced high antiretroviral therapy, mortality from this pathology decreased to 85-99%. Such scattered results are associated only with the nuances of the subtype of the virus, the stage of the disease, the patient's adherence to treatment. After the introduction of therapy, the life expectancy for HIV + without AIDS is from 20 to 50 years, in cases with AIDS from 10 to 40 years.
Life expectancy varies and depends on the following reasons:
• Resistance - the resistance of the virus to therapy; • New treatments and the development of new drugs.
An HIV-infected person who is adherent to treatment can live for decades without developing acquired immunodeficiency syndrome and die for a completely different reason.The main cause of death in AIDS is opportunistic tuberculosis.
Every year more than 70 thousand children are left without parents who have left because of this pathology. With such statistics, the forecast has grown to 40 thousand by 2025.
Therefore, in the moments of the subsequent pleasures and self-satisfaction of personal needs with the following new companion, consider whether it is worth such consequences.