Antiretroviral are

medications for the

treatment of infection by
retroviruses, primarily HIV
In Indonesia
Data from Kementerian Kesehatan(Kemenkes),2010

as much as 1.206 cases of AIDS
1978 - 30 June 2010 21.770 cases
Ratio Male : Female 3:1


WHY increasing.
1.Lack of concern from the community
2.More doctors are well-trained to detect AIDS
3.The HIV that attacks immune system can be spread.

HIGHEST CASES

Jakarta, Jawa Barat, Jawa Timur, Papua, Bali, Sulawesi
Selatan, Sumatera Utara, Riau, Sumatera Barat
Nucleoside Reverse Transcriptase Inhibitor (NRTI)
-emtricitabine (FTC),

Non-nucleoside Reverse Transcriptase Inhibitor
(NNRTI) -capravine (CPV)

Protease Inhibitors (PIs)
- ritonovir (RNV)
- tipranavir (TPV)
- atazanavir (ATV)

Fusion Inhibitor
- enfurtivide (T-20)

Intergrase inhibitors

Maturation inhibitors


STRATEGIES
Once-Daily
Regimens
Antiretrovitral
Treatment
Simplification
Double NNRTI
Regimens
Nucleoside Analogue
- Sparing Regimens
Proactive
Antiretroviral
Switching
Structured
Treatment
Interruptions
WHAT IS HAART ????
Antiretroviral are medications
for the treatment of infection
by retroviruses, primarily HIV.
When several such drugs,
typically three or four, are
taken in combination, the
approach is known as highly
active antiretroviral therapy,
or HAART
ARV attacks the HIV
(Different Style & Approaches)

ARV does not kill/destroy HIV virus, but only delays the
replication of the HIV virus (Delays progression of HIV)

ARV generally used in combination with 3 or more ARV
belonging to >1 generation (Combination Therapy @ ART)

ART works better than single ARV
(prevents resistance to occur)




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NRTI
NNRTI
Inhibit genetic material of HIV
which is used to make DNA from
RNA
NUCLEOSIDE REVERSE
TRANSCRIPTASE INHIBITOR
(NRTI)

3TC (lamivudine)
Abacavir (ABC)
AZT (ZDV, zidovudine)
d4T (stavudine)
ddI (didanosine)
Emtricitabine (FTC)
Tenofovir
(TDF; analog nukleotide)
Nucleoside Reverse
Transcriptase Inhibitor
Mutation
Mutation at position
41 , 215 causes
resistance of
zidovudine



NN
NON-NUCLEOSIDE REVERSE
TRANSCRIPTASE INHIBITOR
(NNRTI)

Delavirdine (DLV)
Efavirenz (EFV)
Etravirine (ETV)
Nevirapine (NVP)
Nonnucleoside Reverse
Transcriptase Inhibitor
Mutation
Mutation at position
106 causes
resistance of
nevirapine
Disables active site of enzyme
&inhibits further replication

PI
PROTEASE
INHIBITOR
Atazanavir (ATV)
Darunavir (DRV)
Fosamprenavir (FPV)
Indinavir (IDV)
Lopinavir (LPV)
Nelfinavir (NFV)
Ritonavir (RTV)
Saquinavir (SQV)
Tipranavir (TPV)
Protease Inhibitor
Mutation

Mutation at position
54 causes resistance
of indinavir, ritonavir,
amprenavir, and
saquinavir

Entry Inhibitor inhibits insertion of HIV virus
into cell

Enfuvirtide (T-20)
Maraviroc (MVC)


Integrase Inhibitor (INI) prevent genetic code of
HIV from combining
with genetic code of cell.
Raltegravir (RGV)



SUMMARY


- Increases life span
- Prevents MTCT
- Reduce HIV viral load in blood
- Increases CD4+ cell count
- Reduce HIV viral replication in body
- Slow progression of HIV
- HAART = 2 RTI + I PI
- Given when CD4 below 350.
(High chances for opportunistic infection)