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The currently available HIV antiviral drugs can improve the
quality of life for a HIV positive person tremendously. It
also helps someone to stay well much longer than they would
without these drugs. The drugs slow down the reproduction
and progression of HIV.
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Antiviral drugs are part of a treatment
regime called HAART, which helps prolong & improve quality
of life - it is not a Cure
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Some people find it easy to make up their mind about treatment.
For others, making a decision may take considerable time.
It is important that you get a balanced view about treatment
issue. Understanding the issue will help you to make the right
decision.
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- CD4 Cell
The main cell HIV attacks is called T-cell or CD4 cell.
The CD4 cell plays an important part in our immune system.
It helps the body to fight illness. Any damage to the CD4
cells can have a serious effect on the immune system. HIV
is attracted to our CD4 cell because it has an identical
knob as the HIV. HIV attaches itself to this knob and gains
entry into our CD4 cells. Once it gains entry HIV produces
more copies of itself in our CD4 cells. Once matured, HIV
exits and kills our CD4 cells. HIV will continue this process
and attack more CD4 cells. As this process continues, there
would be fewer CD4 cells available to help the immune system
to fight illnesses.
- CD4 Test
The CD4 test measures the number of CD4 cells in your blood.
The more CD4cell you have, the stronger is your immune system.
The stronger the immune system, the body can fight illnesses.
A low CD4 count does not mean that you will certainly become
ill, but you will become susceptible to falling ill.
A normal person (a person without HIV) would have a CD4
count of 500 - 1500. Some HIV positive people also have
a normal level of CD4 count but this might not be for long
as HIV in their body will eventually reduce the number of
CD4 cells.
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| That's why treatment is very important
for HIV-positive people. Treatment helps HIV positive people
to maintain a good level of CD4 count. CD4 count is used as
indicator whether or not to initiate HAART. |
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| In Malaysia, CD4 test is available in all
major government hospital treating HIV-positive people. |
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| Viral load refers to the amount of HIV
in your blood. A viral load test indicates how much HIV there
is in the blood. The higher the level of HIV in your blood,
the faster your CD4 cells are being destroyed by HIV. The lower
the viral load, the stronger is your immune system. |
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| Therefore, a high viral load usually indicates
a low CD4 count. A low viral load usually indicates a high CD4
count. |
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| A viral load test can provide information
about the progression of the HIV infection and how best the
treatment is working for you. |
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| After sometime being on treatment, viral
load is usually lowered. The aim of treatment is to bring viral
load to 'undetectable'/ good level, i.e. less than 50 copies.
This means that treatment is working really well for you. |
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High CD4 count, low viral load
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High viral load, low CD4 count
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| Before your doctor initiate HAART, there
are few factors that will be considered : |
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- What is your CD4 cell count ?
- What is your viral load count?
- How is your general health
(such as symptoms of HIV infection/recurrent health problem
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| In Malaysia, we use the WHO guidelines
is initiating HAART. |
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| After considering all the test results
with your doctor, you can find out from your doctor about the
various HIV drugs and combination available., and which are
suitable, including the positive and negatives effects the drugs
have. |
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| Besides being ready medically, you should
only start treatment when you are really ready. You need to
be very committed, since following a drug regiment can be quite
demanding. Once treatment is started it is for life. |
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Treatment is a life long commitment
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| Your doctor should be able to tell you
the best combination for your CD4 count and viral load. It is
hard to tell which is the best combination, since a combination
that suits one person might not suit another. |
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| It is important that the combination of
drugs works medically to |
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- Suppress the virus, higher count of CD4 + lower level
of viral load
- Prolong life and improve quality of life
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| What is also important is that the drug
can be taken on time everyday. It is essential to consider the
restriction and limitation the drugs might have on your life
style. |
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| Here are some of issues that need to be
considered |
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- How many pills?
- How many times a day ?
- Any food restrictions?
- What are possible side effects?
- Are there other medicine or complimentary therapy that
cannot be used when you are on HAART ?
- The cost of HAART
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| The cost of HAART in Malaysia, have reduced
substantially. 4 years ago, the cost of treatment was as high
as RM1,500. |
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| The government now offers 2-free drugs,
a patient on HAART only need to purchase the other drug. The
cost of treatment could vary from RM66 - RM 300 per month, depending
on the combination they are on. |
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