Dispensation of anti-retroviral by Community Based Organisations

By James Achanyi-Fontem, camlink News

The first module of the training was on the generalities of HIV/AIDs and the concept of logistic. Paticipans defined what HIV means, the different types of drugs used to fight the virus and what a treatment protocole means. A video was projected to show how the virus affects the body and its consequencies. It was noted that the treatment with the anti-retroviral only reduces the effect of the virus in the body and does not eliminate it. It clears the viral load in the blood, especially when it is non-detectable. The anti-retroviral re-establishes and preserve the immunological functions, which is the CD4 in the blood stream. This helps to improve the well-being of the patient and reduces mortality.

The standard anti-retroviral protocol is the mono or bi-therapy tablets for treatment and these results to rapid recovery by increasing resistance to the multiplication of the effects of the virus in the body. The treatment is composed of the following: INTI + 1 INNTI : or any of the four combinations associated Zidovudine + Lamivudine+ Efavirenz Zidovudine + Lamivudine + Névirapine Ténofovir + Lamivudine + Efavirenz Ténofovir + Lamivudine + Névirapine The above drugs have principal side effects which need to be taken into consideration: ZIDOVUDINE (AZT) may lead to severe anemia Anémie, neutropénie, nausées, vomissements, myalgie, fatigue, insomnie, hyper pigmentation (ongles, langue), gynécomastie. In this case it is advised to contrôl NFS for research of the cause of anémia and/or neutropénie. LAMIVUDINE (3TC) may lead to Céphalées/insomnie, diarrhée, with some rare cases of neuropathie périphérique. In this case, toleration is generally recommended. Using TENOFOVIR (TDF) may lead to Diarrhées, nausées, flatulences, tubulopathie proximale, néphrotoxicité SD de Fanconi and it is advised to evalulate the patient ; renal function,,and adapte the posology with créatinine < 50ml/mn. NEVIRAPINE (NVP) will lead to rashes cutané that could evaluate towards a syndrome of Stevens-Johnson et Lyell. reactions very frequent in women with CD4 totaling >250 cell/mm3 and >400 cell/mm3 in men. With this, the following effects have been recorded and it is advised to always administer half the dose in the first six months. In case of effects, within 7 days,return patient to clinic of observation of CD4 count. Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaacd4 count is generally 250 for women and 400 for men. EFAVIRENZ (EFV) will show the following effects: T neuropsychiques roubles,dowsiness, insomnie, somnolence, hallucination, possible toxicity cutanée et hépatique. In this case, take medicine to reduce effects in pregnant women and patient suffering from antécédents psychiatriques and convulsions. When in difficulties, contact your care-giver and doctor.