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6:00 am: TB meds
8:00 am: arv: zido/lami

Yung CD4 ko nun 22... but I started ARV therapy only after 3 weeks...

The new pozzie at twitter got his CD4 count, it was 224... and he is asking if that meant he should be on ARV...?

Una, ano ba ang ARV drug o Antiretroviral drug...?


Currently wala pang gamot sa HIV/AIDS... Pero, there are drugs that can slow down the progress of HIV and thus slow down the damage to your immune system... at ito nga yung antiretrovirals (ARV's). ARV's slow down the reproduction rate of HIV. Once the virus is reproducing at a slower rate, it is less able to harm your immune system. If your immune system is functioning properly, your body is less likely to become sick. 

Antiretroviral combination therapy defends against resistance by suppressing HIV replication as much as possible.


Combinations of antiretrovirals create multiple obstacles to HIV replication to keep the number of offspring low and reduce the possibility of a superior mutation. If a mutation that conveys resistance to one of the drugs being taken arises, the other drugs continue to suppress reproduction of that mutation. With rare exceptions, no individual antiretroviral drug has been demonstrated to suppress an HIV infection for long; these agents must be taken in combinations in order to have a lasting effect. As a result, the standard of care is to use combinations of antiretroviral drugs. Combinations usually comprise two nucleoside-analogue RTIs and one non-nucleoside-analogue RTI or protease inhibitor. This three drug combination is commonly known as a triple cocktail.

Di naman natin kailangan malaman, tipong pampagulo lang kasi pero  for better understanding on how it works... ito yung classes ng ARV:

• Entry inhibitors (or fusion inhibitors) interfere with binding, fusion and entry of HIV-1 to the host cell by blocking one of several targets. Maraviroc and enfuvirtide are the two currently available agents in this class.
• CCR5 receptor antagonists are the first antiretroviral drugs which do not target the virus directly. Instead, they bind to the CCR5 receptor on the surface of the T-Cell and block viral attachment to the cell. Most strains of HIV attach to T-Cells using the CCR5 receptor. If HIV cannot attach to the cell, it cannot gain entry to replicate.
• Non-Nucleoside and nucleotide reverse transcriptase inhibitors (NNRTI) inhibit reverse transcription by being incorporated into the newly synthesized viral DNA strand as a faulty nucleotide. This causes a chemical reaction resulting in DNA chain termination.
• Nucleoside reverse transcriptase inhibitors (NRTI) mimic nucleotides and inhibit reverse transcriptase directly by binding to the enzymes polymerase site and interfering with its function.
• Protease inhibitors (PIs) target viral assembly by inhibiting the activity of protease, an enzyme used by HIV to cleave nascent proteins for the final assembly of new virions.
• Integrase inhibitors inhibit the enzyme integrase, which is responsible for integration of viral DNA into the DNA of the infected cell. There are several integrase inhibitors currently under clinical trial, and raltegravir became the first to receive FDA approval in October 2007.
• Maturation inhibitors inhibit the last step in gag processing in which the viral capsid polyprotein is cleaved, thereby blocking the conversion of the polyprotein into the mature capsid protein (p24). Because these viral particles have a defective core, the virions released consist mainly of non-infectious particles. Alpha interferon is a currently available agent in this class. Two additional inhibitors under investigation are bevirimat and Vivecon.

So, yun, without ARV, the virus would just keep replicating, attacking your CD4, killing it... the lesser CD4 count you have, the weaker your immune system, thus rendering your body more susceptible to infections...

Normal CD4 count would be 600 to 1200... pagnagpaCD4 count ka at lumabas na less ng 200, AIDS na... I was Stage 4 AIDS with my 22 CD4... and must be on ARV alredy... now, 200 to 500 CD4 count, medyo debatable... depende kasi sa doctor, sa recommendation niya... tipong should they wait for the CD4 count to drop to critical level o mabuti na yung habang maaga agapan ng wag bumaba...

Problem is ARV requires commitment to adhere and that ARV side effect should also be taken into consideration... 

8:00 pm: arv: zido/lami, efav. Prophylaxis: Cotrimoxazole