Understanding HIV FINDING ANSWERS AND HELP - EASILY AND INDIVIDUALLY

Transcription

1 Understanding FINDING ANSWERS AND HELP - EASILY AND INDIVIDUALLY 1

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3 LIVING POSITIVELY Fortunately the times are over when the diagnosis -positive was synonymous with a significantly shortened life expectancy. With continuous treatment the infection is now classified as a chronic disease. Today most people infected with have a high quality of life and a good perspective of being largely able to live a normal life. The diagnosis changes the entire life. Families, partnerships and friendships are often placed under severe strain, usually based on fears and lack of knowledge. Regular medical examinations or if necessary also medicines become permanently necessary. This brochure explains what actually is and what happens to the body when it has become infected. It is intended to help you to understand the disease better, as this is the basis for a positive life. 3

4 Understanding : WHAT HAPPENS IN MY BODY WHEN I AM -POSITIVE? The immune system becomes weakened HI viruses attack the protective shield consisting of defence cells 4

5 Important: is not the same as AIDS. -positive = infected with the human immune defi ciency virus, but not yet fallen ill. AIDS = Acquired Immune Defi ciency Syndrome: Immune defence is severely weakened the body is no longer able to defend itself against life-threatening diseases (e.g. pneumonia). CD8 CD8 Under normal circumstances our immune system (amongst others or CD8 cells) is able to defend against pathogenic organisms so that we remain healthy. If our immune system is weakened through then other pathogenic organisms are able to multiply without resistance and we become ill. Bacteria, viruses, funguses, parasites CD8 cells/cd8 cells 5

6 Understanding : HOW IS TRANSMITTED? High transmission risk Drugs: No mutual use of syringes Unprotected anal sexual intercourse: Penetration only with condom Unprotected vaginal sexual intercourse: A condom provides additional protection during sex Unprotected oral intercourse: Only with condom/no sperm or menstrual blood in the mouth Important: can only be transmitted from one person to another through the following body fluids: Blood, sperm, vaginal secretion, secretion in the rectum, breast milk. Pregnancy: Strict medical control/no forgetting of the tablet intake Breastfeeding period: No breastfeeding 6

7 No transmission risk Kissing Shaking hands Via breathable air or droplets/ with coughing or sneezing Mutual use of tableware and cutlery Sauna/swimming pool Through medical measures at visit doctor/dentist/in hospital, if usual hygiene regulations are observed. Via insect stings Use of common/public toilets 7

8 Understanding : WHAT IS THE GOAL OF THE THERAPY? Today s treatment possibilities are diverse and have continuously improved over the past years. However, a infection is not able to be cured. Through a timely, lifelong therapy with modern drugs the outbreak of AIDS can in most cases be prevented. Without treatment: Infection -positive AIDS Death (approx years) With treatment: Infection -positive (> 10 years, ideally lifelong) 8

9 The goal of a lifelong therapy: To protect the defence cells in the body against the HI viruses and to thereby prevent the outbreak of AIDS. Medicinal products establish a protective shield against the HI viruses Protective shield reduces the number of HI viruses. Immune defence remains intact infected person many HI viruses few HI viruses 9

10 Understanding : WHAT DO CELLS AND VIRUS LOAD (VL) MEAN? In many cases the number of viruses (Viral Load = VL) decreases so substantially thanks to therapy that they are no longer able to be detected with today s blood tests. A no longer detectable viral load does not mean that one is no longer -positive. The disease how ever is then under good control and the transmission risk for the partner is much smaller. Regular blood tests are important for all individuals who are -positive. The tests measure how many immune cells ( cells) and how many viruses (VL) are contained in a drop of blood. 10

11 Immune cells low Viruses VL high No medication intake Before medication intake: few immune cells, many viruses Protective shield is weakened Start of therapy Immune cells increase Viruses VL decrease Progression under optimum therapy With medication intake: more immune cells, less viruses Protective shield improves Regular intake of the tablets Immune cells high Viruses VL low Therapy success With regular medication intake: many immune cells, few viruses Protective shield is intact 11

12 Understanding : WHAT IS THE PROCEDURE AFTER A POSITIVE TEST? Important: A positive test does not in all cases mean the immediate start of an therapy. The regular check-up of the health status by the doctor is however necessary. The doctor then together with the patient decides when the medication should be started. Typical therapy procedure with infection Determination of the cells and the Viral Load (VL)?! Positive test Regular check-ups with the doctor Therapy preparation Attending to a healthy way of living: balanced, healthy nutrition suffi cient exercise abstaining from cigarettes/alcohol/drugs preventing excessive weight monitor cells/ viral load (VL) discuss start of therapy with the doctor clarify questions 12

13 Start of the combination therapy Warning! Can negatively infl uence the therapy. grapefruit other medicines alcohol drugs Therapy Therapy success Irregular or forgotten intake HI viruses become resistant to one/several active substances Change of therapy But: Selection of medication is limited; The replacement can not be repeated endlessly With regular intake of the tablets (always at the same time every day) there is a good life expectancy. In normal cases AIDS can be prevented. Important to note 13

14 Understanding : HOW DO DRUGS ACT IN THE BODY? Important: An infection is usually treated with a combination therapy consisting of several antiretroviral drugs, the so-called highly active antiretroviral therapy (HAART). This consists of the simultaneous application of usually three active substances from different classes of medicinal drug. So the viruses are combated at different locations and they are pushed back. The viral load becomes reduced. Where does the medication attack the HI viruses? Structure HI virus Infiltration Protease Integrase Virus RNA Reverse transkriptase Enzymes (metabolism catalysers) The HI virus belongs to the retroviruses. It can only multiply if it infiltrates into a human cell. HI viruses penetrate into the immune cells ( cells). So-called entry inhibitors (EI) prevent the penetration of the HI virus into the cell. 14

15 Copy of the virus RNA Incorporation of viral genetic material RT Virus RNA Virus DNA Human DNA Virus DNA With the help of the enzyme Reverse Transcriptase (RT) the virus RNA is transformed to DNA (copied). This is the prerequisite for the incorporation into the human DNA. Nucleoside/Nucleotide analogues (NRTI), and non nucleoside analogues (NNRTI) inhibit the Reverse Transcriptase and thereby the transformation of RNA into DNA. The DNA copy of the viral genetic material is incorporated into the human DNA. Integrase inhibitors (II) prevent this incorporation. Production virus particle Release of new HI viruses VP The cell starts to produce virus material, which is subsequently broken down into the right building blocks through the viruses own enzyme Viral Protease (VP). Protease inhibitors (PI) prevent this process. It is no longer possible to produce functional viruses. Without medication the infected cells continuously produce new infectious HI viruses. These are transported out of the cell and attack further cells. 15

16 Understanding : WHICH FREQUENT SIDE-EFFECTS CAN OCCUR WITH AN THERAPY? Short-term side-effects Usually temporary at the beginning of a therapy Important: Most side-effects occur at the beginning of the therapy and often subside again by themselves. You should nevertheless be observant and report the side-effects to your doctor. In certain cases alleviating medication can be used. Otherwise the therapy will require being changed. A Head Headache Fatigue B Psyche Sleep disorders Nightmares Depression C Stomach/ intestines Diarrhoea Nausea Vomiting D Skin Rashes 16

17 Long-term side-effects Only become apparent over the course of a therapy E Eyes Yellow colouring F Liver/Kidneys/Bones Undergo regular check-up examinations G Stomach Fat deposits (lipodystrophy) H Blood Have cholesterol/ blood glucose levels regularly checked 17

18 Understanding : WHY IS THE REGULAR INTAKE OF THE MEDICATION SO IMPORTANT? If the medication intake is forgotten or missed out then resistances can form and the medication can become ineffective. Example: Intake morning and evening night morning during the day evening Important for all drugs: exact dosing correct time of intake Amount of active substance in the body decreases Repeated medication intake necessary The next dose needs to be taken before the last dose has been completely excreted. Amount of active substance in the body decreases 18

19 What happens if I do not take the medication regularly? Irregular medication intake HI viruses increase and become resistant Disease progresses. Virus spreads. Danger of infection increases. New medication combination is required The selection of medication combinations is limited. Medication becomes ineffective A new medication combination may possibly have more side-effects and/or be less convenient to take. 19

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22 Understanding : MYMICROMACRO FROM MACRO TO MICRO There is still a lot of uncertainty and need for information regarding and AIDS. The available information on the topic of is increasing day by day a macrocosm of facts and opinions. Anyone looking for answers on the Internet is confronted with a vast wealth of information. Thereby often only a fraction is relevant for the specific person the individual microcosm. With the web portal MyMicroMacro Janssen has undergone a commitment to people with and their next of kin, and to improving their living and care situation. Here affected or interested individuals can quickly and simply receive answers for their very specific personal questions. MyMicroMacro is as micro or as macro and as individual as the individual needs. As special as every life situation, every disease progression and every therapy! 22

23 Understanding : FINDING ANSWERS AND HELP INDIVIDUALLY AND COMPLETELY PERSONALLY The direct way to obtain the searched information After anonymous entry of some data about the personal life situation the information offer at is sorted and becomes more specific. From the greater to the smaller. From generalities to what is personal and specific. In your complete personal interests The intelligent content filter increasingly adapts the page step-by-step to the interest profile of the visitor: For example different content is provided for an -positive homosexual man than for a heterosexual woman, who after a risk contact is fearful about a possible infection. This is what individuality looks like The more detailed the data in the input filter, at the same time the more refined the offering and information becomes for the user. 23

24 Finding answers and help individually and completely personally My content with individual information on and AIDS Specific questions and answers in the expert s forum Address finder with specialised therapists, pharmacies and information centres Important dates related to /AIDS in Event Calender Janssen-Cilag GmbH Johnson & Johnson Platz Neuss Germany 24 Mat.-Nr