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HIV

HIV Medication in Malaysia

Infection with Human Immunodefi ciency Virus (HIV) leads to progressive immune destruction as a result
of persistent viral replication. Antiretroviral therapy has been shown to decrease viral replication, increase
CD4+ T-cell count, decrease the frequency of opportunistic infections, improve quality of life and prolong
life expectancy of HIV infected patients.

Although the concept of actual eradication remains speculative at this time, significant progress in
antiretroviral therapy has brought forth the concept of HIV infection as a chronic, manageable condition.
In Malaysia, there are 6 groups of antiretroviral agents that are available:

Antiretroviral Drugs Available in the Ministry of Health, Malaysia

1. Nucleoside Reverse Transcriptase Inhibitors(NRTI)/Nucleotide Reverse Transcriptase
Inhibitors (ntRTI)
a. Zidovudine (AZT) (Retrovir ®)
b. Didanosine buffered(ddI) or enteric coated(ddI EC) (Dinex EC ®)
c. Stavudine (d4T)
d. Lamivudine (3TC)
e. Abacavir (ABC) (Ziagen ®)
f. Tenofovir (TDF) (Tenvir ®)
g. Emtricitabine (FTC) (available as combination with tenofovir)

2. Non Nucleoside Reverse Transcriptase Inhibitor (NNRTI)
a. Nevirapine (NVP) (Hirapine ®)
b. Efavirenz (EFV) (Stocrin ®)
c. Etravirine (Intelence)

3. Protease Inhibitors (PI)
a. Indinavir (IDV) (Crixivan ®)
b. Lopinavir/ritonavir (Kaletra) (Kaletra ®)
c. Saquinavir
d. Atazanavir (ATV)
e. Darunavir (Prezista) (Prezista ®)
f. Ritonavir (Crixivan ®)
g. Nelfi navir (Viracept)

4. Integrase Inhibitors
a. Raltegravir (Isentress)

5. CCR5 Antagonists
a. Maraviroc (Celsentri)

6. Fusion Inhibitor
a. Enfuritide (Fuzeon)

Categories
HIV

Which is the genuine Prep HIV?

We Do NOT SELL PREP Medication

Do you know which is the genuine Prep HIV? Basically a lot of people don’t know how to differentiate which is the “real” and which is the “fake” hiv prep medication.

This is true, i’ve done a survey from Indian suppliers and here are informations i get from them.

Let’s look at the different packaging of each suppliers. Different packaging right?

One of these supplier told me A is selling fake Prep HIV medication. But wait a minute, i google the internet and i found India indeed have cases of fake medication.

Another source https://www.telegraphindia.com/states/bihar/snag-hits-war-on-fake-drugs-197244

That’s is why it’s important to consume the original real HIV PrEP (Pre-Exposure Prophylaxis) to avoid unnecessary side effects, horrible side effects.

If you get the real genuine ones, it doesn’t have any side effects.

How to know who is selling the genuine HIV Prep ones?

We Do NOT SELL PREP Medication

 

Categories
HIV

Early Stage HIV Affects Brain


According to Researchers in Stellenbosch University, they have discovered that the Human Immunodeficiency Virus (HIV), directly affects the brain during the early stages of the infection. Scientists compared those brain of people infected with HIV with those HIV negative while they are performing tasks that trigger specific regions of the brain.

They hope this information will aid future studies about Anti-retroviral treatment as well as interventions that might help to improve the brain function of people living with the virus.

Researcher Doctor Stèfan du Plessis says: “This is something that is very mild in the sense that you would forget where the car keys are, or maybe you forget something on the stove or even just feel mildly depressed or unmotivated – that our research suggests. This is a very minor impact but it’s something that we need to explore further and also treatment options. Our research shows that HIV does have an impact on the brain and that these low-grade cognitive symptoms are likely not just function loss due to patients feeling sick, tired or depressed,

Categories
HIV

Buy Truvada (PrEP) HIV Medication in Malaysia

We have spend 1 month compiling the list. We understand you need it fast, and here we make it easy for you to contact them faster to get PrEP

Buy Prep Malaysia for RM60 (Information with contacts for clinics/agents selling HIV medication and Prep in Malaysia)

Tenvir-em, Isentress, Viraday,….

Contact us 016 982 0330

Location Area is within Kuala Lumpur & Selangor Only

Preview

 

 

 

This few days i have been going through a few pharmacies in Malaysia because a few people ask whether we sell Truvada (a pill combining two AIDS drugs), by people planning to have risky sex.

Unfortunately, it’s not that easy to purchase Truvada online in Malaysia, or where to get prep (Pre-Exposure Prophylaxis (PrEP) or Pills before and after sex can help prevent HIV.

Why so?

Because Malaysian customs prohibit personal import of PrEP.

So where can i buy PreP?

Sorry, we do not sell PREP Medication

Majority of pharmacies do not sell this prep hiv in their outlets.

First, you will need to go to a doctor to ask for ‘prescription’.

Second, you can either queue up at the Government Hospital or Order or Buy from Pharmacy that supplies this “Pil Pencegah HIV”. (Bad news is, you will still need doctors’ prescription)

I believe if you purchase from government hospital it will be cheaper in price if you’re consuming this HIV medication in the long run.

If only this HIV medication is easily available as “pregnancy pill”, i am pretty sure HIV rate will decrease tremendously and sex will be more safer, and more people won’t get infected with this nasty HIV virus. Don’t you guys think so?

If your pharmacy selling Truvada, let me know and i’ll add your shop into this list.

Based on Truvada’s website:

While taking TRUVADA for PrEP:

  • You must continue to use safer sex practices. Just taking TRUVADA for PrEP may not keep you from getting HIV-1.”

Vs Below

In new study, 100 percent of participants taking HIV prevention pill Truvada remained infection-free

“The Centers for Disease Control and Prevention says that PrEP has been shown to reduce the risk of HIV infection by up to 92 percent when taken consistently but is much less effective when taken inconsistently.”

 

So what’s prep pill?

The tablets you can buy are generic medicines. They have the same active ingredients as Truvada, but are manufactured by different companies and have different names. Some of the most widely used are Tenvir-EM (manufactured by Cipla), Ricovir-EM (manufactured by Mylan) and Tenof-EM (manufactured by Hetero). Both versions are approved by the US FDA, which is essential.

**Mylan is the second largest manufacturer of generic medication in the world. Cipla is also a large generic medicine manufacturer, with over one million people living with HIV currently taking their anti-retrovirals worldwide.

It is important to check that the tablet you are buying is a combination pill, containing both tenofovir and emtricitabine. For example, Tenvir-EM contains these two drugs, whereas Tenvir only contains tenofovir and is not recommended for PrEP.

[Make sure that you order a combined pill that contains both TDF and emtricitabine.  For example, you need Tenvir-EM or Ricovir-EM rather than just Tenvir or Ricovir.]

Other generic versions of PrEP with this approval are listed at this page:

https://www.fda.gov/InternationalPrograms/PEPFAR/ucm119231.htm

 

What’s the difference between PrEP and Treatment as Prevention (TasP)?

PrEP is the use of anti-HIV medication by HIV-negative individuals to prevent them from becoming HIV-positive, if exposed. TasP is when an HIV-positive person takes anti-HIV medication and achieves an undetectable viral load (amount of virus in the blood is so low that our monitoring test can’t find it), which makes them essentially un-infectious i.e. unable to transmit HIV to someone else (while preserving and improving their own health and immune system!)

PrEP involves the negative person taking anti-HIV meds, while TasP involves the positive person taking anti-HIV meds. Both approaches are highly effective at preventing HIV transmission.

PrEP uses two anti-HIV drugs combined in one pill, emtricitabine/tenofovir (aka Truvada, Ricovir-EM, Tenvir-EM). HIV treatment may also use these medications, in addition to a third (and sometimes a fourth) agent, or it may use different medications entirely. There are over 30 different medications approved for the treatment of HIV in Canada, while only one combination pill is approved to prevent HIV.

Which is the genuine Prep HIV?

Categories
HIV

4th generation HIV Test Kit

What is the difference?

3rd generation HIV rapid test detects only HIV antibodies in the blood, while 4rd generation HIV rapid test detects HIV antibodies and p24 antigen in the blood.

Why does it want to detect antigen?

Early detection is crucial in when checking for HIV. HIV-1 P24 antigen appears in the blood as early as 14 days after possible infection, by using this to determine whether a person has been infected, detection period is able to cut down to as early as 14 days(or 16 days average)after possible infection.

Is it accurate?

Based on a lab report by Institute of Alboratory Medicine, Cantonal on the new Alere HIV Combo, it detected all positive samples given to it.
The new Alere Combo HIV has been awarded World Health Organization (WHO) prequalification (as of July 2016).

About Alere HIV Combo

The new Alere HIV Combo is an improved 4th generation HIV RDT over the older 4th generation HIV RDT, the Alere Determine HIV-1/2 Ag/Ab Combo. Based on reports, positive samples missed by Alere Determine HIV-1/2 Ag/Ab Combo have been successfully identified by the new Alere HIV Combo.

 

More References:
https://www.journalofclinicalvirology.com/article/S1386-6532(17)30182-8/pdf
https://www.prnewswire.com/news-releases/alere-hiv-combo-test-receives-who-prequalification-300297301.html

 

 

Categories
HIV

The Secret of Their Lives

Most of the children here don’t know they are HIV+. It’s too risky.

Their teachers don’t know. Their neighbors definitely don’t know because if they did, they would have to move again. They’ve moved eight times in ten years, all 28 children. If their teachers knew, they would be isolated and discriminated against or even kicked out of their pricey private school — a school they attend because they don’t have to inform the principal of their disease.

Most of these children don’t even know about the disease in their blood, the disease that killed many of their parents, robbed them of their life in their villages and that was likely passed to them at birth.

They just know that they have strict rules to follow.

Absolutely no fighting. No rough housing. If they get a cut or a scratch, they have their own first aid kit. And they have Mr. Huang.

“The kids are happy now,” Mr. Huang says, his face worn and tired, his spiky, graying hair hinting at his age.

When children pass through the living room of the apartment, they stop to grab his hands or talk to him and his eyes soften as he greets them lovingly.

“They are too young,” Mr. Huang says. “They don’t understand their fate. But as they get older, they will learn. The discrimination will start. They will always have to keep their secret.”

In China, few people understand HIV well, and the disease is highly stigmatized.

Twenty years ago, HIV ravaged entire communities and spread rapidly through both rural and urban areas. Many people died. Today, it is much better controlled, and the government provides a free supply of the daily antiretroviral medication that people living with HIV need to survive. However, public awareness about how HIV is spread remains misunderstood. Schools won’t accept children with HIV, and neither will apartment landlords nor state-run orphanages. Many children with HIV are orphaned or abandoned, and while most have extended relatives, family members are often unable or unwilling to welcome their grandchildren or nieces or nephews with HIV into their homes.

“Sometimes in the village, the adults will steal the children’s medication and eat it,” Holt’s vice president of China programs says, her face in an animated smile at a cute and bouncy 2-year-old boy whose life is about to change. His adoptive family in the United States is coming after Chinese New Year to take him home. “The villagers think the medicine is a miracle drug — that if they take it, they will be safe from all diseases.”

It’s fear, misunderstanding and stigma that land children here — an HIV group home run by Mr. Huang and supported almost entirely by donors in the United States.

Children live in one of two narrow six-story apartments located across a thin community courtyard from each other. The older kids live in one apartment together, with a homework and craft room in the garage, a shared living space, a computer lab with three new donor-purchased computers, and several bedrooms separated for boys and girls with six bunks each. The second apartment is identical, but more tailored for toddlers and babies. Pictures of each child line the stairways in hand-made frames. They smile in candid shots of them riding bikes or playing in the park. One room features a wall covered in photos of children with their American families. The other wall features the kids who are still waiting. There are eight children waiting now — children who are young enough to be matched with an American family and very nearly cleared for adoption.

“The sooner and younger we can find these kids a home, the better,” Mr. Huang says. “There is no life for them in China. It will be a life of pain. They will never have a family here.”

But at the group home, the kids seem happy. Unlike kids we meet at other group homes for children, these kids don’t seem starved for attention. In fact, they barely acknowledge the presence of two American visitors.

Here, children with HIV receive high-quality and adoring care. Caregivers are hard to find, and in almost every case, they came to the group home by word of mouth. Some have HIV themselves, but nobody talks about who does and doesn’t have the disease. However, the secret they keep together seems to bring them all closer. The caregivers and kids seem extremely close-knit. Their care is excellent and the home environment as loving as possible.

Recently, one Holt donor — moved by a waiting child story about a girl who just wanted to learn how to ride a bike — decided to instead send nine bikes for the children in care at this group home. The children are almost constantly riding them around the sprawling apartment complex. Some girls are reading books, while another is building small model homes out of toothpicks.

The kids are having a barbeque this evening. In one of the apartment’s garages, they’ve opened the door and they are blasting Chinese pop music on a cell phone. The kids are all sitting on little step stools around three charcoal grills. On a nearby table, an assortment of hot dogs, and tofu, chicken and duck kabobs are waiting to be grilled.

It’s a warm, fun day right before New Year’s celebrations begin, and the kids are giggling and laughing like the most normal, healthy kids in the world.

But, the reality is, every child here has already experienced tremendous loss and pain. They’ve already lost their family — sometimes because they died, sometimes because of stigma. For one 7-year-old girl, that loss is still fairly new. She’s been here less than a year. Many children who live here started life in a rural, lush mountainside village and now live in bustling Nanning, a city of more than 6 million. Some may already understand why they are here now, but most don’t.

When they turn 12 years old, if they haven’t already been matched with a family, Mr. Huang will talk to the kids about their disease.

At any time, Mr. Huang fears that a neighbor might learn their secret, and they will all have to move again — somewhere far enough away in the city that they are unlikely to run into someone who knows them.

The cost to care for each child at this group home is very high. Mr. Huang must provide everything, from rent and food and clothes to their private school fees, which costs more than 8,000 rmb per year, or more than $1,000 per child.

In addition, these kids need expensive medical care for the many health needs associated with HIV, like pneumonia or treatment for hepatitis. While antiretroviral medicines are covered by the government, no other associated health care costs are covered.

And, Mr. Huang has to pay caregivers who cook for the kids, help them with homework, take them to school and basically create the most home-like environment possible.

Sometimes, the government will ask Mr. Huang to take in a child who has HIV from a nearby orphanage. For those kids, Mr. Huang will receive some financial assistance per month — about 1,000 rmb, the same amount allocated for all kids in orphanage care, about $150 per month.

But not all kids here are referred by orphanages. Some come directly from the countryside or from parents wishing to relinquish them. For these kids, Mr. Huang receives no government help.

Now, Mr. Huang depends on the kindness of Holt donors to keep these children safe. Holt donors are heroes to children in the HIV group homes, because they provide everything the children need to have relatively normal lives. Donors pay rent for the home they live in, provide each child new clothes, school supplies and bedding, ensure every child has caregivers, regular meals and consistent medical care. Without compassionate, kind and loving donors, these kids would have no where to go, no one to care for them and no hope for their future.

Mr. Huang started working with people who were HIV+ in China many years ago, after the first medicines for those with the disease became available. Mr. Huang’s job was to distribute medicine to those who needed it. Through his work, he was connected with Doctors Without Borders, a nonprofit organization that dispatches doctors to remotes and underserved regions around the world, both to provide care and to spread medical knowledge.

Under Doctors Without Borders, Mr. Huang connected physicians with HIV+ patients. In turn, Mr. Huang learned a lot about the disease, much more than ever before. He learned that antiretrovirals could virtually prevent the disease from spreading if they were taken properly and regularly. He learned that common misconceptions about HIV in China were simply untrue: the disease can’t be spread by physical touch, saliva or through the air.

In fact, HIV is a puny disease — generally spread through sexual contact, childbirth, the exchange of blood or sharing of needles. He also learned how many people in rural villages continue to contract the virus today.

Twenty years ago, many people became infected with HIV through blood transfusions, since blood was rarely screened for disease. Now, however, it’s mostly contracted through intravenous drug use.

In the Golden Triangle, opioids like heroin are still common. And drug pushers rely on rural customers to maintain their profit margins. In areas where knowledge about drug use is low, drug traffickers will come to a village and say they want to throw a big party for the people. During the bash, they’ll introduce their product, hoping to trick people into trying the drug for the first time and get people hooked. They don’t care how addiction can destroy families or how disease can impact entire communities. They certainly don’t stop to care about the children left behind.

These kids will face discrimination in every aspect of their lives — from the schools they are able to attend to the jobs they can hold. People will literally avoid sharing their air out of fear.

In their rooms, children’s bedding is folded neatly at the ends of their bunks. Some have pillows or stuffed animals. Their toothbrushes and clothes are arranged in neat little rows.

By all means, it’s a beautiful, homey space — not at all the stereotype of an orphanage. It’s bright, clean and feels like a normal home. But as caregivers dip in and out of rooms, tidying up toys and delivering stacks of clothes many of them share the same sentiments as Mr. Huang. While they are happy these children have a safe place to live, they hope that eventually every child living here will leave — not to enter Chinese society on their own, but to a home in the United States.

At least for now, one slender, 20-something young male caregiver tells us, there is no future here for these kids.

“China is no place to have HIV,” he says. “Maybe one day that will change, but until it does, life here will be hard.”

Categories
HIV

What’s your CD4 and Viral Load

Quick guide to test results

CD4 counts
l Between 500 and 1200 = usual for people who don’t have HIV
l Above 350 = HIV treatment isn’t usually recommended
l Below 350 = HIV treatment is recommended
lBelow 200 = there is a higher risk of illnesses and infections, so HIV treatment is recommended

Your doctor may give your CD4 results as a percentage
l Above 29% = similar to a CD4 count of above 500
l Below 14% = similar to a CD4 count of below 200

Viral load
l Between 100,000 and 1 million = high
l Below 10,000 = for people with HIV not on treatment, this is low
l Below 50 = known as an ‘undetectable’ viral load. The aim of HIV treatment
is to have an undetectable viral load.

(infograph source: NAM aidsmap www.aidsmap.com)

Categories
HIV

14 KEY CONCEPTS FOR HIV

  1. Pathogen — A biological agent that causes disease or illness to its host organism. The most common pathogens to affect humans are bacteria (e.g. salmonella), viruses (e.g. influenza), protozoa (e.g. malaria), fungi (e.g. yeast), and parasites (e.g. tapeworm).
  2. Virus — Unlike bacteria, a virus cannot reproduce on its own. It must get inside a host cell and hijack its systems to do that. Some viruses can exist inside the body in a dormant state where it reproduces at a low level causing few clinical symptoms. The same virus can switch on to an active state marked by aggressive reproduction in the order of billions of virus copies per day. While many drugs exist to kill bacteria (antibiotics), very few antiviral drugs are known.
  3. HIV — The acronym for human immunodeficiency virus. Like influenza or hepatitis, it is a virus that infects humans. HIV is exceptional in three ways: (1) it mainly targets certain cells of the immune system, (2) it is lethal to the host cell and (3) it mutates very rapidly.
  4. HIV types subtypes and CRFs — HIV is not just one virus, it can be divided into two major types, HIV-1 and HIV-2. HIV-1 viruses may be further divided into four groups, M, N, O and P. The HIV-1 group M viruses are the most common ones, and have caused more than 90% of all known HIV infections. Group M can be further subdivided into subtypes and circulating recombinant forms (CRFs). There are nine group M subtypes and more than 50 CRFs known today. As the virus continues to spread and mutate, new subtypes and CRFs will appear.
  5. Immune system — The human immune system has three main lines of defense: physical, innate and adaptive. Physical barriers like skin and mucous membranes keep pathogens from entering the body in the first place. They are the first line of defense. If a pathogen breaches these barriers then the innate immune system provides an immediate but nonspecific response such as inflammation and fever. If the intruder survives the innate response then the adaptive system will start to study the pathogen over the course of the infection to find its weak point and eliminate it. It will use immunological memory to identify this pathogen should it return and mount faster and stronger attacks against it.
  6. T-cells — Many different types of cells are involved in the immune response. One group of cells that is vital to the immune system are called T-cells. T-cells are a type of lymphocyte. Lymphocytes are a type of white blood cell. There are several different types of T-cells, each playing a different role in the body’s immune response.
  7. CD4 cells — A type of T-cell, also known as “Helper T-cells.” Helper T-cells regulate both the innate and adaptive immune responses and help determine which types of immune responses the body will make to a particular pathogen. These cells do not kill infected cells or pathogens directly. Instead, they are the brains of the operation, controlling the immune response by directing other cells to perform these tasks. If the CD4 cells were lost, the body would be completely vulnerable because the other systems of cells wouldn’t know what to do. HIV mainly targets CD4 cells. The virus gets inside the cell and uses it to produce more viruses before destroying its host. When HIV is active, an exponential effect takes place. It is only a matter of time before the CD4 population is rendered to such a low level that they are completely ineffectual. HIV infection leads to low levels of CD4 cells through three main mechanisms: 1) the virus killing its host cell directly; 2) increased rates of self-destruction (apoptosis) in infected cells; and 3) killing of infected CD4 cells by immune cells (CD8 lymphocytes) that recognize and kill infected cells.
  8. CD4 count — Measures the number of CD4 T-cells in the blood to gauge the strength of the immune system in the presence of HIV infection. CD4 has been the primary indicator doctors have used to monitor the overall condition of the patient’s immune system. The test is usually simple to perform and relatively cheap to administer which has lead to its widespread use. The test has two main limitations with regard to HIV management. There are many factors, other than HIV activity, that affect the amount of CD4 T-cells present in the blood at any given time. So the doctor cannot be sure if the CD4 value is caused by HIV activity or other factors. Second, it can take up to 6 months for HIV activity to be reflected in the CD4 count.
  9. Viral load — While CD4 measures the body’s reaction to the virus, viral load measures the number of virus particles in the blood directly. Measurements are usually expressed in number of RNA copies per milliliter of blood. A low viral load is usually between 200 to 500 copies, depending on the type of test used. This result indicates that HIV is not actively reproducing and that the immediate risk of disease progression is low because the HIV is in its dormant state. A high viral load can be anywhere from 5,000 to 10,000 copies and can range as high as one million or more. This means the virus is active and the disease will progress. The viral load test is a more reliable indicator of viral activity than the CD4 test and a more reliable indicator of disease progression. Historically, the test has had one main drawback: While a mainstay of treatment in developed nations, it has been more difficult to perform in resource-limited settings — the delicate test equipment requires laboratory conditions that are uncommon in resourcelimited clinics.
  10. AIDS — When HIV has diminished a person’s CD4 T-Cell count to less than 200 cells/µl (bringing the proportion of CD4 T-Cells to other lymphocytes below 14%) then the person’s immune system is considered to be incapable of mounting a viable defense against invading pathogens. HIV-infected people in this position are classified medically as having acquired immunodeficiency syndrome (AIDS). AIDS is the end game of HIV infection. Just as the virus kills the host CD4 cell, the disease kills the host organism by leaving it entirely vulnerable to the millions of pathogens that assail the body each day. Once the HIV patient gets to this level of immunological vulnerability, they will typically die of opportunistic infections or tumors within 9.2 months if left untreated.
  11. ARVs — An acronym that stands for antiretroviral drugs. These are the drugs used to manage HIV infection. While there is no cure for HIV, these drugs have been successful in slowing the disease’s progression by interfering with the virus at different stages in its development. There are over twenty ARVs on the market today, but only a handful of these are available to patients in developing nations. In most of these countries, there are two main combinations of drugs given to patients, referred to as first line and second line treatment. The drugs used in second line treatment are around eight times more expensive than first line treatment — an important consideration in resource-limited environments. Today, the prevailing logic is to start first line ARV treatment as soon as HIV becomes active, which can be several years from the time of infection. To avoid creating and spreading resistant strains of HIV, it is further suggested to stop first line ARV treatment as soon as the patient stops responding to it and switch to second line. Eventually this too will fail as the virus develops resistance to second line treatment. For most patients in resource-limited settings, once this point is reached no further treatment is available to hold HIV activity at bay.
  12. Resistance — The life cycle of HIV is about a day and a half. During that time it will enter a cell, change the host cell DNA, create copies of itself and release those copies into the blood stream to infect other cells. When the HIV is making copies of itself, it lacks a common proofreading enzyme. This encourages copying mistakes. These mistakes are called mutations. The combination of a short life cycle and high error rate causes HIV to mutate very rapidly. This results in a great genetic variance among HIV. Most of the copying errors will convey no advantage to the mutant. But some errors will result in advantages that make the mutant insensitive to the current ARVs used. This will give that mutant a survival advantage allowing it to give rise to a generation of resistant viruses.
  13. Vaccine — A vaccine is created from compounds that can help the body recognize and destroy pathogens such as bacteria or viruses. The vaccine stimulates an immune system response to the threat. No vaccine for HIV is available today, but there are several ongoing studies around the world working to find one. The possibility of ever producing a vaccine is questioned by many due to HIV’s high mutation rate.
  14. Transmission — Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and viruses within infected immune cells. The three major routes of transmission are unprotected sexual intercourse, contaminated needles and transmission from an infected mother to her baby at birth, or through breast milk.

Versi Melayu

  1. Pathogen – Ejen biologi yang menyebabkan penyakit atau penyakit kepada organisma tuan rumah. Patogen yang paling biasa untuk menjejaskan manusia adalah bakteria (mis. Salmonella), virus (mis. Influenza), protozoa (mis. Malaria), kulat (contohnya yis), dan parasit (cth.
  2. Virus – Tidak seperti bakteria, virus tidak dapat membiak sendiri. Ia mesti masuk ke dalam sel tuan rumah dan merampas sistemnya untuk melakukannya. Sesetengah virus boleh wujud di dalam badan dalam keadaan tidak aktif di mana ia menghasilkan semula pada tahap yang rendah yang menyebabkan sedikit gejala klinikal. Virus yang sama boleh bertukar kepada keadaan aktif yang ditandai dengan pembiakan yang agresif dalam susunan berbilion virus virus setiap hari. Walaupun banyak ubat-ubatan wujud untuk membunuh bakteria (antibiotik), ubat-ubatan antiviral sangat sedikit diketahui.
  3. HIV – Akronim untuk virus immunodeficiency manusia. Seperti selesema atau hepatitis, ia adalah virus yang menjangkiti manusia. HIV adalah luar biasa dalam tiga cara: (1) ia mensasarkan terutamanya sel-sel sistem imun tertentu, (2) ia mematikan kepada sel tuan rumah dan (3) ia bermutasi sangat cepat.
  4. Jenis subtipe HIV dan CRF – HIV bukan hanya satu virus, ia boleh dibahagikan kepada dua jenis utama, HIV-1 dan HIV-2. Virus HIV-1 mungkin dibahagikan kepada empat kumpulan, M, N, O dan P. Virus kumpulan HIV-1 M adalah yang paling biasa, dan telah menyebabkan lebih daripada 90% daripada semua jangkitan HIV yang diketahui. Kumpulan M boleh dibahagikan lagi kepada subtipe dan bentuk rekombinan beredar (CRF). Terdapat sembilan subjek M kumpulan dan lebih daripada 50 CRF yang diketahui hari ini. Oleh kerana virus terus menyebar dan bermutasi, subtipe baru dan CRF akan muncul.
  5. Sistem imun – Sistem imun manusia mempunyai tiga pertahanan utama: fizikal, bawaan dan penyesuaian. Halangan fizikal seperti membran kulit dan mukus menyimpan patogen dari memasuki tubuh di tempat pertama. Mereka adalah barisan pertahanan pertama. Sekiranya patogen melanggar halangan ini maka sistem imun yang semula jadi memberikan tindak balas segera tetapi tidak seperti keradangan dan demam. Sekiranya penceroboh itu bertahan dengan tindak balas semula jadi maka sistem penyesuaian akan mula mengkaji patogen sepanjang jangkitan untuk mencari titik lemah dan menghapuskannya. Ia akan menggunakan memori imunologi untuk mengenal pasti patogen ini apabila ia kembali dan melancarkan serangan yang lebih cepat dan lebih kuat terhadapnya.
  6. T-sel – Banyak jenis sel yang terlibat dalam tindak balas imun. Satu kumpulan sel yang penting untuk sistem imun dipanggil sel T. T-sel adalah sejenis limfosit. Limfosit adalah sejenis sel darah putih. Terdapat beberapa jenis sel T yang berbeza, masing-masing memainkan peranan yang berbeza dalam tindak balas imun badan.
  7. Sel CD4 – Jenis sel T, juga dikenali sebagai “Sel T Helper.” Helper sel T mengatur kedua-dua tindak balas imun yang semula jadi dan adaptif dan membantu menentukan jenis tindak balas imun yang akan dibuat oleh tubuh ke patogen tertentu. Sel-sel ini tidak membunuh sel-sel yang dijangkiti atau patogen secara langsung. Sebaliknya, mereka adalah otak operasi, mengawal tindak balas imun dengan mengarahkan sel lain untuk melaksanakan tugas-tugas ini. Sekiranya sel-sel CD4 hilang, tubuh akan menjadi lemah kerana sel-sel sistem lain tidak akan tahu apa yang perlu dilakukan. HIV terutamanya mensasarkan sel CD4. Virus ini masuk ke dalam sel dan menggunakannya untuk menghasilkan lebih banyak virus sebelum memusnahkan tuan rumahnya. Apabila HIV aktif, kesan eksponen berlaku. Ia hanya satu masa sahaja sebelum penduduk CD4 diberikan kepada tahap yang rendah bahawa mereka benar-benar tidak berkesan. Infeksi HIV membawa kepada tahap sel CD4 yang rendah melalui tiga mekanisme utama: 1) virus membunuh sel hosnya secara langsung; 2) peningkatan kadar pemusnahan diri (apoptosis) dalam sel yang dijangkiti; Dan 3) pembunuhan sel-sel CD4 yang dijangkiti oleh sel imun (limfosit CD8) yang mengiktiraf dan membunuh sel yang dijangkiti.
  8. Kiraan CD4 – Mengukur jumlah sel T CD4 dalam darah untuk mengukur kekuatan sistem imun dengan adanya jangkitan HIV. CD4 telah menjadi petunjuk utama doktor telah digunakan untuk memantau keadaan keseluruhan sistem imun pesakit. Ujian biasanya mudah dilakukan dan agak murah untuk mentadbir yang telah menyebabkan kegunaannya meluas. Ujian ini mempunyai dua batasan utama yang berkaitan dengan pengurusan HIV. Terdapat banyak faktor, selain aktiviti HIV, yang menjejaskan jumlah sel T CD4 yang hadir dalam darah pada suatu masa tertentu. Oleh itu, doktor tidak dapat memastikan jika nilai CD4 disebabkan oleh aktiviti HIV atau faktor lain. Kedua, boleh mengambil masa sehingga 6 bulan untuk aktiviti HIV dapat dilihat dalam kiraan CD4.
  9. Beban Viral – Walaupun CD4 mengukur tindak balas badan terhadap virus, beban virus mengukur jumlah zarah virus dalam darah secara langsung. Pengukuran biasanya dinyatakan dalam bilangan salinan RNA bagi setiap mililiter darah. Virus viral yang rendah biasanya antara 200 hingga 500 naskhah, bergantung kepada jenis ujian yang digunakan. Hasil ini menunjukkan bahawa HIV tidak secara aktif mengeluarkan semula dan bahawa risiko segera perkembangan penyakit adalah rendah kerana HIV berada dalam keadaan tidak aktif. Beban virus yang tinggi boleh berada di mana saja dari 5,000 hingga 10,000 salinan dan boleh berkisar setinggi satu juta atau lebih. Ini bermakna virus itu aktif dan penyakit itu akan berkembang. Ujian viral load adalah penunjuk yang lebih dipercayai aktiviti viral daripada ujian CD4 dan penunjuk penyakit yang lebih dipercayai. Secara bersejarah, ujian itu mempunyai satu kelemahan utama: Walaupun satu-satunya rawatan dalam negara maju, ia lebih sukar dilakukan dalam tetapan terhad sumber – peralatan uji halus memerlukan syarat-syarat makmal yang jarang berlaku di klinik yang di resourcelimited.
  10. AIDS – Apabila HIV telah menurunkan jumlah CD4 T-Cell seseorang kurang daripada 200 sel / μl (menjadikan perkadaran CD4 T-Sel kepada limfosit lain di bawah 14%) maka sistem imun seseorang dianggap tidak mampu meningkatkan ketahanan Pertahanan terhadap patogen yang menyerang. Orang yang dijangkiti HIV dalam kedudukan ini diklasifikasi secara medis kerana telah memperoleh sindrom imunodefisiensi (AIDS). AIDS adalah permainan akhir jangkitan HIV. Sama seperti virus membunuh sel CD4 tuan rumah, penyakit ini menghilangkan organisma tuan rumah dengan meninggalkannya sepenuhnya terdedah kepada berjuta-juta patogen yang menyerang badan setiap hari. Apabila pesakit HIV mendapat tahap ketahanan imunologi ini, mereka biasanya akan mati akibat jangkitan ostektomi atau tumor dalam masa 9.2 bulan jika tidak dirawat.
  11. ARV – Suatu akronim yang bermaksud ubat antiretroviral. Ini adalah ubat-ubatan yang digunakan untuk menguruskan jangkitan HIV. Walaupun tiada ubat untuk HIV, ubat-ubatan ini telah berjaya memperlahankan perkembangan penyakit ini dengan mengganggu virus pada tahap yang berbeza dalam perkembangannya. Terdapat lebih daripada dua puluh ARV di pasaran hari ini, tetapi hanya segelintir ini tersedia untuk pesakit di negara-negara membangun. Di kebanyakan negara-negara ini, terdapat dua kombinasi utama ubat yang diberikan kepada pesakit, yang dirujuk sebagai rawatan baris pertama dan kedua. Ubat-ubatan yang digunakan dalam rawatan baris kedua adalah sekitar lapan kali lebih mahal daripada rawatan baris pertama – pertimbangan penting dalam persekitaran terhad sumber. Hari ini, logik yang berlaku adalah untuk memulakan rawatan ARV pertama sebaik sahaja HIV menjadi aktif, yang boleh beberapa tahun dari masa jangkitan. Untuk mengelakkan pencabulan dan penyebaran strain HIV, lebih baik disarankan untuk menghentikan rawatan ARV pertama sebaik sahaja pesakit berhenti bertindak balas dan beralih ke baris kedua. Akhirnya ini juga akan gagal kerana virus ini akan menimbulkan ketahanan terhadap rawatan baris kedua. Bagi kebanyakan pesakit dalam tetapan terhad sumber, sebaik sahaja titik ini dijangkakan tiada rawatan lanjut boleh didapati untuk memegang aktiviti HIV.
  12. Rintangan – Siklus hidup HIV adalah kira-kira satu setengah hari. Pada masa itu ia akan memasuki sel, menukar DNA sel tuan rumah, membuat salinan sendiri dan melepaskan salinan tersebut ke dalam aliran darah untuk menjangkiti sel-sel lain. Apabila HIV membuat salinannya sendiri, ia tidak mempunyai enzim pembacaan bukti biasa. Ini menggalakkan menyalin kesilapan. Kesalahan ini dipanggil mutasi. Gabungan kitaran hayat pendek dan kadar kesilapan yang tinggi menyebabkan HIV bermutasi sangat cepat. Ini menyebabkan variasi genetik yang hebat di kalangan HIV. Kebanyakan kesilapan penyalinan tidak akan memberi kelebihan kepada mutan tersebut. Tetapi beberapa kesalahan akan menghasilkan kelebihan yang menjadikan mutan tidak sensitif kepada ARV semasa yang digunakan. Ini akan memberikan mutan itu kelebihan kelangsungan hidup yang membolehkannya menimbulkan generasi virus yang tahan.
  13. Vaksin – Vaksin dibuat dari sebatian yang boleh membantu tubuh mengenali dan memusnahkan patogen seperti bakteria atau virus. Vaksin merangsang respon sistem imun terhadap ancaman. Tiada vaksin untuk HIV boleh didapati hari ini, tetapi terdapat beberapa kajian berterusan di seluruh dunia yang bekerja untuk mencari satu. Kemungkinan menghasilkan vaksin akan dipersoalkan oleh ramai kerana kadar mutasi tinggi HIV.
  14. Transmisi – Jangkitan dengan HIV berlaku melalui pemindahan darah, air mani, cairan vagina, pra-ejakulasi, atau susu ibu. Dalam cecair badan ini, HIV hadir sebagai kedua-dua zarah virus percuma dan virus dalam sel imun yang dijangkiti. Tiga laluan penularan utama adalah hubungan seks tanpa perlindungan, jarum yang tercemar dan penghantaran dari ibu yang dijangkiti kepada bayinya pada saat lahir, atau melalui susu ibu.

 

Categories
HIV

Early detection prevent AIDS death toll

Below graph showing the number of people who die from AIDS have reduce dramatically by half since 2005. This is because early detection and early antiviral HIV medications helps to prevent HIV from blooming into AIDS, thus preventing death.

Categories
HIV

3rd generation HIV Test vs 4th generation HIV Test

A lot of people do not quite know what’s the difference between 3rd generation vs 4th generation HIV Test Kit.

How HIV tests work

Third generation HIV tests (ELISA antibody)

When you become infected with HIV, your body will start to produce specific antibodies (proteins that attach to the virus to try and destroy it). An HIV antibody test looks for these antibodies in your blood, saliva or urine. If these antibodies are found, it means you are infected with HIV. This test is only accurate after three months, because this is how long it takes your body to produce enough antibodies for it to show up in a test.

However, First Response HIV Test Kit says you can test after 3 to 4 weeks of exposure. While in my own opinion, to be on the safer side, do a retest after 3 months, 6th month and 1 year later. You will get a lot of opinions from internet though.

 

**90 days is the usual safety window period for HIV antibodies test (which checks ONLY for antibodies and NOT for P24 antigen).

 

Fourth generation HIV tests (ELISA combined antigen/antibody)

Fourth generation tests look for HIV antibodies, but also for something called p24 antigens. The p24 antigens are part of HIV itself, so you have a lot of these in your blood in the first few weeks after infection. This is why you are most infectious to others in this period too. Fourth generation tests can detect (p24 HIV viral protein) from 11 days to 1 month after you have been infected.

[We all already know that the HIV antibody test becomes quite reliable at 4 weeks and as good as conclusive at 6 weeks. Although most health authorities still recommend a 3 months window period. So putting these 2 tests together gives you a very powerful tool to diagnose HIV infection in as little as 3 weeks. When the level of P24 antigen peaks in the blood gives us maximum accuracy.]

Note: The 4th generation HIV test is also known as DUO or COMBO because it looks for hiv 1/2 antibodies, and also the p24 antigen. The p24 antigen is only present in the first two or three weeks. Once enough antibodies start to be produced, the p24 antigen disappears.

**P24 antigen is usually detectable by 28 days, the time when antibodies may still be not detectable. So DUO will check for both antibodies and P24 Antigen and hence will help in possible earlier diagnosis of HIV at the time when antigen will be detectable, but not the antibodies. Once the antibodies start producing, P24 antigen will usually start disappearing and again as DUO will also check for antibodies so it will also be again helpful that time. That is why it is also called Sandwich test.

 

HIV test What do they test for? What is the window period? How long for the results? Reliability
Third generation antibody tests HIV antibodies 3 months  Between 1 to 7 days High
Fourth generation antibody & P24 antigen tests HIV antibodies and p24 viral proteins (antigens) 11 days – 1 month Between a few days and a few weeks High

 So What’s the difference between these 3rd and 4th generation?

The median detection time was demonstrated to be 7 days earlier (range 0 to 20 days) compared to 3rd generation enzyme immunoassay antibody tests. Meaning you don’t have to wait too long to get the results. As for the pricing, 4th generation will be more expensive compare to 3rd generation.

**Fourth generation tests have been widely used in Europe for many years, although a handful of clinics, still use third generation despite current guidelines.

About HIV Seroconversion

(…HIV seroconversion is the time in which a person first develops antibodies for HIV. They will not yet test positive on an HIV antibody test. The word just means that your sero status is converting from being HIV antibody negative to HIV antibody positive)

Research shows that 97 percent of people will have produced enough antibodies to accurately test positive within three months. Sometimes, it takes people as long as six months to test positive, but this is rare.

Because everyone’s window period is different — and because the tests are different — it’s recommended that you test before the three month mark, you get re-tested for HIV after three months if you got a negative test result at first. Or, people who are exposed to HIV frequently may prefer to get tested with increased regularly — say, every few months.

 

What about “delayed Seroconversion” which is rare case?…

The CDC website states

” Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days).Therefore, if the initial negative HIV test was conducted within the first 3 months after possible exposure, repeat testing should be considered >3 months after the exposure occurred to account for the possibility of a false-negative result. Ninety-seven percent of persons will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV”

 

What doctors says about this “rare delayed Seroconversion”, what causes this to happen…

It is extremely rare for a person to take any longer then 6 months to develop detectable antibodies.

In case a individuals have conditions that result in late production of antibodies – testing after 12 weeks or after 6 months is advised. Most of these conditions are rare genetic diseases – and do present much earlier in life and individuals will always be sick with respiratory and diarrheal infections throughout their life.

Such disorders include :

1. Disorders of antibody production: Hypogammaglobulinemia ; X-linked agammaglobulinemia ; IgA deficiency ; IgG deficiency ; IgM deficiency ; Hyper IgM syndrome ; Wiskott-Aldrich syndrome • Hyper-IgE syndrome

2. Common variable immunodeficiency

3. Cell-mediated (T) : Di George’s syndrome ; Purine nucleoside phosphorylase deficiency
Severe combined (B+T) x-linked: X-SCID ; Adenosine deaminase deficiency

4. Conditions resulting in : Leukopenia, Lymphocytopenia , Idiopathic CD4+ lymphocytopenia

5. Complement deficiency

“Your tests doe at 4 months post exposure, might be conclusive.”

 

So What DO YOU THINK? How often should you re-test HIV Test Kit?