Precautions for antiviral therapy

  1.Antiretroviral therapy is a lifelong treatment and cannot be stopped at will once it is started, except in special cases (such as severe side effects) when the doctor agrees to stop the medication.  2, antiretroviral treatment compliance is very important, multiple missed doses will cause viral resistance, resulting in treatment failure, but also lead to no drugs available, because the domestic AIDS drug variety is limited.  3.Commonly used antiviral drugs: (1) Tenofovir: take one tablet a day, the time required to take the drug is relatively fixed (can be before and after the difference of 2 hours or less). The main adverse reactions are kidney damage and osteoporosis, but the proportion of occurrence is very low. After timely detection and discontinuation of the drug can generally be fully recovered.  (2), lamivudine: take one tablet a day, the time should be relatively fixed (can be before and after the difference of 2 hours or less). This drug has fewer adverse reactions.  (3), Efavirenz (trade name: Stonin): also one tablet a day, taken at night before bedtime on an empty stomach. The most common side effects are neurological side effects, such as dizziness, excessive dreams, nightmares, insomnia, depressed mood and even depression. Therefore, patients with a history of depression should not take it. Others can cause skin rash, liver damage, and hyperlipidemia. Dizziness is the most common and usually disappears after a few days or a week or two of taking the drug. Because food, especially high-fat meals, can increase the concentration of the drug and lead to increased side effects, it is recommended to take it on an empty stomach (at least 2 hours after a meal) and not too fatty for dinner. Eating light bread, crackers or fruit before taking the drug will not increase side effects. The drug may cause fetal malformation if taken during the first 3 months of pregnancy, so women who are planning to get pregnant or within 3 months of pregnancy should avoid taking the drug if possible, and women who take the drug should also use good contraception.  The combination of the above 3 drugs is more commonly used in the program, once a day, all in one tablet, taken at the same time at bedtime, very convenient.  (4), zidovudine: the method of taking the drug is twice a day, once a piece, before and after meals can be taken. Common adverse reactions are nausea, vomiting, decreased appetite, headache, muscle and joint pain, decreased white blood cells, anemia, etc.. Long-term use of the drug can also lead to subcutaneous fat atrophy, causing facial and limb wasting, etc.  (5), Lopinavir/Ritonavir (trade name: Crestor): It is a compound preparation made of two drugs, two tablets twice a day, both before and after meals. The main adverse reactions are nausea, vomiting, loss of appetite, diarrhea, etc., and also cause an increase in blood lipids and blood sugar.  (6), nevirapine: the dosing method is special, one tablet per day for the first two weeks. If there are no serious side effects, after two weeks, it will be changed to twice a day, one tablet each time, and can be taken before and after meals. The main adverse reactions are nausea, vomiting, rash, liver damage, etc. If a rash appears, you can take anti-allergy medicine by yourself when the rash is mild, but you need to go to the hospital if the rash is aggravated.  4. Interaction between AIDS drugs and other drugs: Some AIDS drugs such as efavirenz, nevirapine and klebsiella are metabolized by the liver, which will interact with other drugs that are metabolized by the liver such as rifampin, clarithromycin and statin lipid-lowering drugs, resulting in lower or higher concentrations of these drugs. Decreased concentration will reduce the efficacy, and increased concentration will increase the side effects. It is okay to take drugs that are usually used to treat cold and fever, diarrhea, sore throat, etc. However, if the less commonly used drugs, you need to be careful. There are too many varieties of such drugs, probably hundreds of them, to list them all here. You can take a look at the drug instructions, where there is a section on “drug interactions”, which will list the drug interactions in detail.  5.Follow up after antiviral treatment: In order to judge the efficacy and monitor the side effects, you need to follow up regularly after antiviral treatment according to the doctor’s requirements.  (1) Half a month, one month, two months, three months after treatment, and every three months thereafter. Each time, the main tests are liver and kidney function, blood routine, urine routine, blood glucose, blood lipids, electrolytes, etc.  (2) CD4 was tested every 3 months in the first year of treatment, and every 6 months from the second year onwards. (3) Viral load was tested 6 months of treatment, and every year from the second year onwards, and free of charge for patients taking free national antiviral drugs.