NAPWA

AntiretroviralA medication or other substance which is active against retroviruses such as HIV. drugs:

Drugs which suppress the replication of retroviruses, such as HIV. They are called antiviral drugs in this resource. Other terms you may hear include HIV drugs, anti-HIV drugs, Highly Active Antiretroviral Therapy (HAART), and sometimes Antiretroviral Therapy or Combination TherapyHighly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together..

Candidiasis (Candida):

A bacterial fungal infection usually Candida albicans , which can infect the gut, throat or mouth.

CarbohydrateAny of a number of compounds, including sugars and starches, which are important as sources of energy. Along with fat and protein, one of the main constituents of food. foods:

Include bread/bread products, cereals, pasta, rice, fruit, starchy vegetables (potato, sweet potato, corn, legumes), sugary foods and drinks.

CholesterolAn essential component of cell membranes and nerve fibre insulation, cholesterol is important for the metabolism and transport of fatty acids and the production of hormones and Vitamin D. Cholesterol is manufactured by the liver, and is also present in certain foods. High blood cholesterol levels have been linked to heart disease and may be a side effect of some anti-HIV medications.:

An essential blood fatA fat. produced in the liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood., which is only required in small amounts by the body. Excess cholesterol increases the risk of heart disease.

Complementary therapiesA broad range of healing philosophies, approaches, and therapies that Western (conventional) medicine does not commonly use to promote well-being or treat health conditions. Examples include acupuncture, herbs, Traditional Chinese Medicine, etc.:

The various systems of healing that are not regarded as medical treatment by the medical profession. Some medical professionals may support the use of complementary therapies, and others may not. Complementary therapies are sometimes referred to as natural or alternative therapies, and more recently as integrative therapies. ‘Complementary therapies' is the preferred term as it means natural therapies that are complementary to medical treatments, and are not intended to replace them.

Fat accumulation:

The development of fat deposits in the belly, breasts and base of neck between shoulders. Part of the lipodystrophy syndrome.

Folliculitis:

A skin condition with symptoms of red pustules around hair follicles that can itch severely. It can occur anywhere, but is often found on the trunk. It is often caused by the bacteria staphylococcus.

Gastrointestinal intolerance (gut problems):

A general term that describes the common effects of nausea, vomiting and diarrhoea and other gut-related problems. It can also describe any intestinal symptom, such as pain or wind, which is the result of a reaction to anything ingested, including drugs.

Glycaemic index (GI):

A way to rank food based on its effect on blood sugar levels. GI can be rated from the numbers 1 to 100. Low GI foods have a number rating of 55 or less, intermediate GI foods have a value between 56 and 69, and high GI foods have a rating of 70 or more. Low GI foods release glucose slowly into the bloodstream, intermediate GI foods release glucose at a moderate rate, whereas high GI foods are rapidly digested and absorbed resulting in marked fluctuations in blood sugar levels—which is undesirable in normal day-to-day life. Including one low GI food in each meal can assist in blood glucose regulation.

Healthy balanced diet:

Eating mostly grainy breads and cereals, pasta, rice, fruits and vegetables, a moderate amount of lean unprocessed meats, dairy products, nuts, legumes and soy-based products, with small amounts of processed high fat and sugar foods (e.g. soft drink, lollies, cakes, biscuits, butter). The National Health and Medical Research Council (NHMRC) produces dietary guidelines for Australians http://www.nhmrc.gov.au/publications/synopses/dietsyn.htm

Hepatitis:

A general term meaning inflammation of the liver.

Integrase Inhibitors:

A class of antiviral drugs that blocks the action of integrase, an enzyme that integrates genetic material from the HIV into its target cell.

Lactic Acidosis (Lactic Acidemia):

This is excess lactic acid in the blood, and it may have life-threatening effects. When the antiviralsA medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. in the Nucleoside Reverse Transcriptase Inhibitor (NRTIA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different.) class of drugs affect the liver by fatty deposit, serious Lactic Acidosis may occur. Lactic Acidosis results from high levels of a by-product in the muscles called lactate, which may cause symptoms including profuse muscle weakness, tiredness or extreme lethargy, muscle soreness or tenderness, difficulty breathing and shortness of breath. If it is serious, your doctor will stop the drug leading to the condition. More often, a milder or more subtle form of this condition can occur, giving rise to low level acidemia and metabolic acidosis (called lactic acidaemia). Symptoms will be similar and less noticeable, but not life threatening. Increased blood levels of lactate occur in about 15% of people taking NRTIs. Studies suggest d4T may be associated with the greatest risk, but all the NRTIs can cause the underlying problem with liver toxicity and inflammation. There may be symptoms such as mild muscle pains and aches. This milder condition may be more easily controlled and managed with effective therapies and treatment, but is still serious and requires ongoing monitoring by your doctor so that it doesn't worsen.

Lesion:

This is a general term used to describe any area of altered body tissue such as a wound, injury, or inflammation, usually caused by disease or trauma.

Lipoatrophy:

Refers to that part of the lipodystrophy syndrome which results in loss of facial and limb fat of the arms and legs, and accumulation of fat in other parts of the body such as the belly, breast, and base of the neck between the shoulders. The condition is sometimes referred to as altered body shape (or body fat redistribution and fat accumulation). It occurs due to HIV, and seems to be worsened in some people through the taking of nucleosides and protease inhibitors in particular. The key cause of this condition is suggested to be due to mitochondrial toxicity. Most nucleoside drugs cause this condition, especially d4T, ddI and AZT.

Lipodystrophy:

This is a syndrome of loss of fat in the arms, legs, and face; and fat accumulation in the belly, breasts, and base of neck between the shoulders. It is also referred to as altered body shape, body fat redistribution/fat accumulation, or peripheral fat loss/central adiposity. It is associated with blood sugar problems (sometimes called glucose intolerance or insulin resistanceA diabetes-like condition in which, while adequate amounts of insulin are produced by the pancreas, the body does not respond normally to the action of insulin. In the wider community, insulin is related to obesity, while in HIV it may be related to lipodystrophy.) and elevated blood fatsA type of fat in the blood. Elevated triglyceride levels may be a side effect of some anti-HIV drugs. such as cholesterol and triglycerides. These conditions may not occur all together, or may be more pronounced or milder for various people, for reasons not well understood. Although lipodystrophy is due to many causes, including HIV disease itself, HIV antiviral drug toxicities do contribute to the syndrome. However, the reasons for this have not been fully identified.

Mitochondrial toxicity / Damage to the Mitochondria:

Mitochondria are microscopic simple organ-like structures contained within all cells of the body. They are the source of energy in the cell and are involved in the oxygen exchange which allows cells to ‘breath' and to produce energy. Some HIV antiviral drugs may destroy mitochondria or cause them to become abnormally large.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs, ‘Nucleosides' or ‘Nukes'):

Antiviral drugs which interrupt the HIV protein called reverse transcriptase. They work by disrupting the viral reverse transcriptase from binding with the DNA of the host cell (e.g. CD4 cells). Instead of stealing nucleosides from the human cell's DNA, the viral reverse transcriptase takes the nucleosides of the drug instead, acting like a ‘dummy'.

Nucleotide Reverse Transcriptase Inhibitor (NtRTI):

Antiviral drugs, which interrupt the HIV protein called reverse transcriptase, in the same way as NRTIs do, but do not require as many biochemical changes in the cell for the drug to become active.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs, ‘Non-nucleosides' or ‘Non-nukes'):

Antiviral drugs, which interrupt the HIV protein called reverse transcriptase. They work similarly to the NRTIs by disrupting the viral reverse transcriptase, but do not act as a ‘dummy' building block like the NRTIs do. They act as a ‘blocker' by stopping the stealing of the host cell's DNA. However, the precise way in which they do this blocking remains unknown.

Pancreatitis:

Inflammation of the pancreas gland. Disorders of the pancreas can affect insulin levels which control blood sugars, and also affect the digestion and breakdown of foods. Symptoms of pancreatitis include intense pain in the lower back.

Peripheral Neuropathy:

Nerve damage causing pain, numbness, tingling in hands, feet, and wrists.

Protease Inhibitors (PIs):

Antiviral drugs which interrupt the HIV protein called protease. They work at the last stage of HIV virus reproduction. They act against the HIV enzyme called protease which assembles and releases new virus particles from the CD4 cells.

Psoriasis:

A skin condition which often occurs as a new disease after HIV infection. People who have psoriasis before HIV infection may experience a more severe form. Symptoms include red, scaly and itchy lesions. The initial lesions often begin like seborrheic dermatitis, but usually spread to moist areas of the body such as the armpits and groin, then to the elbows, knees, and lower back. Psoriasis lesions in the armpits and groin look identical to seborrheic dermatitis, but when psoriasis effects the trunk, it tends to be more fixed and with thicker scales.

Seborrhoeic dermatitis:

A common skin condition in people with HIV. It is more commonly known as dandruff when it affects the scalp. It is also commonly found on the face (especially around the eyebrows), chest, back, groin and armpits. A fungus called Pityrosporum ovale can cause it.

Thrush:

See Candidiasis

Triglycerides:

A major form of fat that is also found in the bloodstream. High triglycerides, as well as high cholesterol levels, are both linked to increased risk of heart disease and diabetes[Diabetes mellitus] A disorder in which sugars in the diet cannot be metabolised into energy due to a lack of the enzyme insulin. Late-onset diabetes mellitus may be a long-term side effect of some anti-HIV drugs..

Xeroderma (dry skin):

A fairly common skin condition for people with HIV. It appears as a flat, slightly scaly and flaky rash which comes and goes. It can occur anywhere on the body, but is most commonly found on the front of the lower legs. The cause is unknown, but is likely to be directly related to HIV. Other possible causes include inadequate nutrition, long-standing illness, lowered immunity, and poor hygiene.

Managing side effects