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The HIV AIDS Virus Alert

Dr Nalin Nag

BE POSITIVE: Treatment
All patients should undergo a full physical examination regularly, along with lab tests like blood counts, liver functions, kidney functions, chest X ray and hepatitis B. Baseline CD4 count and viral load testing should be done and treatment should be started in all symptomatic and symptomless patients with a CD4 count of less than 350 cells/ cu mm (normal count is 500-1500 cells).

AntiRetroviral Therapy (ART) has completely changed the course of illness and an invariable fatal disease has been tamed to become a chronic manageable infection. Numerous antiretroviral drugs are now available and are used in combination of three to four agents to effectively stop viral replication and reversal, and bring improvement in disease. Virus becomes undetectable in blood at the end of six months to one year in most cases.

Treatment is lifelong and patient’s full compliance and adherence to treatment is of utmost importance to prevent the failure of therapy. Most drugs interact with others, so precautions should be taken while co administration of multiple drugs is involved. Side effects need to be monitored and need prompt management. This requires proper training and expertise - and it comes with experience, with time.

Associated diseases like TB, pneumonia and other opportunistic conditions also have to be managed and most of the time, need to be stabilized before starting antiretroviral therapy. Proper nutrition, immunization, lifestyle and stress management go a long way in improving the quality of life of HIV patients who are now expected to have a fuller life span on proper antiretroviral therapy. Till date, no preventive vaccine is available in spite of a great deal of research in this field.

A positive attitude towards life, support from family and friends, condemnation and discouragement of discrimination by society at large of people having HIV/AIDS are the need of the hour. Strict laws are required to protect and preserve the dignity and self respect of all concerned.

  • Worldwide estimation of people living with HIV AIDS – 33 million
  • Worldwide death rate due to HIV AIDS - 25 million
  • Indians living with HIV AIDS – 2.4 million, and the rate is rising
  • Incidence is highest among sex workers and their clients, homosexuals, injected drug users and truck drivers.
  • Factors responsible for AIDS are lack of awareness, gender inequality, mobility and migration of people, and high rates of Sexually Transmitted Diseases (STDs).
Dr Nalin Nag is Sr Consultant - Internal Medicine, Indraprastha Apollo Hospitals, New Delhi.
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