The evolution of HIV treatment, explained by an expert

World AIDS Day is celebrated on December 1 each year to raise awareness of this chronic condition. On the occasion of World AIDS Day 2020, here is everything you need to know about HIV / AIDS treatment and how it has evolved in recent years.

World AIDS Day 2020: HIV can spread through direct contact with an infected person

The HIV or human immunodeficiency virus attacks the cells in your body that help fight infections and diseases. Hence, the person becomes vulnerable to other conditions and diseases such as bacterial, viral or protosol infection. HIV is spread through contact with certain body secretions. It can spread through unprotected intercourse, sharing injectable equipment, or any type of direct contact with an infected person. However, that risk is much lower now with all medical standards and practices followed with utmost sterility and precautions. Let’s assume that untreated HIV can lead to an acquired immunodeficiency syndrome, which is AIDS. So a person who has HIV does not need to have AIDS. It is only when the person with HIV has a drop in CD4 cell count of less than 200 that the person begins to get opportunistic infections and enter complete nodes.

An HIV-infected person would be asymptomatic with symptoms such as relentless undiagnosed fever, loss of appetite, weight loss, headache, excessive fatigue, chills, muscle pain and swollen lymph nodes, skin rashes. There may also be symptoms such as a superadded bacterial and fungal infection with cough, difficulty breathing, diarrhea, fatigue, genital or anal sores, and recurrent oral ulcers that do not heal. If patients become infected with the CNS from HIV, there may be convulsions, meningitis. There may also be a memory problem after which the patient should be hospitalized as he will enter AIDS syndrome.

World AIDS Day: Early detection can help manage symptoms and control the severity of the condition
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In the early 1990s, drugs to treat HIV had just been introduced but there were several factors for which not everyone had access to it. People stopped treatment midway through the course as it would last a long time due to financial constraints. With government intervention, education awareness programs run by various organizations and NGOs, the drugs are very affordable, administered in municipal hospitals and are available in a fixed combination of drugs, which reduces the load of pills .

Read also: World AIDS Day 2020: Learn about the causes, symptoms and prevention of HIV / AIDS

The risk of HIV infections for healthcare professionals after exposure to needle sticks through infected blood is approximately 0.3-0.5%. This risk increases if a larger volume of blood is exposed. Exposure to other body fluids such as tears, blood, saliva and urine also carries a lower risk. Universal precautions and safety devices are the mainstays in preventing infection after exposure. Antiviral drugs offer some protection and should be considered after each exposure. Therefore preventive measures should not only be directed against HIV infection but also by creating the right awareness. The promotion of the use of safe sexual practices, the screening of blood and blood products, the production of maternal transmission by strengthening anti-birth care, universal precautions between people, the care of patients with HIV infection, the development of Safe antiretroviral drugs and socioeconomic rehabilitation can help control the spread.

Also read: World AIDS 2020 focuses on resilience and the impact of the HIV / AIDS epidemic

The change in mortality from an HIV-infected person culminating in AIDS has changed over the past decade. The introduction of combined antiretroviral treatment, as mentioned earlier, effectively controls virus replication, restores the immune system and reduces complications associated with immunodeficiency. HIV infection has gone from a progressive and accelerating cost disease to death to a manageable disease or a non-fatal chronic evolution. This was a significant breakthrough. Progressively as we see that the indications for antiretroviral treatment have been broadened, the available drugs have improved, the side effects have been reduced, the expected survival has increased to become in many cases similar to that or to an HIV-free population. Sometimes a person is so asymptomatic that the family member, the circle of friends, no one even realizes that the person has HIV because the viral load and copies of the virus are so low in the bloodstream. These positive changes in HIV management have led to some logical consequences, so the average age of people living with HIV has increased and the average age of patients seen in the clinic is now, say, 50.

Hence the positive evolution that has taken place in HIV treatment with good counseling, helpful approaches that seek to reduce transmission from one person to another has reduced the stigma of HIV in society. A patient is learning to experience chronic disease with the doctor’s hand, good advice and proper nutrition.

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(Dr. Monica Goel, medical consultant, PD Hinduja hospital and MRC)

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