End inequalities, end AIDS, World AIDS Day 2021 Today

Dr Mangala Borkar

AIDS was first reported nearly 40 years ago. The virus attacks white cells (CD4) in the body that are responsible for immunity and resistance to opportunistic infections and cancers. For few initial years, an infected person who harbours the virus in his body, may not have any symptoms and can be diagnosed only by a blood test. It mainly spreads by sexual method, but may also spread from a positive pregnant lady to her baby, infected needles used by drug users and rarely by blood transfusion - as blood is screened for infections before it is given to a patient.

Current status of HIV

Prof Dr Meenakshi Bhattacharya

HOD Medicine, Nodal officer, ART, GMC, Aurangabad

As per India HIV Estimation 2019 report, the estimated adult HIV prevalence trend has been declining since the epidemic’s peak in the year 2000 and has been stabilizing. In 2019, HIV prevalence among adult males was estimated at 0.24% and among adult females at 0.20%. Access to effective HIV prevention, diagnosis, treatment and care, through the largest network of ART and sub-ART centres under one of the most successful organisations National AIDS control Organisation (NACO), HIV infection has become a manageable chronic health condition, enabling people living with HIV to live healthy, longer lives. Recent advanced single dose monthly injections are a new ray of hope for HIV infected patients and families.

A Sea Change

Dr Anand Phatak

Physician in-charge, Infectious diseases, Hedgewar Rugnalaya

In my 20 years of experience of dealing with HIV positive patients, I have observed some welcome changes in recent days - the social, family ostracisation, abandonment of HIV affected individuals has grossly decreased. Family takes care, spouses do not disown the HIV positive partner. In earlier years, even medical staff used to almost panic if a positive patient was admitted, now they treat HIV patients as any other, with due precautions. I have three positive patients who married positive counterparts. Overall, awareness is good and stigma has declined.

Opportunistic infections in AIDS

Dr Ruhi Siddiqui, Medical officer, ART, GMC

Common Opportunistic Infections (OI) caused by microbial agents due to immunosuppression are - Tuberculosis (TB), Herpes Zoster, Herpes Simplex, Oesophageal Candidiasis, Toxoplasmosis, Pneumocystis, pneumonia.

Type of OI depends upon the CD4 count and whether patient is taking regular treatment.

Most OIs are treatable

TB is the commonest OI and the leading cause of death in AIDS.

AIDS patients are 19 times more likely get TB.

Therefore close monitoring of patients for weight loss, fever, diarrhea, cough, declining CD4 count, adherence to treatment is very important.

Toxoplasmosis, Cytomegalo Virus infections, Cryptococosis are commonly seen in cases with CD4 less than 100.

The success of NACO

Dr Madhukar Salve, Senior Medical officer, ART.

National Aids Control Programme was launched by Government of India in 1992 and has undergone expansion and development in five phases so far. It has adapted the 90-90-90 policy - By 2020, (at least) 90% of infected persons should be aware about being infected, 90% should be on treatment and 90% should be well controlled.

Women account for 41% of HIV cases. It is observed in 2.2% commercial sex workers, 4.2 % gays (MSM) and 9.9% of intravenous contraband drug users.

Now the goal is, by 2024, to decrease new infection by 80%, increase self-awareness, treatment to 95%, eliminate mother to child transmission and social stigma related to AIDS.