Anti-retroviral Drugs-A Hope!

“There is no symptom in HIV positive people,” says Dr. Raj Harjani. According to him, only ELISA test for HIV would reveal that a person is infected with HIV or not in the initial stages. Hence it is highly advisable for people to get tested for HIV if there is a history suggestive of unprotected sexual intercourse in past. Having 34 years practice in skin diseases, Dr. Harjani has managed HIV/AIDS treatment for the last 18 years.
AIDS: The group of symptoms and diseases of Acquired Immune Deficiency Syndrome (AIDS) are associated with the damage HIV does to the immune system. Diseases involve all the systems of body especially central nervous system, gastrointestinal system and respiratory system. Weight loss is the main symptom or sign of AIDS. TB and cancers are frequently seen in AIDS patients.
HIV: Human Immune Deficiency Virus (HIV) is the causative agent of AIDS. The presence of HIV doesn’t mean that person has AIDS. Its presence in the body tells us the status of the person. HIV positive means the person is infected with the virus and similarly HIV Negative means he is not infected with it.
Stages of disease when person is infected with HIV: a. Acute Retroviral Syndrome: This can occur immediately within 3 weeks of exposure to HIV, viral flu like syndrome characterized by fever, cough, sore throat, headache and rash lasting for 2-7 days.
b. Late Latent phase: (i) Asymptomatic: The person infected with HIV may remain for 3-5 years asymptomatic, except in some cases Herpes zoster or genital Herpes simplex is noted.
(ii) Symptomatic phase: Usually the symptoms include prolonged fever, weight loss and loss of appetite, recurrent watery diarrhea, seizures, headache, skin rash and oral ulcers.
Anti-Retroviral medicines: The blood tests CD4 and viral load are 2 monitoring parameters and prognostic markers. Dr. Harjani explains, “The treatment currently being used is called Anti-Retroviral Therapy (ART) and drugs are called Anti-Retroviral drugs (ARVs). Anti-Retroviral medicines halt or stop the replication of virus in the blood hence destruction of immune system otherwise occurring because of HIV is stopped. Body recovers and so does the immune system. All the 32 ARVs are available in world, while only 12 essential ARVs are available in India. When 3 or 4 ARVs from at least 2 classes are taken and given to HIV/AIDS patient for the entire life then patients may live a near normal life.”
Message to the readers: HIV infection and there by getting in to syndromic stage of HIV/AIDS is acceptable and a tolerable thing. But stopping ART in the midst of treatment, without the knowledge and help of HIV/AIDS specialist is unacceptable and unpardonable. Stopping the ART or having irregular doses or less doses or missed doses are called Poor Adherence to Therapy, which can lead to mutant viruses leading to HIV drug resistance further causing failure of 1st line treatment and then one has to start 2nd line treatment which is less effective and more expensive. HIV infected patients have to take ART early and rest of life from HIV experts only after undergoing a series of counseling sessions and when the patient is ready to start the treatment. The decision of starting ART and the onus of continuing the treatment lies solely on the patient. It should not be done in a hurry. Besides, many physicians start ART without the knowledge of the patients, which is wrong. It can lead to HIV drug resistance and 1st line failure, because invariably patients stop ART as their health improves. Finally now HIV infected discordant couples (where husband is HIV positive and wife is HIV Negative) can have a HIV negative baby without infecting the mother with HIV. There will be no HIV positive baby, born to HIV positive women by 2015. We will be almost controlling mother to child transmission by 2015. This was revealed by experts at AIDS 2012 conference which was held at Washington DC, USA from in July 2012.
This article was first published in Eve’s Times magazine and has been reproduced here with the permission of the editor, Swati Amar.