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RSTV: IN DEPTH- HIV: NEW HOPE

RSTV

Introduction:

HIV, the virus that causes AIDS, is one of the world’s most serious public health challenges. Around 37 million people worldwide are living with HIV. Of these, 1.8 million are children under 15 years of age

  • The remarkable research breakthrough that appears to have cured the anonymous “London Patient” of HIV is based on a stem cell transplant involving CCR5-delta 32 homozygous donor cells. This is the same treatment that cured Timothy Ray Brown, known as the “Berlin Patient” when he received two stem cell transplants in 2007 and 2008.
  • The news comes nearly 12 years to the day after the first patient known to be cured, a feat that researchers have long tried, and failed, to duplicate. The surprise success now confirms that a cure for HIV infection is possible, if difficult, opine researchers

What Is HIV?

  • HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases.
  • It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or through sharing injection drug equipment.
  • If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome).
  • The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have it for life.
  • However, by taking HIV medicine (called antiretroviral therapy or ART), people with HIV can live long and healthy lives and prevent transmitting HIV to their sexual partners. In addition, there are effective methods to prevent getting HIV through sex or drug use, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
  • First identified in 1981, HIV is the cause of one of humanity’s deadliest and most persistent epidemics.

What Is AIDS?

  • AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.
  • In the U.S., most people with HIV do not develop AIDS because taking HIV medicine every day as prescribed stops the progression of the disease.
  • A person with HIV is considered to have progressed to AIDS when:
    • the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.)
    • they develop one or more opportunistic infections regardless of their CD4 count.
  • Without HIV medicine, people with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. HIV medicine can still help people at this stage of HIV infection, and it can even be lifesaving. But people who start ART soon after they get HIV experience more benefits—that’s why HIV testing is so important.

Symptoms:

  • Some people with HIV do not show symptoms until months or even years after contracting the virus.
  • However, around 80 percent of people may develop a set of flu-like symptoms known as acute retroviral syndrome around 2–6 weeks after the virus enters the body.
  • The early symptoms of HIV infection may include:
    • Fever
    • Chills
    • joint pain
    • muscle aches
    • sore throat
    • sweats particularly at night
    • enlarged glands
    • a red rash
    • tiredness
    • weakness
    • unintentional weight loss
    • thrush
  • These symptoms might also result from the immune system fighting off many types of viruses.
  • However, people who experience several of these symptoms and know of any reason they might have been at risk of contracting HIV over the last 6 weeks should take a test.

Asymptomatic HIV:

  • In many cases, after the symptoms of acute retroviral syndrome, symptoms might not occur for many years.
  • During this time, the virus continues to develop and cause immune system and organ damage. Without medication that prevents the replication of the virus, this slow process can continue for an average of around 10 years.
  • A person living with HIV often experiences no symptoms, feels well, and appears healthy.
  • Complying rigidly to a course of ART can disrupt this phase and suppress the virus completely. Taking effective antiretroviral medications for life can halt on-going damage to the immune system.

HIV and AIDS: What’s the connection?

  • To develop AIDS, a person has to have contracted HIV. But having HIV doesn’t necessarily mean that someone will develop AIDS.
  • Cases of HIV progress through three stages:
    • stage 1: acute stage, the first few weeks after transmission
    • stage 2: clinical latency, or chronic stage
    • stage 3: AIDS
  • As HIV lowers the CD4 cell count, the immune system weakens. A typical adult’s CD4 count is 500 to 1,500 per cubic millimeter. A person with a count below 200 is considered to have AIDS.
  • How quickly a case of HIV progresses through the chronic stage varies significantly from person to person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it can last indefinitely.
  • There is no cure for HIV, but it can be controlled. People with HIV often have a near-normal lifespan with early treatment with antiretroviral therapy. Along those same lines, there’s technically no cure for AIDS. However, treatment can increase a person’s CD4 count to the point where they’re considered to no longer have AIDS. (This point is a count of 200 or higher.) Also, treatment can typically help manage opportunistic infections.
  • HIV and AIDS are related, but they’re not the same thing.

India and HIV/AIDS:

  • According to National AIDS Control Organization of India, the prevalence of AIDS in India in 2015 was 0.26% i.e about 2.11 million people.
  • India is home to the world’s third-largest population suffering from HIV/AIDS.
  • India aims to end HIV/AIDS by 2030 and is a signatory of UNAIDS programme 90-90-90 strategy by 2020.
  • It is also enshrined in Government of India’s National Health Policy (NHP 2017)
  • In 2017, 79% of people living with HIV were aware of their status, of whom 56% were on antiretroviral treatment (ART)

Prevention:

  • Wear condoms to prevent other STIs.
  • Receive vaccinations for potential OIs.
  • Understand the germs in your surrounding environment that could lead to an OI. A pet cat, for example, could be a source of toxoplasmosis. Limit exposure and take precautions, such as wearing protective gloves while changing litter
  • Avoid foods that are at risk of contamination, such as undercooked eggs, unpasteurized dairy and fruit juice, or raw seed sprouts.
  • Do not drink water straight from a lake or river or tap water in certain foreign countries. Drink bottled water or use water filters.
  • Ask your doctor about work, home, and vacation activities to limit exposure to potential OIs