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What is HIV?…

What is HIV?…

HIV is the name of a virus responsible for the disease AIDS. HIV is the acronym (short form) for ‘Human Immunodeficiency Virus’. This virus attacks the immune system only in humans and weakens it.

What is AIDS?…

What is AIDS?…

When a group of symptoms is observed in a HIV infected individual after the immunity of a person has decreased below a certain level, the condition is known as AIDS. AIDS is the acronym (a short form) for ‘Acquired Immunodeficiency Syndrome’. When the immunity is low, several infections or other ailments may affect the body.

How does one get infected with HIV?…

How does one get infected with HIV?…

HIV can get transmitted ONLY through

  • Transfusion of contaminated blood.
  • Unprotected sexual contacts with an HIV infected individual.
  • Injuries with contaminated needles and sharp edged instruments.
  • From an HIV infected mother to her child.

How does HIV affect the human body?…

How does HIV affect the human body?…

Immunity is the capacity of our body to resist infections by disease causing germs. It mostly depends on the white blood cells in our blood. Our immune system protects us from various infections. There are many types of white blood cells; one of them are called the CD4 lymphocytes. These ‘CD4’ cells play an important role in the functioning of the immune system. When HIV enter our body, they can reside and thrive only in these CD4 cells. The viruses use the CD4 cells for its replication. In the process the viruses multiply but the CD4 cells die. Eventually the number of HIV in the body increases and number of CD4 cells decreases resulting in a deficient immune system.

What happens when our immune system weakens?…

What happens when our immune system weakens?…

When our immune system weakens, the body cannot fight off other infections effectively. Thus, the body becomes more susceptible to acquiring various infections. Such a person with weakened immune system would fall ill frequently with ailments such as recurrent cough, cold, fever, diarrhoea, herpes simplex (commonly known as cold sores or fever blisters). It would be obvious that the infections that are already common in the given population would be more common and severe in persons with deficient immunity. TB and herpes zoster have special importance in HIV. Many people carry the germs causing these diseases in their bodies but do not have the disease. They manifest only when immunity of the person is reduced due to any reason. As HIV infection is an important reason for decrease in immunity, many persons with HIV infection suffer from these diseases. So it is suggested that all such patients be advised to get screened for HIV. Please remember that this does not mean every person having these diseases also has HIV infection. It just provides a chance for early diagnosis.

How can we identify a person infected with HIV?…

How can we identify a person infected with HIV?…

We cannot identify whether a person has HIV or not by mere observation. Blood tests need to be performed to see if an individual has HIV infection. ELISA based anti-HIV tests are performed to diagnose presence of HIV.

How is HIV infection detected?…

How is HIV infection detected?…

Methods to actually identify the presence of HIV in the blood are complex and expensive. HIV infection is diagnosed by testing for substances called antibodies prepared by our body in response to the presence of virus. The most commonly used blood tests for diagnosing HIV infection are based on ELISA (Enzyme-linked ImmunoSorbent Assay) technique. A positive test result needs to be confirmed by two more tests using different test kits. The results should be interpreted by an experienced person.

A test called Western Blot test could also be performed for confirmation of HIV infection. However, this test is expensive and does not provide any added advantage over the above mentioned protocol; therefore it should be used when definitive diagnosis of HIV becomes difficult  due to disparity in test results.

What should a person do after he/she is detected to be HIV infected?…

What should a person do after he/she is detected to be HIV infected?…

A newly diagnosed person should visit a physician having enough experience of managing HIV. With the doctor’s advice other blood tests such as CD4 cell counts, hemogram, liver and kidney function tests, tests for other co-existing infections such as syphilis and hepatitis B, ultra-sonography of abdomen, X-ray of chest to rule out tuberculosis, etc. need to be done to assess the current status of HIV disease. The doctor would also determine if the person needs any medication for HIV. The person must continue visiting the doctor for routine checkups and tests as and when suggested.

Is there any remedy for this disease?…

Is there any remedy for this disease?…

Yes. Now effective medicines known as the ‘Anti Retroviral Therapy’ (ART) are available, which when taken appropriately can help an individual stay healthy for many years. However, these medicines do not cure the disease but keep it under control. Therefore once started ART has to be taken life-long,. This can be compared to treatment of a disease like diabetes. Though there is no permanent cure, the disease can be kept under control for many years.

How do the ART medicines work?…

How do the ART medicines work?…

ART medicines create obstacles in the process of replication of the virus inside the CD4 cells. This restrains the growth of HIV. Once the number of viruses is reduced significantly (in fact most regimens usually push the levels of virus circulating in the blood to undetectable levels within 6 months), the number of CD4 cells increases thereby improving the immune system. A stronger immune system helps keep other infections at bay and the person can lead almost a normal life.

When are ART medicines started?…

When are ART medicines started?…

Current recommendations state that ART medicines are to be started when the number of the CD4 cells per cubic milliliter of blood goes below 350. As these medicines have to be used in particular combinations, an expert’s advice should be sought before starting ART.

Now-a-days one gets to see several advertisements saying that HIV/AIDS can be completely cured by th…

Now-a-days one gets to see several advertisements saying that HIV/AIDS can be completely cured by th…

Till date, no medicine has been found in any branch of medicine which can cure HIV. Thus, one should not believe such advertisements. Such advertisements are aimed at making money by taking disadvantage of people’s vulnerabilities.

What else can one do to keep one’s immune system well?…

What else can one do to keep one’s immune system well?…

Balanced healthy diet, regular exercise and adequate rest during the day would definitely help keep one more fit. Apart from this, traditional remedies, Yoga, Pranayam etc. can also help improve one’s immunity. One should strictly avoid addictions which could harm the body in any way. One should try to be calm and should not worry.

What precautions should one take while taking ART medicines?…

What precautions should one take while taking ART medicines?…

  • Once started, these medicines have to be taken lifelong.
  • The medicines should be taken regularly and on time.
  • Some medicines work better on an empty stomach while some need to be taken on a full stomach. Thus, follow the advice of your physician.
  • Do not stop the medicines once you start feeling better.
  • Do not change the dosage of the medicines on your own.
  • Do not stop the medicines even if you observe any side effects of the medicines and consult your doctor immediately.
  • CD4 tests need to be done regularly after every 6 months to see if the medicines are working properly.
  • Avoid all addictions (alcohol, cigarette, beedi, tobacco chewing, drugs) while taking ART. Interaction of alcohol with some medicines can prove to be harmful.

What would happen if ART is not taken properly?…

What would happen if ART is not taken properly?…

If the blood levels of medicines are maintained consistently then only they can effectively prevent the viral multiplication. If ART medicines are taken irregularly, the blood levels of medicines in the body fluctuate allowing the virus to replicate. If the virus is allowed to replicate in the presence of lower levels of medicines it finds ways to prepare itself to fend against the medicines. Eventually, the medicines would stop having any effect on the viruses. This means that the virus becomes resistant to that particular medicine. Thus, these medicines become useless for that particular individual. As the medicines stop working, the level of virus (the viral load) starts increasing, numbers of CD4 cell in the blood starts decreasing and the person’s health would start deteriorating again.

By how many years would a person’s life increase if he/she is taking ART regularly?…

By how many years would a person’s life increase if he/she is taking ART regularly?…

The experience suggests that almost a normal life expectancy can definitely be achieved in case of adults if the person is taking regular ART. However, this is dependent on several factors such as stage of the disease when ART was started, how regularly was it taken, and was it effective for that particular individual and so on.

How much do ART medicines cost?…

How much do ART medicines cost?…

ART medicines are available free of cost at Government’s ART centers situated at the District Hospitals as well as other places. There are now many Link ART Centers which could be very conveniently placed near your place of residence. At Prayas, ART is available at rates much lower than the market rates.

The classical first line treatment would cost somewhere between Rs.1000 to 3000 per month in other private set ups. The second line and third line treatments are much more costly.

Are the free medicines available at government centers inferior in quality?…

Are the free medicines available at government centers inferior in quality?…

Not at all!

They are all quality assured.

Free ART medicines available at the government centers are as good and effective as those available in the market.

Are all children born to HIV infected mothers infected with HIV?…

Are all children born to HIV infected mothers infected with HIV?…

No. There is only about 25-30% chance that a child born to a HIV infected mother is infected with HIV. This means that out of four HIV infected pregnant women, only 1 woman’s child could be infected with HIV.

Mother to Child transmission of HIV can now be prevented.

 

When does the transmission of HIV from mother to child occur?…

When does the transmission of HIV from mother to child occur?…

The transmission of HIV from mother to child can occur either when the baby is in the mother’s womb, during delivery or while breastfeeding the baby.

Can mother to child transmission of HIV be prevented?…

Can mother to child transmission of HIV be prevented?…

Yes. The risk of mother to child transmission of HIV can be reduced considerably. Effective medicines are now available which can help prevent the mother to child transmission of HIV. Timely, appropriate and regular medicines along with some other strategies can reduce the risk of transmission to less than 1-2%.

‘Prevention of Mother to Child Transmission Program’ of Prayas provides free medicines to HIV infected women for preventing such transmission to their babies.

 

Should a HIV infected mother avoid breastfeeding her baby?…

Should a HIV infected mother avoid breastfeeding her baby?…

The chance of transmission of HIV through breast milk is not much. Also the advantages of breast milk are several. It has been observed that babies not given breastfeeding are more likely to have repeated illnesses such as diarrhea, pneumonia, etc. and are also more likely to succumb to such infections as compared to the breastfed babies. Several effective medicines are now available which when taken appropriately by the mother and/or given to the baby during breastfeeding, can reduce the transmission of HIV through breast milk considerably. 

The decision to breastfeed or not needs to be taken after careful consideration of both these facts that though there is some risk of transmission through breast milk which can be substantially reduced by medicines, but at the same time there is also considerable risk of illness, hospitalization and death among non-breastfed babies. If needed this matter should be discussed with the counselor or the doctor in order to choose appropriate option.

Blood loss during menstruation reduces the quantity of HIV in a woman’s body and thus she lives long…

Blood loss during menstruation reduces the quantity of HIV in a woman’s body and thus she lives long…

No. This is a misbelief.

Once infected with HIV, the disease progresses in the same way in men and women. In India, most of the times, it is seen that women get the infection from their husbands. In other words the husband is already infected for quite some time before transmitting the infection to wife. HIV in men is often detected only when they start showing any symptoms. Thus, their disease may have already progressed to an advanced stage. When a man is detected to be HIV infected, his partner’s detection follows almost immediately. Women, thus get an advantage of early detection and thus an opportunity to get treatment on time as against men.

Timely detection and initiation of treatment at the right time help women survive longer than men.

Their longer survival has nothing to do with their blood loss during menstruation.

Are other members in the house at a risk of acquiring HIV due to the bleeding occurring in menstruat…

Are other members in the house at a risk of acquiring HIV due to the bleeding occurring in menstruat…

Apart from the menstruating woman, no one comes in direct contact with the menstrual blood. Thus, there is no such risk of acquiring HIV even if a HIV infected woman in a household is menstruating.

Moreover, HIV being extremely fragile, it does not survive if it comes in contact with water, sunlight or soap.

Standard habits of cleanliness such as washing the blood soaked cloth and drying it thoroughly, proper disposal of sanitary pads and cleanliness of the toilets should definitely be maintained by all.  In any case, HIV could not be transmitted to other people through casual contacts.

What kind of work can be undertaken by an HIV infected individual?…

What kind of work can be undertaken by an HIV infected individual?…

There are no restrictions on the kind of work an HIV infected individual can undertake. Any work which may be harmful to a HIV infected individual’s health should be avoided.

There are generally hardly any work places where an infected person can pass on the infection to others unless it involves unsafe sex.

What diet should a HIV infected individual take?…

What diet should a HIV infected individual take?…

There are no particular diet restrictions in this disease. One should eat on time and should have a balanced diet. The diet must include sprouts, green-leafy vegetables, other vegetables, milk and milk products. One can also consume meat. However, all food items should be cooked properly and should be fresh. One should also eat fruits. Drink plenty of water during the day. Remember to have boiled water as far as possible. Avoid outside food which is uncooked or not covered.

Should all the children of an HIV infected woman be tested for HIV?…

Should all the children of an HIV infected woman be tested for HIV?…

Yes. It is very important that all the children born to a HIV infected woman are tested for HIV. Even though the woman has been detected to be infected today, we do not know when the actual infection has occurred. Thus, all the children of the woman who are less than 18 years of age at the time of her detection should be tested for HIV unless there is definite evidence that the infection occurred after that child’s birth. Children older than 18 years should be provided information and suggested voluntary testing.

As we have already discussed the chances of transmission are small but it is always better to know as early as possible, than repent later. It has been seen that infected children can remain healthy for many years and so, just because the child is healthy should not be equated with absence of infection.

Early diagnosis followed by early treatment prevents intellectual and physical retardation and helps achieve normal developmental milestones in growing children.

What is the current state of HIV vaccine research?…

What is the current state of HIV vaccine research?…

The research about the HIV vaccine is ongoing but has not reached any definitive stage.

A vaccine is mostly used to prevent a particular infection. The HIV vaccine research is based on this same premise. Even in the future if a vaccine for HIV becomes available, the idea is to use it for HIV uninfected individuals to prevent them from acquiring HIV infection in the future.

Who should get tested for HIV?…

Who should get tested for HIV?…

HIV gets transmitted only in the well known particular ways. Anyone who feels that he/she might have had an exposure to the virus because of a particular risk should get himself/herself tested for HIV. At times it will be difficult to assess risk except for sexual behavior. So everyone should get tested voluntarily before marriage, during pregnancy. Doctors should suggest test to all patients having sexually transmitted infections, tuberculosis (TB) or herpes zoster as these are more commonly associated.

Here is a list of indications for testing

  • If one’s sexual partner is infected with HIV.
  • All children of an HIV infected woman (who are less than 18 years of age at the time of woman’s detection) if there is no definitive proof that the infection occurred after the child’s birth
  • If one has had unprotected sex with an unknown individual.
  • If one’s sexual partner has any sexually transmitted infection.
  • If one has a symptom of sexually transmitted infection.
  • If one is an injecting drug user.
  • If one has had illnesses like TB or herpes zoster.
  • All pregnant women.
  • If one have recurrent illnesses (like cough, cold, fever, diarrhea, fever blisters etc.) which are not being cured with usual treatment.
  • In case of blood contact with patient’s blood through an accidental injury to a health care provider while providing care to patients.
  • Pre-marital testing.
  • In case of semen donation, or organ donations.
  • In case of a history of blood transfusion.
In almost all hospitals a patient’s blood is tested for HIV before any operative procedure.

 

How can one protect self from acquiring HIV?…

How can one protect self from acquiring HIV?…

  • Avoid taking blood from unauthorized blood banks.
  • Avoid unprotected sexual contact with unknown individuals.
  • Avoid unprotected sexual contact with multiple partners or with a partner who may have multiple sexual partners.
  • Ensure that needles and other instruments being used for you in a clinic or hospital have been sterilized.
  • HIV infected pregnant women can take medicines to prevent mother to child transmission of HIV.
  • Health care providers should always adhere to universal precautions while providing care to patients.

Am I at risk of acquiring HIV if I help an injured individual involved in a road accident?…

Am I at risk of acquiring HIV if I help an injured individual involved in a road accident?…

No. There is no risk of acquiring HIV in this way. One can get infected with HIV only if HIV infected blood or bodily fluids enter another person’s body. If the helper in this situation does not have any open wounds or cuts on his/her body, there remains no risk of acquiring HIV. If one feels the need, then protective rubber gloves or plastic bags could be used while helping person/s injured in a road accident.

How many people in India have HIV as of now?…

How many people in India have HIV as of now?…

About 24 lakh people are living with HIV in India as of 2012. In India, the prevalence of HIV is 0.3% of the adult population, i.e. 3 per 1000 individuals are infected with HIV. In comparison with some other countries of the world, this percentage is very low. However, India ranks third in the world in terms of number of people living with HIV considering India’s sizable population.

 

Prayas-Amrita Clinic, Athawale Corner, Karve Road, Deccan Gymkhana, Pune - 411 004, Maharashtra, India.
Tel.: +91-20-25441230/65615726 Tel./Fax: +91+20-25420337 E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.