AIDS has long been synonymous with stigma and fear, with mankind still unable to fully comprehend the disease. A condition that was treated as an epidemic when it first surfaced, there are many patients who are now living normal lives despite being diagnosed thanks to the advancement in medicine.
Many films have also been made to spread awareness about the disease including 2014’s The Normal Heart, which showed the rise of the HIV-AIDS crisis in New York City between 1981 and 1984. Bollywood also made an attempt with My Brother Nikhil in 2005.
HIV (human immunodeficiency virus) is a virus that can lead to infection. It only infects humans and attacks the immune system, making it weak and unable to work as effectively. Unlike with other viruses, our immune system is unable to attack and clear HIV from the body.
Explains Dr Anil Vardani, senior consultant, Internal Medicine, BLK Super Speciality Hospital, “You can have HIV without developing AIDS (acquired immunodeficiency syndrome) and many people live for years with HIV without developing AIDS, due to advances in treatment. But if you have AIDS, you have to have HIV.”
The medical diagnosis of AIDS consists of having HIV and having a very low count of CD4 cells and/or an opportunistic infection, which are infections caused by pathogens (bacteria, viruses, fungi, or protozoa) that take advantage of the weakened immune system, and are otherwise not so frequent in people with a healthy immune system. An HIV-infected person is diagnosed with AIDS after developing one of the defined AIDS indicator illnesses.
The virus spreads between people through blood, using shared needles and sexual contact. Infected pregnant women can pass HIV to their baby during pregnancy, delivery or through breast-feeding.
An HIV positive patient can suffer from a wide range of symptoms like prolonged fever, chronic diarrhoea, opportunistic infections like tuberculosis, fungal infections which can be severe and even lead to debility and death.
Rapid weight loss, weakness, prolonged swelling of armpits or neck and malaise should prompt a person to test for HIV, particularly if there’s a history of multiple sexual partners, blood transfusion and unsafe sex etc.
Prince Harry and Meghan Markle attended a World AIDS Day event in Nottingham on December 1 in their first joint royal engagement. The Prince said,
Profuse night sweats, sores of the mouth, anus, or genitals, pneumonia, red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids, and memory loss, depression, and other neurologic disorders, are some other symptoms.
Doctors say that after the early stage of HIV infection, the disease moves into the clinical latency stage, sometimes also referred to as chronic HIV infection. During this stage, the virus is still active but replication of the virus in the human body is at very low levels.
People with chronic HIV infection may not have any HIVrelated symptoms, or only mild ones. For people who aren’t taking medicine to treat HIV (ART), this period can last a decade or longer, but some may progress through this phase faster. People who are on ART may be in this stage for several decades.
If a patient is not on ART, eventually the virus will weaken his/her immune system and the patient will progress to the late stages of the infection.
Dr Manisha Arora, senior consultant, internal medicine, Sri Balaji Action Medical Institute, adds, “We can’t rely on the symptoms in this case. The only and scientific way of knowing that the person is HIV positive is by getting it tested as many people don’t show any symptoms for months or years.”
If you think you may have been exposed to HIV and could be in the early stage of HIV infection, get an HIV test, which detect antibodies (proteins your body makes as a reaction against the presence of HIV), not HIV itself. But it can take a few weeks or longer for your body to produce these antibodies.
Doctors say that enzyme linked immunosorbent assays (ELISAs), rapid tests and western blots (WBs) are the common tests for detecting HIV antibodies. Polymerase chain reaction (PCR) is a test which detects virus and viral products and is therefore useful in the window period of HIV infection when antibodies have still not formed.
PCRs are also the test of choice in early infancy diagnosis in a child less than 18 months as maternal antibodies may be present in the infant’s circulation.
Standard ART consists of the combination of antiretroviral drugs to maximally suppress the HIV virus and stop the progression of HIV disease. ART is available free of cost at more than 400 NACO centres across India or can be prescribed by private practitioners and purchased from chemist shops.
But there are many success stories of patients living healthy lives even after being diagnosed.
One such patient was a 30-year-old woman who worked as a domestic help in Delhi, and was referred to Dr Anil a few years ago. Her husband had succumbed to lung tuberculosis a year prior. She had four kids, the youngest being four years old and suffering from generalised lymph node swelling, prominent in the neck region.
“We tested them and found the mother and the youngest child had HIV and the mother was HIV+ as defined by low CD4 counts,” he says.
While both the mother and her youngest child were referred to NACO centre at AIIMS, and put on ART, a crucial aspect was educating the family at her workplace. Says Dr Anil, “I convinced them that no one in their family is at risk of getting the infection. They agreed to let her continue work and even increased her monthly wage.”
Adds Dr Vikramjeet Singh, consultant physician, Aakash Healthcare Super Speciality Hospital, who is has been treating an HIV+ man for seven years now, “I meet his family and talk to them about him. I encourage him to try and lead a normal life. Beyond medicine, good mental health is needed to survive this disease.”
Dr Vikramjeet credits the decline in the number of patients suffering from AIDS number to improved public awareness and control programme by NGOs and the government.
Dr Vinay Bhat, consultant, internal medicine, Columbia Asia Hospital, Ghaziabad, adds, “Awareness has improved considerable, and so, diagnosis is quicker than ever before. Many ART centres have now been established at accessible points, where a patient can go for treatment.”
Beyond medicine, good mental health is crucial in order to lead a normal life while being HIV positive. Photo: Mail Today
BE SAFE, NOT SORRY
As this is a virus that can be transmitted through sexual activity, here are some precautions you can take to ensure that you stay HIV-free.
DR DHRITY Vats, senior wellness consultant, Healthians, says, “Even today, the word sex is considered to be a taboo, and any open discussion is shunned. With the growing number of sexual interactions between individuals, safety and awareness should be the top most priority.”
Involvement in any sexual activity where a condom is not used is unprotected sex. A condom can be used by both or any one partner.
Sexual contact with someone who has HIV greatly increases your chances of contracting the virus. Moreover, in the absence of condom, the body fluids come in contact with each other such as the blood, semen, vaginal fluids, pre-cum or anal mucus and the virus transmits to the blood stream of the sexual partner.
It is a myth that STD including HIV/AIDS can only be transmitted through vaginal sex.
According to research, it is most commonly spread my anal sex as the lining of the anus is thinner and is torn easily. When the HIVinfected semen comes in contact with the broken skin chances of getting infected are high. Same is in the case of oral sex. If you have ulcers or broken skin, that too can be risky. HIV is passed via the delicate and absorbent mucous skin of the penis, vagina, lining of the rectum and the mouth and throat (if there’s some broken skin).
You can be at a risk of having HIV if you have multiple sex partners, you have had sex – anal or vaginal – with an HIV-positive partner, you have been diagnosed with or if your partner or you have any sexually transmitted infection.
SAFE TO BEAR CHILDREN
MOTHERS living with AIDS are often scared and struggle disclosing their HIV positive status to their children. Many mothers even avoid disclosing their disease to their children, with an aim to protect themselves and their children from social negligence.
Doctors say that today, women with AIDS can mother children but for that they have to be regularly on ART therapy and should maintain CD4 counts within normal range. Because of the use of HIV medicines and other strategies, the risk of mother-to-child transmission can be lowered to 2 per cent or less.
The risk of mother-to-child transmission of HIV is low when HIV is detected as early as possible during pregnancy (or before a woman gets pregnant).
Women with HIV receive HIV medicines during pregnancy and childbirth and, in certain situations, have a scheduled caesarean delivery. Babies born to women with HIV receive HIV medicines for 4 to 6 weeks after birth. Most HIV medicines are safe to use during pregnancy. In general, HIV medicines don’t increase the risk of birth defects