HIV and AIDS:
Expanding at an Alarming Rate in Pakistan
HIV stands for human immunodeficiency virus. People
with HIV can enjoy a long and healthy life by taking antiretroviral treatment which is
effective and available to all. Once a person has HIV, the earlier they
are diagnosed, the sooner they can start
treatment which means they will enjoy better health in the long term. It’s
possible for antiretroviral treatment to reduce the level of HIV in the body to
such low levels that blood tests cannot detect it. People living with HIV whose
viral load is confirmed as undetectable cannot pass on HIV. Regular testing for HIV is important to know the status of patient. HIV is
found in semen, blood, vaginal and anal fluids, and breastmilk. Therefore, using condoms during sex is the best way to prevent HIV and other sexually
transmitted infections. If someone inject
drugs, always use a clean needle and syringe, and
never share equipment. If someone is pregnant and living with HIV, the virus in her blood could pass into
her baby’s body, during birth or afterwards through breastfeeding. HIV infects white blood cells in the body’s immune
system called T-helper cells or CD4 cells. The virus attaches itself to the
T-helper cell; it then fuses with it, takes control of its DNA, replicates
itself and releases more HIV into the blood. Knowing how HIV infects the body helps
people understand prevention and treatment options, and why it’s important to
start antiretroviral treatment as soon as possible after testing positive. HIV
cannot grow or reproduce on its own. Instead, the virus attaches itself to a
T-helper cell and fuses with it. It then takes control of the cell’s DNA,
replicates itself inside the cell, and finally releases more HIV into the blood
– continuing the multiplication process. In this way HIV weakens the
body’s natural defenses and over time severely damages the immune system. How
quickly the virus develops depends on a person’s general health, how soon after
getting HIV they are diagnosed and start antiretroviral treatment, and how
consistently they take their treatment. (Source: https://www.avert.org/about-hiv-aids/what-hiv-aids)
Mazhar Ali Dootio
[My this article is published in theleader.com.pk]
Pakistan
was long considered a low prevalence country for HIV, but the disease is
expanding at an alarming rate, particularly among intravenous drug users and
sex workers. HIV is a virus that attacks cells in the immune system, which is one
body’s natural defense against illness. The virus destroys a type of white
blood cell in the immune system called a T-helper cell, and makes copies of
itself inside these cells. T-helper cells are also referred to as CD4 cells. As
HIV destroys more CD4 cells and makes more copies of itself, it gradually
weakens a person’s immune system. This means that someone who has HIV, and
isn’t taking treatment, will find it harder and harder to fight off infections
and diseases. If HIV is left untreated, it may take up to 10 or 15 years for
the immune system to be so severely damaged that it can no longer defend itself
at all. However, the rate at which HIV progresses varies depending on age,
general health and background. According to Wikipedia, HIV is
recognized as a health concern in Pakistan with the number of cases
growing. Moderately high drug use and lack of acceptance that non-marital sex
is common in the society have allowed the HIV epidemic to take hold
in Pakistan, mainly among injection drug users (IDU), male, female
and transvestite sex workers (MSW, FSW and TSW) as well as the
repatriated migrant workers. HIV infection can lead to AIDS that may
become a major health issue. The
Wikipedia page, which was last
edited on 6 March 2019 at 02:24 (UTC), presents
the sample distribution of high risk groups in the following
table.
|
Province
|
IDUs
|
MSWs
|
TSWs
|
FSWs
|
|
Punjab
|
2,248
|
1,439
|
1,786
|
3,347
|
|
Sind
|
2,213
|
1,440
|
1,337
|
1,472
|
|
KPK
|
325
|
436
|
718
|
712
|
|
Baluchistan
|
730
|
359
|
338
|
345
|
The
National AIDS Programme’s latest figures show that by the mid of first decade
in new millennium, the number of HIV cases have increased to approximately
0,102 million (http://www.nacp.gov.pk/). This number was estimated little over 4,000, as the
HIV cases reported since 1986. The UN and government estimated the number of
HIV/AIDS cases around 97,000 ranging from a lowest estimate of 46,000 to a
highest estimate of 210,000
AIDS is
a set of symptoms or syndrome
as opposed to a virus caused by HIV. A person is said to have AIDS when their
immune system is too weak to fight off infection, and they develop certain
defining symptoms and illnesses. This is the last stage of HIV, when the
infection is very advanced, and if left untreated will lead to death. AIDS
stands for acquired immune deficiency syndrome; it is also called advanced HIV
infection or late-stage HIV. AIDS is a set of symptoms and illnesses that
develop as a result of advanced HIV infection which has destroyed the immune
system.
The
earlier a person is diagnosed with HIV and starts treatment, the
better their long-term health. Some people don’t get any symptoms during stages
1 and 2, but they can still pass on HIV. This is why HIV is often transmitted
by people who don’t know they have the virus. The symptoms of HIV at each stage
can vary in type and severity from person to person and some people may not get
any symptoms at all for many years. Without treatment, the virus replicates in the body and causes more and more
damage to the immune system. Around one to four weeks after getting
HIV, some people will experience symptoms that can
feel like flu. These may not last long and you may only get some of the flu
symptoms or none at all. Experiencing these symptoms alone is not a reliable
way of diagnosing HIV. Symptoms can include: fever (may be raised temperature),
body rash, sore throat, swollen glands, headache, upset stomach, joint aches
and pains, muscle pain. These symptoms can happen because body is reacting to
the HIV virus. Cells that are infected with HIV are circulating throughout the
blood system. The immune system, in response, tries to attack the virus by
producing HIV antibodies. Timing varies but once someone has HIV it can take his
or her body up to a few months to go through the seroconversion process. It may
be too early to get an accurate HIV test result at this point, but the levels
of virus in blood system are high at this stage. If HIV patient are not getting
treatment then they may be more likely to get serious infections, or bacterial
and fungal diseases that the body would otherwise be able to fight off.
Symptoms can include: weight loss, chronic diarrhoea, night sweats, fever, persistent
cough, mouth and skin problems, regular infections and serious illness or
disease. (Source: https://www.avert.org/about-hiv-aids/what-hiv-aids)
The
researchers and scientists believe that they can
find a cure for HIV. They know a lot about HIV, as much as certain cancers.
Scientists are researching two types of cure: a functional cure and a sterilising
cure. A functional cure would suppress the amount of HIV virus in the body to
such low levels that it can’t be detected or make someone ill but it would
still be present. Some people think that antiretroviral treatment is
effectively a functional cure, but most define a functional cure as something
that suppresses the virus without the need for ongoing antiretroviral
treatment. A sterilising cure is one where the HIV virus is eradicated from the
body completely. There is only one known person who’s been cured in this way:
Timothy Brown, also known as the 'Berlin Patient'.
In 2007-08, Brown had chemotherapy and a bone marrow
transplant to treat leukaemia. His transplant came from someone with a natural
genetic resistance to HIV. He was cured of HIV but scientists don’t fully
understand why. Also, because bone marrow transplants can be dangerous, they’re
not practical as a wider HIV cure. However, this process has given researchers
important information that they’re using to work towards a cure.
Pakistan's
growing population suffers the burden of having insufficient access to quality
healthcare. HIV outbreaks at Ratodero, a small city and Taluka of Larkana. "According
to some government reports, around 600,000 quack doctors are operating across
the country and around 270,000 are practicing in the province of Sindh,"
said UNAIDS in a statement. Provincial health officials have also noted that
patients are at particular risk of contracting diseases or viruses at these
clinics, where injections are often pushed as a primary treatment option. (source:
https://www.aljazeera.com/news/2019/05/coming-dozens-hiv-outbreak-sparks-panic-pakistan-190516061341489.html). The reuse
of syringes, surgical instruments, instruments of barbers, unauthenticated
blood transfusions, wrong sexual connections etc. may be sources to spread the
HIV virus in Ratodero. According to VOA News, Pakistan is registering
approximately 20,000 new HIV infections annually, the highest rate of increase
among all countries in the region, warns the World Health Organization (WHO). The
international body says mortality among Pakistanis living with the virus, which
causes the deadly AIDS disease, is also rising, in spite of the availability of
life saving antiretroviral therapy. The government figures show that only 16
percent of the estimated 150,000 people living with HIV had been tested and
only 9 percent have access to lifesaving treatment. The remaining 135,000
people are walking around in the communities as carriers of (HIV) infection who
are ready to transmit infections to those who are not infected, even to their
unborn babies. The HIV epidemic in Pakistan remains largely concentrated among
the key populations, including people who inject drugs, the transgender
community, sex workers and their clients and men who have sex with men. Official
estimates show that Pakistan has seen a 45 percent increase in new HIV
infections since 2010. The number of new HIV infections will continue to
increase dramatically if implementation rates of intervention remain at current
levels. (Source: https://www.voanews.com/a/who-says-hiv-epidemic-spreads-at-alarming-rate-in-pakistan/4683295.html).
More
complex challenges are determining how to integrate many of HIV activities
within other health activities, improve planning to anticipate future direction
of the epidemic and its response and to enhance efficiency and effectiveness of
the interventions. The newspaper information shows a slower case detection and
confirmation as well as any response services for the infected population.
“An
ounce of prevention is worth a pound of cure”
