HIV – HTV https://htv.com.pk Fri, 05 Jun 2020 07:00:58 +0000 en-US hourly 1 Poverty and HIV: A Deadly Nexus https://htv.com.pk/health/poverty-and-hiv Thu, 30 May 2019 08:04:03 +0000 https://htv.com.pk/?p=44781

In April, the issue of HIV surfaced in Ratodero, Larkana, when about 12 children visited a hospital with symptoms of fever, vomiting and weight loss. A large number of children visiting the hospitals with the same symptoms rang alarm bells and a local pediatrician sent the blood samples of 11 children for testing. They were […]

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In April, the issue of HIV surfaced in Ratodero, Larkana, when about 12 children visited a hospital with symptoms of fever, vomiting and weight loss.

A large number of children visiting the hospitals with the same symptoms rang alarm bells and a local pediatrician sent the blood samples of 11 children for testing. They were all tested HIV positive.

As of May 20, around 553 children have been tested HIV positive.

A pediatrician, who was believed to be the only qualified doctor for children in Ratodero, was held responsible for the outbreak.

Though the virus can also be transmitted to children through breastfeeding and through mother to fetus, in the case of Ratodera, the mothers of virus affected children were also tested but they didn’t carry the virus.

According to the WHO consultant and physician, Dr Arshad Altaf, the infection spread due to reuse of syringes and drip sets used by quacks in this area.

Keeping in view the number of children affected, it is unlikely that only one doctor is responsible for the outbreak because in Pakistan even qualified doctors use the same syringes,” he says.

The WHO defines a safe injection as one that does not harm the recipient or the provider and does not result in waste that is dangerous to the community.

The Poverty Nexus

The reuse of single-use disposable syringes that led to a HIV outbreak in Ratodero can be attributed to poverty. Dr Altaf mentions that patients in rural areas are extremely poor and cannot afford to pay extra. Therefore, doctors offer services in which cheap medicines and injections are part of the package.

On the other hand, once diagnosed, it is important to note that HIV cannot be cured. It can be treated and contained. HIV patients have to take medicine all their lives.

And for the people of Ratodero, they have to travel for treatment as the town is quite far from Larkana and Karachi. But their poverty restricts them to do so, says Dr Altaf adding that when the child’s health improves parents think he/she doesn’t need treatment anymore and so they stop going.

RELATEDAIDS In Children – Problems, Prevention And Prognosis

A local journalist Sheeraz Mehmood Pathan, who has been covering the HIV outbreak in Ratodero, also shared that he met some families who told him that they have already visited Larkana seven to eight times for the treatment of their children, and it is financially taxing.

Keeping in view the large number of HIV affected children and poverty, parents hoped that the government might consider setting up a facility in their town. However, this has not been the case. So far, the government with the help of an NGO called Global Fund has only been providing free-of-charge medicines to the patients.

Moreover, poverty also restricts parents from taking proper care of their children. Dr Fatima Jehangir, a consultant family physician at the Ziauddin Hospital, says that HIV affected children need more nutritional care to boost their immunity because this disease makes them immunocompromised, making them more prone to infections. But most parents cannot afford to provide such care.

Under 5 Most Affected

According to the findings of a preliminary report submitted by a Field Epidemiology and Laboratory Training Program team on May 16, the most affected age group in the 534 HIV positive cases so far is between two and five, followed by age groups six to 15.

Among these, female children have been the most affected and the youngest child in the outbreak is less than a month old.

The report also revealed that around 14,810 individuals were screened between April 25 to May 16 and the number of HIV positive cases was found to be 534. Of them, 49.4% were male and 50.6% were female.

Such a significant number of patients in a small town of just 0.33 million people, according to the Census 2018, requires specialized doctors. Dr Jehangir says that usually infectious disease specialists treat HIV patients and during this treatment long-term precautions have to be taken to stop further spread. Monitoring of blood markers also have to be conducted in order to determine the stage of the disease. However, Ratodero lacks such facilities or doctors.

Immediate Action

The report says an immediate action should be taken against quacks, unauthorized laboratories and blood banks. So far, the Sindh Healthcare Commission has sealed around 71 clinics in Ratodero alone. It also suggests that more HIV screening camps should be set up at THQ hospital Ratodero to identify hidden cases.

Recently, only after the outbreak the government set up a ward for HIV affected children in Chandka Hospital Larkana, which was previously unavailable.

Pathan said that as of May 23, around 317 children have visited the ward. “At least seven children have died so far while the condition of five more is critical,” he mentioned.

RELATED: HIV In Pakistan: An On-Going Battle!

Dr Altaf elaborates that in order to prevent reuse of syringes there should be a mechanism where the health facility, small or large, if private, properly disposes these syringes in a sharps container and after that, it either burns or buries these syringes in a proper pit.

Incineration is common in Pakistan, but incinerators are only available at medium to large government facilities in rural areas, he says. There is no mechanism where the government health centers, where there is a functioning incinerator, accepts healthcare waste of private facilities, he adds.

He suggests that the government can institute a mechanism in which it can sub-contract the sharp collection system to a contractor and then the contractor charges a nominal fee per kilo for the sharps and transports the waste to the incinerator. In fact, Dr Altaf recalls that this system was functional in the early 2000s in Karachi but it could not sustain because the laboratories and health centers wouldn’t pay the collection charges regularly to the contractor.

Such an attitude needs to change lest we want more children to fall victim to medical negligence.

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Giving AIDS Drugs during breastfeeding can prevent mother-to-child transmission https://htv.com.pk/news/shielding-babies-hiv-breastmilk Thu, 22 Mar 2018 05:50:05 +0000 http://htv.com.pk/?p=17590

Giving anti-AIDS drugs directly to infants breastfed by their HIV-positive mothers significantly reduces their risk of contracting the killer virus, researchers said. Less than 1.5 percent of children, given one of two anti-viral drugs during 12 months of breastfeeding, caught the virus from their mothers, said a study published in The Lancet medical journal. This […]

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Giving anti-AIDS drugs directly to infants breastfed by their HIV-positive mothers significantly reduces their risk of contracting the killer virus, researchers said.

Less than 1.5 percent of children, given one of two anti-viral drugs during 12 months of breastfeeding, caught the virus from their mothers, said a study published in The Lancet medical journal.

This was the first study to assess the effectiveness of AIDS drugs to prevent mother-to-child transmission in infants breastfed for longer than six months.

Breastfeeding, especially in poor countries, is one of the best ways to improve infant survival, but is also an avenue for women to pass the AIDS-causing virus on to their infants.

The latest findings will feed into an ongoing debate which stacks the nutritional benefits of breastfeeding up against the risk it holds for transmitting the virus which causes AIDS.

The World Health Organization (WHO) recommends that HIV-positive women, especially in developing countries, breastfeed their infants for at least 12 months, the best way to get the nutrients they need and avoid serious illnesses such as diarrhea and pneumonia.

When the mothers themselves were taking antiretroviral (ARV) drugs, the risk of transmission is about 0.2% per month, thus 2.4% in total over 12 months of breastfeeding.

But when special child ARV formulations were given to the baby directly, the risk was about 1.5%, said the study, which involved some 1 200 children in Burkina Faso, South Africa, Uganda, and Zambia.

The study was done before the UN’s health organ decided earlier this year that all people living with HIV should be given ARVs regardless of the level of CD4 immune cells in their body, a measure of HIV progression.

Previously, ARV treatment had been recommended from a level of about 350 cells per cubic millimeter, compared to about 500-1 200 in a healthy person.

The researchers tested two drugs given directly to the infants, lamivudine, and lopinavir and found they were equally effective.

Prolong infant treatment -Existing treatments help infected people live longer, healthier lives by delaying and subduing symptoms, but do not cure AIDS.

Many people in poor communities do not have access to life-giving drugs, and there is no preventive vaccine.

“This finding justifies the extension of infant pre-exposure prophylaxis until the end of HIV exposure” through breastfeeding, the study authors said.

And they highlighted “the need to inform mothers about the persistent risk of transmission throughout breastfeeding to prevent them from stopping giving the treatment to their babies too soon.”

The team found that most of the HIV infections in the study groups were due to the treatment being stopped.

To this end, more research was needed for a more palatable baby medicine or potentially long-acting injectable drugs.

Thirty-nine million people have died of AIDS, according to UN estimates, and about 35 million are living with the immune system-destroying virus today, overwhelmingly in poor countries.

Source: AFP-Relaxnews

 

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Vaginal ring cuts HIV risk by nearly one-third: studies https://htv.com.pk/news/vaginal-ring-cuts-hiv-risk-nearly-one-third-studies Fri, 23 Feb 2018 13:43:27 +0000 http://htv.com.pk/?p=16883 Vaginal ring cuts HIV risk by nearly one-third: studies

The dapivirine ring was even more effective in women over 25, who saw their HIV risk drop 61 percent while using the ring, developed by the nonprofit International Partnership for Microbicides (IPM). The findings, released at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, mark the first time a long-acting vaginal ring has […]

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Vaginal ring cuts HIV risk by nearly one-third: studies

The dapivirine ring was even more effective in women over 25, who saw their HIV risk drop 61 percent while using the ring, developed by the nonprofit International Partnership for Microbicides (IPM).

The findings, released at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, mark the first time a long-acting vaginal ring has been shown to significantly reduce the risk of HIV infection in women, researchers said.

The research also adds a new dimension to preventing HIV infection by encouraging healthy people to take anti-retroviral drugs, a strategy known as PrEP, or pre-exposure prophylaxis.

Previous trials using another anti-retroviral drug — tenofovir — in pill form and as a vaginal gel have not been shown effective in African women.

In contrast, studies using Truvada, a preventive daily pill in gay men, have shown significant success.

Women bear greatest burden

The latest findings came from two large phase III clinical trials, in which thousands of women in Africa were randomly assigned — and taught — to insert a vaginal ring that either contained the active medication or a placebo.

“The Ring Study, led by IPM, showed that the monthly dapivirine ring safely reduced HIV infection overall by 31 percent compared to a placebo,” said a statement from IPM.

“Similar results were seen in ASPIRE, led by the US National Institutes of Health-funded Microbicide Trials Network (MTN), which found that the ring safely reduced infection by 27 percent overall,” it added.

“This is the first time two phase III studies have confirmed statistically significant efficacy for a microbicide to prevent HIV.”

Finding ways to prevent the virus that causes AIDS in women is important because more than half of the 35 million people in the world who currently are infected with HIV are women — and most reside in sub-Saharan Africa.

Women need additional preventive measures because they are often unable to negotiate consistent condom use with their partners, experts say.

The Ring Study enrolled 1,959 HIV-negative women ages 18-45 at seven sites in South Africa and Uganda. It began in 2012 and began reporting its results early based on the successes seen.

ASPIRE ran from 2012-2015 and enrolled 2,629 HIV-negative women ages 18-45 at 15 sites in Malawi, South Africa, Uganda and Zimbabwe.

Both studies found large differences in how effective the ring was at preventing HIV according to the age of the women using it.

“Little to no protection was seen in women ages 18-21 across both studies – 15 percent in The Ring Study and no protection in ASPIRE,” said the IPM statement.

But women over 21, who appeared to use the ring more consistently, saw their risk of HIV drop by 56 percent in the ASPIRE study.

Those over 25 had a 61 percent reduced risk.

“These findings were statistically significant and supported by a trend in The Ring Study which also showed higher efficacy (37 percent) for women over 21,” said the IPM.

More research is needed to understand what factors could have led to the difference in outcomes, scientists presenting the findings said at CROI.

“These findings give new hope to many women at high risk who need more and different options to effectively protect themselves from HIV,” said Zeda Rosenberg, founding chief executive officer of IPM.

A report detailing the latest research was simultaneously published in the New England Journal of Medicine.

 

Source: AFP

 

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Thailand first in Asia to eliminate mother-to-baby HIV, https://htv.com.pk/news/thailand-first-asia-eliminate-mother-baby-hiv Thu, 09 Jun 2016 09:47:15 +0000 http://htv.com.pk/?p=19778

Thailand has become the first Asian country to eliminate mother-to-child transmission of HIV,

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Image courtesy: Google

Thailand has become the first Asian country to eliminate mother-to-child transmission of HIV, the World Health Organization said yesterday, a milestone in the fight against the disease. The announcement is a boost for a generation of Thai health workers who have transformed the nation from one of Asia’s most HIV-ravaged societies to a pin-up for how to effectively tackle the crisis. Describing the elimination as a “remarkable achievement”, the WHO said Thailand was “the first (country) with a large HIV epidemic to ensure an AIDS-free generation.”

Belarus and Armenia were also declared free of mother-to-baby HIV transmissions yesterday but both nations have a much lower prevalence of the virus. Previously Cuba was the only other country to have eliminated mother-to-child transmission under the WHO’s criteria back in July 2015. The global health body said Thailand’s routine screening and universal free medication for pregnant women with HIV was crucial in stopping the virus being passed to new generations.

If left untreated, mothers with HIV have a 15-45 percent chance of transmitting the virus to their children during pregnancy, childbirth or while breastfeeding. But taking antiretroviral drugs during pregnancy significantly reduces those chances to just over one percent. In 2000 Thailand became one of the first countries in the world to provide free antiretroviral medication to all pregnant women diagnosed with HIV.  Screening for the virus during pregnancy is also routine, even in the country’s most remote areas, the WHO added.

Not 100 percent effective

According to Thai government figures, the number of babies born with HIV has dropped from 1,000 in 2000 to just 85 last year, a large enough fall for the WHO to declare mother-to-child transmission over. A small number of cases are taken into account, as treatment with medicine is not 100 percent effective. It is a major turnaround for Thailand. The country went from 100,000 HIV cases in 1990 to more than a million three years later, fuelled in part by its huge sex trade. Health workers initially struggled to persuade governments to act.

But an eventual push to distribute free condoms among sex workers throughout the late 1990s and the widespread rollout of antiretroviral drugs in the 2000s has seen huge success and won the country widespread praise. “Thailand’s progress shows how much can be achieved when science and medicine are underpinned by sustained political commitment,” UNAIDS Executive Director Michel Sidibe said in a statement. But there is still work to be done.

The UN estimates there are some 500,000 living with HIV in the kingdom, while infection rates have risen slightly in recent years, particularly among gay men. Piyasakol Sakolsatayadorn, Thailand’s Minister of Public Health, said the landmark announcement “belongs to everyone” but added “a challenge remains: how we make this success sustainable.” Each year, 1.4 million women living with HIV around the world become pregnant. The number of children born annually with HIV was 400,000 in 2009. By 2013, the number was down to 240,000.

Source: AFP

 

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Alcoholism drug may help design HIV cure: Study https://htv.com.pk/news/alcoholism-drug-may-help-design-hiv-cure-study Tue, 17 Nov 2015 13:19:48 +0000 http://htv.com.pk/?p=13104 Alcoholism drug may help design HIV cure: Study

The medication, called Disulfiram, draws out the AIDS-causing virus without any side effects for patients, according to a study published in The Lancet.

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Alcoholism drug may help design HIV cure: Study

The medication, called Disulfiram, draws out the AIDS-causing virus without any side effects for patients, according to a study published in The Lancet.

In people undergoing treatment for AIDS, the virus can take cover in certain cells and hide away, only to reemerge once therapy is stopped.

This latency has been one of the biggest hurdles in developing a cure.

“Waking up” the virus – and then destroying it — is a promising strategy for ridding patients of HIV.

But other drugs which are able to rouse HIV from its dormant state are toxic to humans.

In clinical trials led by Sharon Lewin, a professor at the University of Melbourne, 30 people on antiretroviral treatment (ART) were given increasing doses of Disulfiram over a period of three days.

At the highest dose, there was evidence of slumbering HIV being stimulated, with no side effects.

“This trial clearly demonstrates that Disulfiram is not toxic and is safe to use, and could quite possibly be the game changer we need,” Lewin said in a statement.

The next step will be to test Disulfiram’s rousing effect in combination with a virus-killing drug.

“Waking up the virus is only the first step to eliminating it,” said the study’s lead author Julian Elliott, head of clinical research in the department of infectious diseases at Alfred Hospital in Melbourne, Australia.

“Now we need to work out how to get rid of the infected cell.”

Approximately 34 million people have died of HIV-related causes worldwide. By the end of 2014, there were an estimated 36.9 people living with HIV globally.

News source: AFP

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