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DateLine Sunday, 19 August 2007

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Government Gazette

Know it. Beat it

Eight ICAAP confab kicks off at the BMICH today:

Will HIV/AIDS patients be able to fight a lonely battle for survival? Most probably it will be losing one unless they get the support of the society.

Taking a giant leap forward to create a better world - a world free from AIDS - the 8th International Congress on AIDS in Asia and the Pacific (ICAAP), confab with over 2,000 participants around the globe has kicked off today at the BMICH. The conference started under the theme 'Waves of Change Waves of Hope' will be concluded the on August 23.

Among several meaningful objectives one major objective of the ICAAP is to ensure that communities that are infected, affected and vulnerable to HIV/AIDS and their families are free from stigmatization, marginalisation and discrimination by addressing political, social, economic and cultural barriers and working towards societies in which they can enjoy the full range of human rights and protections as enshrined in the Universal Declaration of Human Rights and associated Protocols.

Though people know very much about HIV/AIDS, still there is a room for creating more awareness on the subject.

What does "AIDS" mean?

AIDS stands for Acquired Immune Deficiency Syndrome: * Acquired means you can get infected with it.

* Immune Deficiency means a weakness in the body's system that fights diseases.

* Syndrome means a group of health problems that make up a disease. AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make "antibodies" - special molecules to fight HIV.

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called "HIV-Positive."

Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don't get sick for many years. As HIV disease continues, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don't cause any problems can make you very sick if your immune system is damaged.

These are called "opportunistic infections."

How do you get AIDS?

You don't actually "get" AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who's infected, even if they don't look sick and even if they haven't tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

* having sex with an infected person;

* sharing a needle (shooting drugs) with someone who's infected;

* being born when their mother is infected, or drinking the breast milk of an infected woman. Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.

There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing, especially if you have open sores in your mouth or bleeding gums.

What happens if I am HIV positive?

You might not know if you get infected by HIV. Some people get fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash for one or two weeks. Most people think it's the flu. Some people have no symptoms.

The virus will multiply in your body for a few weeks or even months before your immune system responds. During this time, you won't test positive for HIV, but you can infect other people. When your immune system responds, it starts to make antibodies. When this happens, you will test positive for HIV.

After the first flu-like symptoms, some people with HIV stay healthy for ten years or longer. But during this time, HIV is damaging your immune system. One way to measure the damage to your immune system is to count your CD4+ cells. These cells, also called "T-helper" cells, are an important part of the immune system. Healthy people have between 500 and 1,500 CD4 cells in a millilitre of blood.

Without treatment, your CD4 cell count will most likely go down. You might start having signs of HIV disease like fevers, night sweats, diarrhoea, or swollen lymph nodes. If you have HIV disease, these problems will last more than a few days, and probably continue for several weeks.

How do I know if I have AIDS?

HIV disease becomes AIDS when your immune system is seriously damaged. If you have less than 200 CD4+ cells or if your CD4 percentage is less than 14 percent, you have AIDS.

If you get an opportunistic infection, you have AIDS. The most common ones are:

* PCP (Pneumocystis pneumonia), a lung infection,

* KS (Kaposi's sarcoma), a skin cancer,

* CMV (Cytomegalovirus), an infection that usually affects the eyes, see Fact Sheet 504; and

* Candida, a fungal infection that can cause thrush (a white film in your mouth) or infections in your throat or vagina.

AIDS-related diseases also include serious weight loss, brain tumours, and other health problems. Without treatment, these opportunistic infections can kill you.

AIDS is different in every infected person. Some people die in a few months after getting infected, while others live fairly normal lives for many years, even after they "officially" have AIDS. A few HIV-positive people stay healthy for many years even without taking antiretroviral medications (ARVs).

Is there a cure for AIDS?

There is no cure for AIDS. There are drugs that can slow down the HIV virus, and slow down the damage to your immune system. There is no way to "clear" HIV from the body. Other drugs can prevent or treat opportunistic infections (OIs). In most cases, these drugs work very well. The newer, stronger ARVs have also helped reduce the rates of most OIs. A few OIs, however, are still very difficult to treat.

HIV symptoms

HIV, or the human immunodeficiency virus, is a sexually transmitted disease that assails the immune system. The virus attacks your CD4 cells (or T4 cells), which are necessary to fight off illnesses.

Eventually, the virus overwhelms the CD4 cells and your body becomes unable to fight off diseases and infections. Once your body's CD4 cell count falls below 200 per cubic millimetre of blood, and/or an opportunistic infection takes hold of your weakened immune system, you will be diagnosed with AIDS (Acquired Immunodeficiency Syndrome). Symptoms of HIV vary according to what stage of the infection you are in.

Early symptoms of HIV

The earliest symptoms of HIV infection occur while your body begins to form antibodies to the virus (known as seroconversion) between six weeks and three months after infection with the HIV virus. Those who do show early HIV symptoms will develop flu-like symptoms.

This can include: fever, rash, muscles aches and swollen lymph nodes and glands. However, for most people, the first symptoms of HIV will not be apparent.

Although the infection is slowly taking hold of your body, the majority of those infected with HIV will be asymptomatic. Only by being tested for HIV can you know for sure if you have been infected. Yet, despite the absence of HIV symptoms, you are still highly contagious during this time making it very much a possibility to infect others, including your baby.

HIV/AIDS symptoms

As the infection progresses, people with HIV grow increasingly susceptible to illnesses and infection that don't normally affect the healthy population. Even though many of these illnesses can easily be treated, those with HIV often have such weakened immune systems that typical cures fail.

Without treatment, people infected with HIV can expect to develop AIDS eight to ten years after HIV infection. Taking HIV medications, however, can slow down this progression. With treatment, it can take ten to 15 years or more before you develop AIDS.

In the later stages of HIV, before it progresses to full blown AIDS, signs of HIV infection can involve more severe symptoms.

Symptoms of AIDS

To be diagnosed with AIDS, your T4 cell count must drop to below 200 per cubic millimetre (in healthy adults, a T4 cell count of 1,000 or more per millimetre is normal) or be infected with an opportunistic infection.

Opportunistic infections are so named because they take advantage of your weakened immune system. They include:

* Chronic yeast infections or thrush (yeast infection of the mouth)

* Fever and/or night sweats

* Easy bruising

* Bouts of extreme exhaustion

* Unexplained body rashes

* Appearance of purplish lesions on the skin or inside mouth

* Sudden unexplained weight loss

* Chronic diarrhoea lasting for a month or more Additionally, vision loss, nerve damage and brain impairment can also occur.

Signs of brain deterioration include troubles thinking, loss of co-ordination and balance and behavioral changes. While there are treatments to help prolong the life of those infected with the AIDS virus, there is currently no AIDS cure. The best way to protect yourself is by taking preventative measures.

HIV prevention

There are many steps you can take to help protect yourself against and prevent HIV and AIDS.

Sexual prevention

One of the main ways HIV transmission occurs is through vaginal, anal, and oral sex. Therefore, the best way to prevent being infected with the HIV virus is by practising abstinence. This means to refrain from having sex.

Having sex within a long-term, mutually monogamous relationship with someone who has tested free of HIV is also considered to be safe.

If you do choose to be sexually active and are not in a committed, mutually monogamous relationship, it is imperative that you use condoms each and every time you have sex.

While condoms cannot completely eliminate your risk of being infected with HIV, using them consistently and properly can significantly reduce your risk of infection.

Needle risk

It is possible to contract HIV by using contaminated needles. Most commonly, this refers to needles and syringes used for intravenous drugs. However, it can also include needles used in tattooing and piercing.

For intravenous drug users, the best way to prevent being infected with HIV is to quit using drugs. Failing this, though, you can reduce your risk of infection by:

* Never sharing or reusing needles for drug injection

* Always safely disposing of your needles or taking them to a needle exchange centre.

If you are getting a tattoo or a piercing, be sure that the facility you go to only uses new, sterile needles. The facility should also dispose of used needles in a safe and sanitary manner.

Blood contact

One method of transmitting HIV is through contact with an infected person's blood. Since the early 1980s, all blood services and blood banks in North America have utilized rigorous screening procedures to ensure that all the blood they collect and distribute is free of the HIV virus.

However, not all countries have the facilities or resources for this type of screening. If you are planning on donating blood, make sure the needles they use are new and sterile. If you are receiving blood, ask about the screening process of the blood being used in the procedure.

Healthcare workers are also at risk of being infected with HIV through direct contact with an infected person's blood. People working in a healthcare setting should take the following precautions to lower their chances of accidental contact and infection:

* Wash hands thoroughly with soap and warm water both before and after a procedure

* Always use protective barriers (i.e. latex gloves, masks) when you are in direct contact with bodily fluids including blood

* If possible, always use new, single-use disposable needles and syringes for all injections. Safely dispose of this injection equipment immediately after use.

* Promptly disinfect any contaminated equipment that is not disposable after use. If you think you may have come into contact with an infected person's blood, it is a good idea to go for HIV testing.

HIV and pregnancy

Because it is possible to pass the HIV virus onto your unborn child, it is highly recommended that all pregnant women, regardless of whether they display any HIV symptoms, have an HIV test done during their pregnancy.

Pregnant women who are HIV positive should discuss with their healthcare provider about starting treatment. Mother-to-child HIV transmission is also possible through breast milk. If you are HIV positive, discuss with your doctor the pros and cons of breastfeeding your child. You may be advised to avoid breastfeeding.

Hep C and HIV together

Because HIV and Hep C are both spread by contact with infected blood, many people are "coinfected" with both viruses. Coinfection has some special problems. Hep C makes HIV disease worse. This is probably due to liver damage. However, Hep C doesn't seem to interfere with antiretrovirals (ARVs).

* People with both infections are more likely to be depressed. This can lead to missed doses of medications (poor adherence, and are more likely to have problems thinking)

* For people with HIV, Hep C can be more serious and can cause serious liver damage and liver failure more quickly. Hep C treatment for coinfected people is successful for about 25 percent with genotype 1 and 50 percent with genotypes 2 or 3.

* People with HIV are more likely to transmit Hep C to others because their Hep C viral loads are higher.

* The drugs used to treat HIV are hard on the liver. However, we don't know if ARVs make Hep C worse.

* Sometimes HIV should be treated first. If someone meets the guidelines for HIV treatment, and they have a mild case of Hep C, their HIV should be treated first. Leaving advanced HIV untreated for 6 to 12 months could have serious consequences.

* Sometimes Hep C should be treated first. However, if HIV doesn't need to be treated yet (if CD4 cell counts are high enough, and HIV viral load is low enough), it's a good idea to treat Hep C first. Then the liver can be in better condition to deal with HIV drugs.

* Hep C coinfection slows down the rate of increase in CD4 cell counts during HIV treatment.

AIDS Infonet

 

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