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| Sunday, 30 November 2003 |
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| News Business Features Editorial
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The killer disease Tomorrow is World AIDS Day. Despite a global effort to stem the rising tide of this deadly disease, the number of patients with HIV/AIDS now stands at 40 million. Tragically 95 per cent of them live in developing nations including Sri LankA:
AIDS is a disease caused by a virus which can break down the body's immune system and can lead to fatal infections and some forms of cancer. AIDS stands for Acquired Immune Deficiency Syndrome HIV stands for Human Immunodeficiency Virus, the virus which causes the disease. HIV Infection means infection with the AIDS virus or AIDS virus infection. When the AIDS virus enters a persons body, it penetrates certain cells in the body where it can remainduring the life of the person. In some people who are infected, the virus remains dormant for years before it causes AIDS. These people may look and feel healthy. However, they may spread the virus to sexual partners during this period. They could infect others through donation of their blood. In others, the viruses becomes very active, multiplies rapidly, spreads through the body and causes AIDS quickly. This may happen a few months or several years after the virus infected them. The virus causes AIDS in the following way: It disables or destroys certain kinds of cells which normally helps the body to fight disease. As a result, the body cannot defend itself against infections and certain cancers. These patients are then susceptible to infections and cancers - diseases which a healthy person could resist. AIDS is the most severe kind of illness caused by the AIDS virus HIV. But, other illnesses also result from infection with the virus and usually get worse with time and develop into AIDS. The virus and the immune system HIV - The virus that causes AIDS belongs to a class of viruses called retroviruses. Like all viruses the (HIV) virus reproduces only in living cells. Once the virus enters a host cell, permanent infection is established. The Immune deficiency in AIDS stem largely from the - gradual depletion of a specialized group of white blood cells called T-Helper or T-4 cells, which plays a key role in regulating the immune response. HIV selectively infects T-helper cells as well as several other types of cells in the immune system. The virus multiplies in the T-helper cells and destroys them. The destruction of large numbers of T-helper cells, is partly responsible for the immune deficiency. There are as yet many other factors not fully understood which could account for the disastrous effects on the immune system. How AIDS is spread Transmission of HIV always involves exposure to body fluids of an infected person. The virus has been isolated from various body fluids. The greatest concentrations have been found in blood, cerebrospinal fluid, semen and vaginal secretions. Lower concentrations have been found in saliva, tears, breast milk, urine and amniotic fluid. AIDS is spread when blood, semen or vaginal secretions of an infected person comes into contact with the blood of a healthy person. There are three main ways by which the virus can be transmitted to another: By Sexual contact The most common way that the AIDS virus is spread is when a person has sexual intercourse with a person who already has the virus. An infected man has the virus in his blood and semen. An infected woman has it in her blood and vaginal secretions. The virus can be passed on either in sexual intercourse between homosexuals or intercourse between a man and woman - from an infected man to a woman, and from an infected woman to a man. By transfusion of infected blood or blood products. If the blood or blood products containing the AIDS virus is given to an uninfected person, then that person becomes infected with the AIDS virus. By contaminated Needles and Syringes Syringes, needles, knives, razor blades, ear piercing tools or any other instrument used to cut, pierce or inject the body can contain the blood of a person infected with the AIDS virus. If such instruments are used without proper sterilization, then the AIDS virus can be passed on to an uninfected person through these instruments. By an infected pregnant woman To her unborn child during pregnancy or childbirth. Approximately 15-25 per cent of infants born to infected mothers will be infected with the virus. How the AIDS virus does not spread No case of transmission of the virus is known to have occurred by: Touching or shaking hands of a person who is infected with the virus. Living together with an HIV infected person. Playing together. Swimming in a swimming pool or river, where an infected person is. Kissing of lips of an infected person. Sharing cups, plates and other utensils used by an infected individual.By being bitten by insects such as mosquitoes, bed bugs etc. By coughing or sneezing. By contact with towels, bed linen etc. used by an infected person. By toilet seats used by infected persons. By donating blood. Some people even fear that donors may catch AIDS by giving blood. There is in fact no risk when sterile equipment is used for blood collecting. It is also not spread by food or water. Symptoms/signs Infection with HIV (Virus) takes many forms. It ranges from a complete absence of symptoms, to mild illness, to debilitating neurological disorders and fatal disease. AIDS is the end stage of the infection Many people infected with the virus have no symptoms, and do not know that they are carrying the virus as they appear healthy and feel well. HIV infection can be subdivided into five stages: (i) Acute illness, (ii) Latency phase, (iii) Stage of persistent Generalised Lymphadenopathy, (iv) Aids Related Complex (ARC), (v) AIDS. Acute illness: The acute phase may occur 2-12 weeks after infection. Antibodies to the virus appear in the blood 6-12 weeks after infection, but may take as long as 6-8 months or more. Some of the clinical manifestations are: Fever, Rash, Sore throat, headache, night sweating, cough and sometimes enlargement of lymph nodes. Often these features subside after about 2 weeks or a little longer. The Latency Phase: This phase is characterised by an absence of illness. The infected individual shows no external signs of disease. Stage of Persistent Generalised Lymphadenopathy (PGL). An infected individual has reached this stage when lymph nodes larger than 1 c.m. in diameter are found in two or more sites other than the groin, for periods of at least three months duration - in the absence of any other illness. Lymphadenopathy is one of the most common signs of HIV infection. AIDS Related Complex (ARC) Patients in this stage may have weight loss, malaise, fatigue, anorexia, watery diarrhoea, abdominal discomfort, fever, night sweating, headache, itching, lymphadenopathy and perhaps leisions of the skin and mucous membranes. AIDS AIDS itself represents the most severe stage of the clinical spectrum of HIV infection. Full blown AIDS clinically shows 3 clearcut manifestations: (i) Severe and life-threatening opportunistic infections. (ii) Opportunistic rare forms of cancers. e.g. Kaposis Sarcoma and B-cell lymphomas. (iii) Neurological disease. Courtesy 'AIDS' a publication of the Health Education Bureau written by Dr. Marcus Fernando. **** HIV/AIDS in the world - Facts and figures Worldwide, AIDS kills more than 8,000 people everyday; 1 person every 10 seconds. HIV accounts for the highest number of deaths by any single infectious agent. Since the beginning of the epidemic, AIDS has claimed more than 25 million lives; more than 14 million children have lost one or both parents to AIDS. Every year, an estimated 3 million people die of AIDS of whom 500,000 are children under the age of 15 years. Nearly 5 million persons (4.2 million adults and 700,000 children) are newly infected with HIV each year; more than 95 per cent of them belong to developing countries Almost 50 per cent of newly HIV-infected adults in 2003 were women and 50per cent were young adults in the 15-24 years age group. WHO ***** AIDS - A non conventional approach Acquired Immune Deficiency Syndrome is a condition in which the Human Immuno-deficiency Virus (HIV) invades and destroys infection-fighting cells called T-lymphocytes, leaving the body open to a range of fatal diseases. HIV infection is usually symptomless at first and can take ten years or more to develop into AIDS. Conventional treatments Antiviral, antibacterial and antifungal drugs are all used to pre-empt or combat infection. A cocktail of three powerful antiviral drugs, including azidothymidine (AZT) and a protease inhibitor, now look capable of making AIDS treatable Complementary treatments Although some claim to treat HIV, most focus on alleviating symptoms, enhancing well-being and boosting the immune system. Massage - To relieve distress and encourage relaxation. Acupuncture - May help alleviate symptoms and increase immune function. Because of the use of needles, a highly trained practitioner must be consulted. (caution: do not take any of these during pregnancy). **** Web sites on AIDS For those who are on the look-out for information on AIDS HIV here are several sites that are worth visiting: www.aids.org - AIDS.ORG is a non-profit organisation dedicated to the global online distribution of HIV/AIDS information reaching more than 170 countries worldwide. There's also a newsletter, an AIDS bookstore and a selection of useful sites. www.thebody.com - The Body is comprehensive award-winning site, featuring information on a wide range of topics within the field of HIV/AIDS. www.aegis.com - This is a comprehensive site created by the AIDS Education Global Information System (AEGIS). Key issues include treatment, prevention and living with HIV. www.theaidschannel.com - This web site is very unique in that it is a true Internet Broadcast Channel, and features a live component - a "window" into the day-to-day life of a person living with HIV/AIDS, and his family, as they cope with the challenges that HIV/AIDS brings to them. (The Hindu) ###### Fighting AIDS - the Sri Lankan example Sri Lanka's first AIDS patient was discovered in 1986. Today the cumulative number of HIV/AIDS patients is 507 with an estimated 7,500 HIV carriers. by CAROL ALOYSIUS
The Sunday Observer asked, the following doctors at the National Sexually Transmitted diseases and AIDS control (NSACP) Program- Dr. (Mrs.) Kanthi Senanayaka, Consultant Venereologist, Dr. Shantha Hettiarachchi, Medical Officer and Dr. Kulasiri Buddhakorala, Consultant, National STD/AIDS Control program, how Sri Lanka's health Ministry was dealing with the problem. This is what they had to say. Q: According to your estimates Sri Lanka has around 507 cumulative HIV cases as on July 2003. Of these 303 are men and 204 are women. What does this ratio signify? A: It means that the number of women is now almost equal to that of males. The ratio is 40 percent of women and 60 percent of males. This is a growing trend in this part of the world where infection takes place even though women have sex only with their husbands. It is the male partner who usually infects the woman although there are cases of it happening the other way round. Q: What is the most common mode of transmission? A: In Sri Lanka the current trend is by local or indigenous transmission - of which 845 are the result of heterosexual relationships between an infected person and a non-infected person. Only 12 percent are by homosexual relationships while 3 percent are mother to child transmissions and 1 percent from blood transfusions. Q: Where is the largest number of patients concentrated? A: Around 63 percent are from the Western Province. The rest are scattered in almost equal proportions elsewhere in the island. Q: Which segment of the population is most vulnerable to the disease? A: Young people and women. Young people because of their changing lifestyles and risky behaviour combined with their lack of adequate knowledge about AIDS. Women because of the refusal of their infected sex partners to engage in protected sex by wearing condoms. Sex workers, street children and youth and beach boys are also at high risk. Q: So what is the National AIDS Control Program doing to arrest the spread of AIDS among these vulnerable groups? A: Even before we had our first AIDS case we began an awareness program in schools and among youth clubs about how AIDS spreads and how it can be prevented. These programs are continuing islandwide where we use the media as well to raise awareness. We're trying to debunk myths about the disease to bring about an attitudinal chance among the public. Our main thrust is condom promotion among high risk groups. Q: Has there been a positive outcome of these programs ? A: Yes. In fact we can say that our programs to create awareness on Sexually Transmitted Diseases, has brought down the numbers of STD's especially traditional diseases like syphilis and gonorrhoea dramatically. Q: What about changing the risky behaviour patterns of these young people? What kind of message do you have for them? A: As far as sexual behaviour is concerned our message is to abstain from sexual relations and delay first sexual contact as far as possible. If this is not possible we say "Use a condom". We also advise sex workers to try and limit their number of partners. Ideally one should have sex only with one's husband or else withs one faithful partner. Any other relationships must be considered causal. Q: So are condoms freely available for both males and females here? A: Yes we distribute them free at our STD clinics and they are also available at our office at De Saram Place. There are also condom wending machines and they are available at supermarkets and pharmacies as well. The cost of a condom for males is around five rupees. The female condom is more expensive. Unfortunately it is not moving so fast. Q: Why? A: Perhaps because it is not made of rubber like the male condom but is of a synthetic material. Whatever the reason it is a global trend. I guess more education has to be given to our women on this matter. Q: What have you done to treat infected persons? Are these drugs accessible to all infected persons or only a tiny fraction because of their exorbitant costs? A: When the first anti-retroviral drug was developed in 1996 it cost around 12,000 US dollars per year for a person i.e. around Rs. 1.2 million. However in year 2000 the Indian pharmaceutical Industry manufactured a generic of these drugs at a much more affordable price. We are trying to negotiate to get down these drugs which will cost only Rs. 3,000 a month or 30 dollars which works out to one dollar a day. Q: What would you say is the most important message that World's AIDS Day has to give ? A: Its theme as in the previous year is `Live and Let Live'. This underscores the importance of fighting stigma and discrimination which are the most negative factors in our war against AIDS. Our Ministry is going all out to get the public at large to change their attitudes towards AIDS patients from one of rejection to acceptance. |
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In S.E. Asia the number of HIV/AIDS patients is six million.We dedicate
this page to all victims of HIV/AIDS and to those who are actively
involved in fighting this global enemy.
