NEW DELHI, Apr 7: Soon, it could be possible to imagine the marital life of a couple, having one HIV-infected partner, as pleasant as of any other healthy couple, according to a study.
Transmission of HIV infection from infected to uninfected partner can be reduced by 92 per cent to 96 per cent by putting the patient on routine anti-retroviral treatment (ART)- the drug therapy routinely used to improve quality of life of HIV/AIDS patients, according to a study quoted in a new book on HIV/AIDS.
Contrary to the prevalent perception that HIV transmission from infected to uninfected partner is definite, the breakthrough can prove boon for such couples, which are termed as Serodiscordant couples.
“Recent studies, including one large multinational study conducted in 13 sites in 9 countries of Latin America, Africa and Asia, including Pune and Chennai in India, have demonstrated effectiveness in preventing HIV transmission in Serodiscordant couples, where one partner is HIV-infected and other is not,” says Dr Jai P Narain, who has edited “Three Decades of HIV/AIDS in Asia” just launched by Sage Publications.
The book is a compilation of research works of various health experts and addresses evolving nature of HIV/AIDS and its unprecedented health and development threats in Asian countries.
“Of 1763 such couples studied, the study showed that ART was 96 per cent effective in preventing HIV transmission to HIV- negative partners. These findings shows that ART can not only reduce death rate and improve the quality of life of HIV patients but also reduce the HIV transmission”, he says, quoting the study conducted in various sites of Brazil, India, USA, Botswana, Kenya, Malawi, South Africa, Thailand and Zimbabwe.
The study is quoted in the chapter titled “Emerging issues with HIV and TB Prevention” which Dr Narain has co-authored.
Associated with HIV and TB control programme of WHO since 1988, Dr Narain is currently working as Senior Advisor to Government of India on Epidemiology and also served as Director, Department of Communicable Diseases, WHO South–Asia Regional Office.
Dr Narain says drugs used in ART therapy prevent HIV transmission from infected to uninfected partner by lowering the count of HIV virus in the blood of infected partner.
“In HIV, ART is expected to reduce the infection load or the viral load to such low levels that HIV infection cannot be passed on to the uninfected partner. In summary, this is an example of “treatment as prevention” or treatment acts as a prevention strategy” he adds.
According to him the new approach, if successful would prove a boon for countries like India, where 2.4 million people are presently estimated to be living with HIV/AIDS and theoretically capable of spreading infection to their un-infected partners.
“However, this risk of infection can be reduced substantially if infected individuals are diagnosed and treated with ART. The concept is now clear and well established that HIV treatment can also prevent [transmission of] HIV,” says Dr Narain who adds that the approach could be exploited maximally if more and more HIV patients diagnosed and put on ART therapy.
A chapter by Ranjit Roy Chaudhury gives a strategy to enhance the access to ARV drugs. M Shaukat et all in another chapter lists the major challenges of the HIV/ AIDS in India- the Epidemic and the national response.
“Utilisation of ART depends on awareness of the value of testing and knowing one’s HIV status, and availability of drugs, infrastructure and staff. Stigma-associated discrimination is still a key factor in deciding access to testing and resultant linkage to treatment services among high-risk polpulations….. A three-centre cohort study of patients initiated on ART in India reported that 16 per cent were lost to follow -up and 35 per cent missed their monthly appointments to pick up drugs,” the paper quotes.
The book, which its editor termed as a compendium of various research papers, contains chapter on country specific HIV related problems being faced by countries such as Bangladesh, Sri Lanka, where the disease has low prevalence rate and also from Combodia, China, India, Pakistan, Thailand and Vietnam, the countries facing very high HIV patient load.
In the area of care and support ART is now a global priority and a standard of care in both the developed and developing countries, according to Bharat Rewari and Po-Lin Chan in the boook.
Besides improving survival and the quality of life, ART can also help eliminate mother-to child transmission of HIV, as seen from the experience of Thailand described by Tanarak Pilpat in the volume.
In this context striving for the target of universal coverage, including of ART, is achievable provided additional resources are available and national capacity is strengthened. Chaturbhuj et al discuss the need for monitoring the emergence of drug resistance, a major concern.
The book specifically identifies the barriers that continue to prevent access to HIV services by key population groups and calls for intensification of actions to meet the unmet goals and targets.
Besides, the book, also traces the natural history of HIV infection and addresses the burning issues of degree of HIV epidemic and intervention among sex workers, Injectible Drug Users (IDUs) and transgender population apart from dedicating exclusive chapters on prospectus if HIV vaccine development in Asia and implications and feasibility of commercial health insurance for HIV patients in India. (PTI)
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