COVID-19 and Human Immunodeficiency Virus (HIV) strategy
Part of: GS-III- Health – S&T (PT-MAINS-PERSONALITY TEST)
Recently a person suffering from HIV has been treated in London called as ‘London Patient’. He is the second person after Timothy Ray Brown who got cured of HIV. He has been cured with CCR5-delta 32 technique, which is based on a stem cell transplant involving CCR5-delta 32 homozygous donor cells.
Human Immunodeficiency Virus (HIV)
HIV attacks CD4, a type of White Blood Cell (T cells) in the body’s immune system. T cells are those cells that move around the body detecting anomalies and infections in cells. After entering body, HIV multiplies itself and destroys CD4 cells, thus severely damaging the human immune system. Once this virus enters the body, it can never be removed.
CD4 count of a person infected with HIV reduces significantly. In a healthy body, CD4 count is between 500- 1600, but in an infected body, it can go as low as 200. Weak immune system makes a person prone to opportunistic infections and cancer. It becomes difficult for a person infected with this virus to recover from even a minor injury or sickness. By receiving treatment, severe form of HIV can be prevented.
Types of HIV – PT SHOT
- Most Common
- Further categorized in 4 groups
- Group M [Major]
- Group N [Non-M & Non-O]
- Group O [Outlier]
- Group P
- 90% of the cases are caused by Group M HIV.
- This is found primarily in Western Africa, with some cases in India and Europe.
- There are 8 known HIV-2 groups (A to H).
- HIV-2 is closely related to simian immunodeficiency virus endemic in a monkey species (sooty mangabeys).
- HIV is transmitted from person to person through bodily fluids including blood, semen, vaginal secretions, anal fluids and breast milk.
- To transmit HIV, bodily fluids must contain enough of the virus. A person with ‘Undetectable HIV’ cannot transfer HIV to another person even after transfer of fluids.
- ‘Undetectable HIV’ is when the amount of HIV in the body is so low that a blood test cannot detect it. Treatment can make this possible. But regular monitoring of the same through blood tests is also required.
- Around 80% of people infected with HIV develop a set of symptoms known as Acute Retroviral Syndrome, around 2-6 weeks after the virus enters into body.
- The early symptoms include fever, chills, joint pains, muscle aches, sore throat, sweats particularly at night, enlarged glands, a red rash, tiredness, weakness, unintentional weight loss and thrush.
- A person can carry HIV even without experiencing any symptoms for a long time. During this time, the virus continues to develop and causes immune system and organ damage.
- Since the beginning of epidemic, more than 70 million people have got infected with HIV virus and about 35 million have died.
- Globally, 36.9 million People were living with HIV at the end of 2017. Of these, 1.8 million were children under 15 years of age.
- According to Global HIV & AIDS statistics, only 59% of those infected with HIV are receiving the antiretroviral drugs.
- The African Region is the most affected region with 1 in 25 adults living with HIV.
- The total number of people living with HIV was estimated at 21.40 lakh in 2017.
- India witnessed over 87,000 new cases in 2017 and saw a decline of 85% compared to 1995.
- Anti-Retroviral Therapy:
- It is a combination of daily medications that stop the virus from reproducing.
- The therapy helps in protecting CD4 cells thus keeping the immune system strong enough to fight off the disease.
- It, besides reducing the risk of transmission of HIV, also helps in stopping its progression to AIDS (a spectrum of conditions caused by infection due to HIV).
- Stem Cell Transplant:
- Under this, an infected person is treated with stem cell transplant from donors carrying a genetic mutation that prevents expression of an HIV receptor CCR5.
- CCR5 is the most commonly used receptor by HIV-1. People who have mutated copies of CCR5 are resistant to HIV-1 virus strain.
- It has been reported that till now, only two people have been cured of HIV by experts using this method of treatment. The first person is Timothy Ray Brown (Berlin Patient) who was cured in 2007 and the second is known as London Patient, who just got cured of HIV.
- The difference in the treatment of both patients is that the Berlin Patient was given two transplants and he underwent total body irradiation while the London Patient received just one transplant and also less intensive chemotherapy.
- Researchers find this method very complicated, expensive and risky.
Policies and efforts
National Aids Control Program
- The National AIDS Control Organization, Ministry of Health and Family Welfare launched the first phase of National AIDS Control Programme in 1992.
- Over time, the focus has shifted from raising awareness to behavior change, from a national response to a more decentralized response and to increasing involvement of NGOs and networks of Person Living with HIV/AIDS (PLHIV).
- Subsequently, second, third and fourth phases have been launched in 1999, 2007 and 2014 with better implementation and improved strategy.
HIV/AIDS Act, 2017 Implemented
- Recently, The Ministry of Health and Family Welfare, enforced the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017 (HIV/AIDS Act, 2017) in force from 10th September 2018.
India’s HIV Burden
- With an HIV prevalence of 0.26% in the adult population, India has an estimated 2.1 million People living with HIV (2015). India has third largest number of cases in the world.
- Bio-behavioural surveys confirm that HIV prevalence is high or ‘concentrated’ among ‘key populations’ (KPs) who have unprotected sexual contacts with multiple partners or who engage in injecting drug use.
- These populations include female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (TG), people who inject drugs (PWID), long-distance truck drivers and migrants.
National Strategic Plan for HIV/AIDS and Sexually Transmitted Infection (STI) 2017 – 2024
- The National AIDS Control Organization (NACO) has now revised the national approach to reach ‘the last mile’ – in order to ensure a more effective, sustained and comprehensive coverage of AIDS related services.
- This approach is being implemented by the NACO through a seven-year National Strategic Plan on HIV/AIDS and STI, 2017-24.
By 2020, the focus of the national programme will be on achieving the following fast track targets:
- 75% reduction in new HIV infections,
- 90-90-90: 90% of those who are HIV positive in the country know their status, 90% of those who know their status are on treatment and 90% of those who are on treatment experience effective viral load suppression
- Elimination of mother-to-child transmission of HIV and Syphilis
- Elimination of stigma and discrimination
By 2024, the further achievements envisaged are:
- 80% reduction in new HIV infections
- Ensuring that 95% of those who are HIV positive in the country know their status, 95% of those who know their status are on treatment and 95% of those who are on treatment experience effective viral load suppression
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)
- The Global Fund is a 21st-century partnership organization designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics.
- Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector and people affected by the diseases.
- The Global Fund raises and invests nearly US$4 billion a year to support programs run by local experts in countries and communities.
- GFATM play a significant role in India’s health sector It contribute a substantial portion of the external development assistance to the health sector.
- A new initiative called 'Project Sunrise' was launched by Ministry of Health and Family Welfare in 2016, to tackle the rising HIV prevalence in north-eastern states in India, especially among people injecting drugs
The Red Ribbon
- The red ribbon is the universal symbol of awareness and support for people living with HIV.
- Wearing a ribbon is a great way to raise awareness on and during the run up to World AIDS Day.