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- People living with HIV have been protesting outside offices of the National AIDS Control Organisation (NACO) for five days, demanding that they receive medicines in a timely manner following shortages for nearly five months. Around 50,000 people have been affected due to the shortage, according to the protesters.
What is HIV?
- Human immunodeficiency virus or HIV is an infection that attacks the immune system by destroying the body’s immune cells called CD4, which help it respond to infection.
- Once HIV attacks the CD4 cells, it starts replicating and destroying the cells, weakening the body’s immune system and making it more prone to certain “opportunistic infections” that take advantage of the weak immune system.
- In a nutshell, if HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).
- Bodily fluids such as blood, semen, vaginal fluids, rectal fluids and breastmilk can be carriers for HIV.
- It can be transmitted through unprotected sex, transfusion of contaminated blood, sharing needles and syringes, and from a mother with HIV to her infant during pregnancy.
- Typically, the time between HIV transmission and AIDS diagnosis is 10-15 years, although it may occur sooner.
- There's no vaccine to prevent HIV infection and no cure for AIDS. Protecting oneself from infection is the way ahead.
What medicines are unavailable?
- The main shortage is of dolutegravir, used as part of the first-, second-, and third-line antiretroviral therapy (ART)
Antiretroviral Therapy (ART)
The treatment for HIV is called antiretroviral therapy (ART). ART involves taking a combination of HIV medicines (called an HIV treatment regimen) every day. ART is recommended for everyone who has HIV.
- NACO recommends dolutegravir as the preferred drug for treatment of HIV-positive adults, adolescents and children (aged more than 6 years with bodyweight more than 20 kg),” according to the 2021 guidelines for HIV care and treatment by the organisation.
- There is also a shortage of nevirapine syrup that is given to infants with HIV.
- There is a stockout of at least one or more medicines across 12 states, most facing problems with paediatric and second and third lines of antiretrovirals.
Why is the shortage a concern?
- While there is no cure for HIV infection, ART aims to reduce the replication of HIV and bring the viral load to undetectable levels.
- There has been a decline in mortality and illness resulting from HIV infection due to better availability of affordable and effective ART.
- Continued suppression of the virus with the use of ART over time leads to reduction in the progression of HIV, the frequency of opportunistic infections, and increases lifespan and quality of life.
- If medicines are skipped, there is a possibility of the viral replication increasing and taking backwards the progress made in treatment.