Times Wellness Chat line 1Dec09 2-3 pm. Extract. Kripa-AIDS. WAD 2009 Activity
Welcome to the TimesWellness.com chat with Dr Shashi Menon, Medical Director, Kripa Foundation,INDIA who will attempt to dispel myths, talk about how to take care of a patient with HIV and tell you why HIV positive patients should not lose hope
admin:
The expert will be online soon. The chat will begin shortly.
This is a moderated chat room. That means that your messages won't appear until a moderator approves it.
admin:
Dr Shashi Menon, Director, Kripa Foundation, is here. He will take your questions now. The chat is subject to moderation. In order to get quick responses kindly formulate your doubts into a single query and refrain from sending the same in bits and pieces
binu:
hi doctor, what's the news on the AIDS vaccine ? will we be seeing it soon or is it just false hope ?
DrMenon:
Hi Friend, Please understand current AIDS Vaccine efforts are still on. There are a variety of vaccines being researched and tried. Some of them are directed at controlling virus multiplication, others at reducing the impact on immune cells number and function. No one vaccine to date had demonstrated ability to remove the virus from the host body. For more details, visit www.aidsinfo.nih.gov and see the section on vaccine trials.
abhinav to binu:
hi doctor,can oral sex cause aids??
DrMenon:
Dear enquirer, Saliva by itself has antiviral properties. Quantity of virus detected in saliva from an otherwise healthy oral cavity is negligible. Hence oral transmission of HIV is a theoretical possibility based on the presence of any inflammation, wound or bleeding source in the mouth. In such a case, it may result in being a blood borne transmission and not a saliva based transmission. Even when indulging in oral sex (peno-oral or vagina-oral) prefer to use a barrier for safety.
Giovanni:
I would like to know, once a person is diagnosed HIV +, what is the current survival rate, considering modern trends in prophylaxis?
DrMenon:
Good question friend. While HIV infection is well recognised to be a progressively immuno depleting infection (65-85% over 6-8 years time), scrupulous health practices, medical and laboratory monitoring, timely diagnosis of minor illnesses and treatment and suitable prophylaxis for Opportunistic Infections help to preserve immunity well beyond 10 years before any significant decline. All this, without even having to start on AntiRetroviral Treatment (ART). In well managed patients who are immunodepleted and on good effective ART medicines, 5 year survival is well beyond 85%. Thats good hope!
Giovanni:
In a HIV+ couple, is it a surety that the child born of them would be HIV+ too. Or is there a chance that the child will not carry the virus?
DrMenon:
Regarding Mother to Child HIV transmissions, approximately 24% transmission potential exists from an infected mother to baby per pregnancy. The risk factor varies in different stages of pregnancy, but is maximal at time of delivery. A small percentage occurs during breast feeding. With proper prophylaxis during pregnancy / delivery and suitable modality post delivery, risk reduces to 8%. It is nearly 'nil' when the mother is on ART and her plasma viral load is below detectable levels. Please realise that NOT EVERY CHILD borne to an HIV infected mother is positive.
binu:
i've heard that private hospitals refuse to admit HIV positive people, is this true ?
DrMenon:
Dear friend, Stigma, Discrimination based on a profound lack of Awareness are underlying reasons for many of our social ills. Inappropriate behaviour by the medical fraternity is no exception. However, not all private hospitals deny caring for HIV positive patients. I am happy to say care is available in the private sector. It should improve with more awareness. We all live in hope.
abhinav to binu:
sir, what are the exact symptoms of aids?
DrMenon:
AIDS is a complex of symptoms desciptive of a variety of infections and cancers which are extremely unusual or not normally seen in non HIV infected individuals. The presence of HIV having resulted in severe immunodepletion, these infections by viruses, bacteria’s, protozoa and fungi as also unusual dermatologic diseases and tissue and blood cancers affect even very young persons. Most commonly they are Pneumonias, Tuberculosis, Fungal infections affecting lungs, Gastrointestinal passages, Liver and other body tissues, blood and intracranial tissue. There are many many more, unfortunately!
Giovanni:
Is it true that (Anti-retroviral therapy) ART is completely subsidized by the Government?
DrMenon:
ART is a 'generic' term applicable to the use of a suitable combination of Anti HIV medicines that are expected to cause a profound reduction of the virus numbers, maintain virus depletion and permit the recovery of immune capacity to the extent possible. The need for changes in ART depend on suitability and tolerance, efficacy, presence of viral resistance to the drugs and the financial equation. Government provides for free ART to the suitable candidates who are registered with the National programme (First line drugs) and a limited number of patients needing 'Second line Drugs'.
deepak:
Hello Doctor. If a male is carrying the HIV+ virus, whereas female is negative, is there any procedure that they can give a birth to a child, where the child and the mother are safe. As i've heard about sperms washing procedure. Is there any chance of transmission of virus from father to mother or a child.
DrMenon:
Dear friend, cant promise any fool proof methods. If the concerned partners are taking effective ART, their HIV viral load is below detectable levels, and rigorous sperm washing techniques are being used, then chances of a HIV free baby are good. Even if nothing is done, 1 in 5 such pregnancies only may carry the virus to the baby. Pregnancy related prophylaxis mecication is a must. This issue needs to be discussed in details in another circumstance with the consultant and I urge you to do so. Regards.
binu:
do you think mandatory hiv test are important ?
DrMenon:
Friend, this is a vexing issue at many levels. Presently, mandatory testing is permitted only by judicial order, among specified incarcerated populations and under rules of the Defense Service Act in India. A Bill is pending in parliament that if passed, may provide much clarity on this issue. Granting Mandatory Testing in wide circumstances is foolhardy as it does not take into consideration individual autonomy, lack of appropriate support/guidance following the test and moreover, it is easy to fool the system on many ocassions. I feel current laws are appropriate, but there is a clear lack of 'Awareness' and 'Counselling'.
binu:
despite all the awareness campaigns going on around regularly and on world aids day, why is it that people still discriminate against aids patients ?
DrMenon:
Thanks for raising this issue. People are under the impression that one person's awareness would solve the proble. This is not so. Our whole social approach needs reworking. As time goes by, Stigma concerning Tuberculosis and less so of Leprosy has significantly reduced. All this in about a centry! That of Cancer is still a major source of suffering. Is it any wonder that a new Disease based of Human biological demands and Risk Behaviour would be the subject of Stigma and the object of Discrimination? And this disease is well recognised only since 1986! So be patient and work harder.
admin:
Hi, That's all we have time for. Thanks for participating in the chat. Hope your doubts are clarified.
