Urging early care, expert says what kills are opportunistic infections, not HIV

Lara Adejoro

An HIV Clinician and Antiretroviral Therapy Coordinator at the General Hospital, Lagos, Dr. Samuel Alori, says early detection, access to care and treatment can help reduce HIV-related mortality in the country.

Alori says what kills People Living With HIV/AIDS are opportunistic infections, and not HIV as widely believed.

Such opportunistic infections include tuberculosis, cryptococcal meningitis, skin infections, oral candidiasis, and other viral infections, he said.

Recall that the National Agency for the Control of AIDS says the number of people who died of AIDS-related causes in Nigeria within the first six months of the year 2020 was 20,500.

According to NACA, 1.8 million people also currently live with the disease in Nigeria.

NACA Director-General, Dr. Gambo Aliyu, partly blamed the high mortality on lack of access to treatment and the disruption of medical services brought about by the COVID-19 pandemic.

Alori, however, said PLWHA who are on antiretroviral drugs must ensure that their viral loads are suppressed to be less than 1,000 copies per milliliter.

According to him, reducing deaths among PLWHA is multifactorial and patients must ensure that they comply with taking their ARV drugs.

Speaking in an interview with PUNCH HealthWise, Alori said, “Those who test positive to HIV must be on ARV and must be retained in care and those that are retained must ensure that they comply with taking their drugs accordingly.

“Ninety-five percent of those on ARV must have their viral loads suppressed and it must be less than 1,000 copies per milliliter.

“They should take their drugs regularly as at when due, go for their tests as recommended and disclose their status to their partners and conquer stigmatisation and discrimination.”

The expert said if the medication is taken as prescribed, it reduces the amount of HIV in the body to a very low level, keeps the immune system working, prevents illness, and reduces the risk of transmission.

“If your viral loads are suppressed, the possibility of transmitting it is minimal. It is also important to adhere to other preventive measures like abstinence from sex and use of condoms.

“Those who present at the healthcare facilities late risk being critically ill, but they are advised to go to the nearby healthcare facilities so they can take care of the opportunistic infections.

“What kills people most are the opportunistic infections and not HIV itself. It is essential they visit the healthcare facilities so that they can manage opportunistic infections and treatment.

“They have to make themselves available for the treatment of the opportunistic infections like tuberculosis, cryptococcal meningitis, skin infections, oral candidiasis, and other viral infections.

“If they are sick and coming down with severe shortage of blood, they should go for treatment at the appropriate healthcare facilities,” Alori noted.

Alori however said there is a need to create more awareness to sensitive people on the importance of early testing and treatment.

“The government has put in place measures to ensure that 95 percent of the population go for testing. We also have self-testing policies in place that everybody can get tested and be referred to the appropriate centre.

“There is a need to create awareness so that more people can come for testing and be placed on treatment immediately if they test positive,” he said.

The World Health Organisation says HIV continues to be a major global public health issue, having claimed almost 33 million lives so far.

“However, with increasing access to effective HIV prevention, diagnosis, treatment, and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives

“There were an estimated 38.0 million people living with HIV at the end of 2019.

“As a result of concerted international efforts to respond to HIV, coverage of services has been steadily increasing. In 2019, 68 percent of adults and 53 percent of children living with HIV globally were receiving lifelong antiretroviral therapy,” the world health body said.

It added that a great majority (85 percent) of pregnant and breastfeeding women living with HIV also received ART, which not only protects their health but also ensures the prevention of HIV transmission to their newborns.

“However, not everyone is able to access HIV testing, treatment, and care. Notably, the 2018 Super-Fast-Track targets for reducing new paediatric HIV infections to 40,000 was not achieved. Global targets for 2020 are at risk of being missed unless rapid action is taken.

“Due to gaps in HIV services, 690,000 people died from HIV-related causes in 2019 and 1.7 million people were newly infected,” it said.

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