New approaches in HIV/AIDS and STDs treatment

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Worried by the high prevalence of HIV/AIDS in country, various international and national organisations have launched programmes to combat the incurable disease at different times – though not much impact has been felt in the country, as Nigeria still remains the second largest country with the highest incidence of the disease.

Recently, the country witnessed the launch of the national operational plan for the elimination of mother to child transmission of HIV in Nigeria (2015-2016) with the theme, “No child should be born with HIV in Nigeria.” Lamenting the scourge of the virus at the launch, President Goodluck Jonathan explained that the epidemic had gone beyond the health sector and had significantly threatened the economies and developmental efforts of many countries in the world, including those in the sub-Saharan countries with over three million people living with HIV, having more than half of the people infected as women and young people within the productive age group.

The president, who assured Nigerians that the government would step up its support systems to quicken the eradication of mother-to-child HIV/AIDS transmission by the year 2016, said government had begun the release of fund for the implementation of the President’s Comprehensive Response Plan for HIV/AIDS (PCRP).

 Understanding HIV/AIDS

Human immunodeficiency virus, or HIV, is the virus that causes acquired immune deficiency syndrome (AIDS). The virus weakens a person’s ability to fight infections and cancer. People with HIV are said to have AIDS when they develop certain infections or cancers or when their CD4 (T-cell) count is less than 200. CD4 count is determined by a blood test in a doctor’s office.

Having HIV does not always mean that you have AIDS. It can take many years for people with the virus to develop AIDS. HIV and AIDS cannot be cured. However, with the medications available today, it is possible to have a normal lifespan with little or minimal interruption in quality of life. There are ways to help people stay healthy and live longer.

HIV attacks and destroys a type of white blood cell called a CD4 cell, commonly called the T-cell. This cell’s main function is to fight disease. When a person’s CD4 cell count gets low, they are more susceptible to illnesses.

AIDS is the more advanced stage of HIV infection. When the immune system CD4 cells drop to a very low level, a person’s ability to fight infection is lost. In addition, there are several conditions that occur in people with HIV infection with this degree of immune system failure – these are called AIDS-defining illnesses.

 Transmission of HIV

A person gets HIV when an infected person’s body fluids (blood, semen, fluids from the vagina or breast milk) enter his or her bloodstream. The virus can enter the blood through linings in the mouth, anus, or sex organs (the penis and vagina), or through broken skin.Both men and women can spread HIV. A person with HIV can feel alright and still give the virus to others. Pregnant women with HIV also can give the virus to their babies.

 Means of contracting HIV:

• Sharing a needle to take drugs
• Having unprotected sex with an infected person

You cannot get HIV from:

• Touching or hugging someone who has HIV/AIDS
• Public bathrooms or swimming pools
• Sharing cups, utensils, or telephones with someone who has HIV/AIDS
• Bug bites

Anyone can get HIV if they engage in certain activities. You may have a higher risk of getting HIV if you:

• Have unprotected sex. This means vaginal or anal intercourse without a condom or oral sex without a latex barrier with a person infected with HIV.
• Share needles to inject drugs or steroids with an infected person.The disease can also be transmitted by dirty needles used to make a tattoo or in body piercing.
• Receive a blood transfusion from an infected person.
• Are born to a mother with HIV infection. A baby can also get HIV from the breast milk of an infected woman.

Health care workers are at risk on the job and should take special precautions. Some health care workers have become infected after being stuck with needles containing HIV-infected blood, or less frequently, after infected blood comes into contact with an open cut or through splashes into the worker’s eyes or inside his or her nose.

 Statistics of people living with HIV/AIDS in Nigeria

According to the Director General of the National Agency for the Control of AIDS (NACA), Professor John Idoko, 3.4 million Nigerians are living with HIV/AIDS, with Benue emerging as the state with the highest number of HIV/AIDS cases, while Kebbi is the lowest.

Clinical experiences have shown that young women have higher risks of contracting the virus than young men. Young adults in Nigeria are more susceptible to contracting HIV/AIDS, possibly due to being more sexually active. Some of the factors that predispose Nigerians to contracting the HIV/AIDS virus include the high prevalence of other STIs (Sexually Transmitted Diseases), prostitution, clandestine high-risk homosexual and heterosexual practices, international women trafficking, irregular and inept blood screening and risky practices among itinerant workers.

From a 2011 report, Nigeria accounts for 10 per cent of the global HIV burden, as It is estimated that about 210,000 people die yearly in Nigeria from the condition. In Men who have sex with men (MSM), the HIV prevalence in Nigeria is 17.2 per cent. Brothel and non-brothel female sex workers (FSW) have a HIV prevalence of 24.5 per cent, while people who take intravenous drugs (IDUs) have a HIV prevalence of 4.2 per cent.

 HIV tests

The only way to know if you have HIV is to take an HIV test. Most tests look for signs of HIV in your blood. A small sample of blood is taken from your arm. The blood is sent to a lab and tested for HIV.

Clinics that do HIV tests keep your test results secret. Some clinics even perform HIV tests without ever taking your name (anonymous testing). You must go back to the clinic to get your results. A positive test means that you have HIV. A negative test means that no signs of HIV were found in your blood.

• Standard tests. These blood tests check for HIV antibodies. Your body makes antibodies in response to the HIV infection. These tests can’t detect HIV in the blood soon after infection because it takes time for your body to make these antibodies. It generally takes two to 8 weeks for your body to produce antibodies, but in some cases it can take up to six months.
• In standard tests, a small sample of your blood is drawn and sent to a lab for testing. Some of the standard tests use urine or fluids that are collected from the mouth to screen for antibodies.
• Rapid antibody tests. Most of these are blood tests for HIV antibodies. Some can detect antibodies in saliva. Results are available in under 30 minutes and are as accurate as standard tests.
• Antibody/antigen tests. These tests can detect HIV up to 20 days earlier than standard tests. They check for HIV antigen, a part of the virus that shows up 2-4 weeks after infection. These tests can also detect HIV antibodies. A positive result for the antigen allows treatment to begin earlier and the patient to avoid infecting others. These are blood tests only.
• Rapid antibody/antigen test. One antibody/antigen tests delivers results in 20 minutes.
• In-home test kits. These kits screen blood and saliva for HIV antibodies. The Home Access HIV-1 Test System requires a small blood sample that is collected at home and sent to a lab. The OraQuick In-Home HIV Test can detect HIV antibodies in saliva, if the antibodies are present (which can take up to 6 months). The user swabs the upper and lower gums of their mouths, places the sample in a developer vial, and can get results in 20-40 minutes. A follow-up test should be done if the result is positive.
• HIV Testing for Pregnant Women. If a woman has HIV while pregnant, she can work with her health care provider to help reduce the risk that her baby will have HIV, too. With treatment, less than 2 out of 100 babies born to women who have HIV will be infected. Without treatment, about 25 out of 100 babies will be infected.

Symptoms of HIV

Some people get flu-like symptoms within a month after they have been infected. These symptoms often go away within a week to a month. A person can have HIV for many years before feeling ill.

As the disease progresses, both women and men may experience yeast infections on the tongue (thrush), and women may develop severe vaginal yeast infections or pelvic inflammatory disease. Shingles is often seen early on, often before someone is diagnosed with HIV.

 Symptoms of AIDS

• A fever that won’t go away
• Sweating while you sleep
• Feeling tired all the time (not from stress or lack of sleep)
• Feeling sick all the time
• Losing weight
• Swollen glands (neck, groin, or underarms)
• Oral thrush

 Other infections affiliated with AIDS

People with AIDS are extremely vulnerable to infection, called AIDS-defining illnesses, and often exhibit the following conditions:

• Kaposi’s sarcoma, a skin tumour that looks like dark or purple blotches on the skin or in the mouth
• Mental changes and headaches caused by fungal infections or tumours in the brain and spinal cord
• Shortness of breath and difficulty breathing because of infections of the lungs
• Dementia
• Severe malnutrition
• Chronic diarrhea

 Treatment of HIV

Today, there are a variety of treatments that, when used in combination can significantly slow down and in some cases stop altogether, the progression of HIV infection.

After HIV infection is confirmed, your doctor will start you on a drug regimen consisting of several drugs; combinations of different types of anti-HIV drugs sometimes are called HAART, for highly-active antiretroviral therapy (HIV is a kind of virus called a retrovirus).

Taking HAART therapy is very manageable yet isn’t necessarily easy. These drugs must be taken at the right time, every single day. Also, a range of side effects may occur, including: diarrhoea, nausea, rash, vivid dreams, or abnormal distribution of body fat. And, especially if medications are taken incorrectly or inconsistently, the virus can mutate, or change, into a strain resistant to treatment. The good news is that there are now several HIV medications that are only taken once a day. If there is resistant virus, however, these may not work and other medication options must be used.

If your disease has progressed to AIDS, your treatment may also include drugs to combat and prevent certain infections.Your doctor can monitor how well your HIV treatment is working by measuring the amount of HIV in your blood (also called the viral load.) The goal of treatment is to get the viral load undetectable on labs tests; ideally less than 20 copies. This does not mean the virus is gone or cured, it means the medication is working and must be continued.

 Prevention of HIV/AIDS

The best way to protect yourself from HIV is to avoid activities that put you at risk. There’s no way to tell by looking at someone if he or she has HIV. Always protect yourself.

• Use latex condoms (rubbers) whenever you have any type of sex (vaginal, anal, or oral).
• Don’t use condoms made from animal products.
• Use water-based lubricants. Oil-based lubricants can weaken condoms.
• Never share needles to take drugs.
• Avoid getting drunk or high. People who are drunk or high may be less likely to protect themselves.

You can help prolong your life by taking good care of yourself and developing a good relationship with an experienced doctor specialising in HIV and AIDS. Also, be consistent about taking your HIV medications as prescribed and getting regular lab work to catch any problems early.

Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are generally acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids.

Some such infections can also be transmitted non-sexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles.

It’s possible to contract sexually transmitted diseases from people who seem perfectly healthy — people who, in fact, aren’t even aware of being infected. Many STDs cause no symptoms in some people, which is one of the reasons experts prefer the term “sexually transmitted infections” to “sexually transmitted diseases.”

 Symptoms

Sexually transmitted infections (STIs) have a range of signs and symptoms. That’s why they may go unnoticed until complications occur or a partner is diagnosed. Signs and symptoms that might indicate an STI include:

• Sores or bumps on the private parts or in the oral or rectal area
• Painful or burning urination
• Discharge from the man-hood
• Vaginal discharge
• Unusual vaginal bleeding
• Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread
• Lower abdominal pain
• Rash over the trunk, hands or feet

Signs and symptoms may appear a few days to years after exposure, depending on the organism. They may resolve in a few weeks, even without treatment, but progression with later complications — or recurrence — sometimes occurs.

 Causes of STIs

Sexually transmitted infections can be caused by:

• Bacteria (gonorrhea, syphilis, chlamydia)
• Parasites (trichomoniasis)
• Viruses (human papillomavirus, private part herpes, HIV)

Sexual activity plays a role in spreading many other infectious agents, although it’s possible to be infected without sexual contact. Examples include the hepatitis A, B and C viruses, shigella, cryptosporidium and Giardia lamblia.

 Complication of STIs

Possible complications include:

• Sores or bumps anywhere on the body
• Recurrent private part sores
• Generalised skin rash
• Pain during intercourse
• Scrotal pain, redness and swelling
• Pelvic pain
• Groin abscess
• Eye inflammation
• Arthritis
• Pelvic inflammatory disease
• Infertility
• Cervical cancer
• Other cancers, including HIV-associated lymphoma and HPV-associated rectal and anal cancers
• Opportunistic infections occurring in advanced HIV
• Maternal-foetal transmission, which causes severe birth defects

Treatments and drugs

STIs caused by bacteria are generally easier to treat. Viral infections can be managed but not always cured. If you’re pregnant and have an STI, prompt treatment can prevent or reduce the risk of infection of your baby. Treatment usually consists of one of the following, depending on the infection.

• Antibiotics. Antibiotics, often in a single dose, can cure many sexually transmitted bacterial and parasitic infections, including gonorrhoea, syphilis, chlamydia and trichomoniasis. Typically, you’ll be treated for gonorrhoea and chlamydia at the same time because the two infections often appear together.Once you start antibiotic treatment, it’s crucial to follow through. If you don’t think you’ll be able to take medication as prescribed, tell your doctor. A shorter, simpler treatment regimen may be available. In addition, it’s important to abstain from s*x until you’ve completed treatment and any sores have healed.
• Antiviral drugs. You’ll have fewer herpes recurrences if you take daily suppressive therapy with a prescription antiviral drug, but you can still give your partner herpes at any time.Antiviral drugs can keep HIV infection in check for many years, although the virus persists and can still be transmitted. The sooner you start treatment, the more effective it is. Once you start treatment — if you take your medications exactly as directed — it’s possible to lower your virus count to nearly undetectable levels.

Partner notification and preventive treatment

If tests show that you have an STI, your sex partners — including your current partners and any other partners you’ve had over the last three months to one year — need to be informed so that they can get tested and treated if infected. Official, confidential partner notification effectively limits the spread of STIs, particularly syphilis and HIV. The practice also steers those at risk toward appropriate counselling and treatment. And since you can contract some STIs more than once, partner notification reduces your risk of getting re-infected.

• Prevention

Don’t drink alcohol excessively or use drugs. If you’re under the influence, you’re more likely to take sexual risks.

• Avoid anonymous, casual sex. Don’t look for sex partners online or in bars or other pickup places. Not knowing your sex partner well increases your risk of possible exposure to an STI.
• Communicate. Before any serious sexual contact, communicate with your partner about practicing safer sex. Reach an explicit agreement about what activities will and won’t be OK.
• Abstain. The most effective way to avoid STIs is to abstain from sex.
• Stay with one uninfected partner. Another reliable way of avoiding STIs is to stay in a long-term mutually monogamous relationship with a partner who isn’t infected.
• Get vaccinated. Getting vaccinated early, before sexual exposure, is also effective in preventing certain types of STIs.

Report compiled by TemitopeObayendo with additional information from:

Nigeria Bulletin, WebMD Medical Reference and Planned Parenthood Organisation