Covid shines spotlight on AIDS treatment in India

There is an urgent need to mitigate the risk of the emergence in the future of multi-mutated variants like Omicron by stepping up efforts to control advanced HIV disease, said a public health lawyer and campaign manager. access by Médecins Sans Frontières (MSF) to South Asia. . In an interaction with Activity area, Leena Menghaney explained how the implementation by the National AIDS Organization (NACO) of the World Health Organization recommendations for diagnosing and treating advanced HIV disease has faced multiple delays and negligence. However, the Department of Health can no longer afford to do so following a new variant of worry.

According to Science magazine, SARS_CoV-2 may have mutated in people with weakened immune systems, giving rise to new variants in people with cancer or living with HIV who have uncontrolled HIV infection. Covid infection can persist for months in these people.

Scientists in South Africa have traced a Covid sample to a 36-year-old woman who was not receiving effective treatment for HIV. Tests revealed that she had a persistent Covid infection for 216 days and had accumulated into 32 mutations. This should be of concern to the Ministry of Health in India.

“People with advanced or uncontrolled HIV who have a high viral load of the HIV virus are immunosuppressed and if co-infected with Covid are much more likely to die from the coronavirus, and their neglect by the HIV program could result in the emergence of variants of Covid, “Menghaney said.

“According to official figures, at least 35% of people living with HIV who come under India’s HIV treatment program are immunocompromised and often die from diseases such as tuberculosis, meningitis, pneumonia and serious bacterial infections. In addition, for those who are already on treatment, the government has not followed antiretroviral therapy (a cocktail of three drugs) very well with regular viral load tests, ”she said.

“Viral load tests can tell whether antiretroviral therapy is working or not, but services have been cut off during the pandemic. Both for public health and for the benefit of the patient, people with advanced HIV need more attention in the HIV program, ”Menghaney added.

NACO, under the Ministry of Health, is a nodal agency responsible for formulating policies and implementing interventions to prevent and control HIV in India. According to Menghaney, NACO does not have a specific intervention to reach this population with advanced HIV and provide services, including Covid testing. It is a reminder that efforts to fight Covid must go hand in hand with efforts to end AIDS in India as a public health problem.

“We need to close the gaps in the HIV treatment cascade. So we have to get everyone diagnosed. There is a need to reach people with AIDS and provide them with diagnostics and effective treatment, ”Menghaney added.

“We are by no means safe because Omicron is extremely infectious, it could reach the community level given past cases. There could be breakthrough infections, and that can overwhelm health systems, ”she warns.

According to a recent study, Omicron will be dominant by mid-January in the UK. “Waves in India can come at different times, and the government is already preparing the health system in advance to deal with any new wave of Covid. At the same time, interventions for information, education and counseling (IEC) measures are extremely critical, ”Menghaney said.

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