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The Human Immuno- Deficiency Virus

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The Human Immuno- Deficiency Virus

Dr Nnenna Chidolue

Human Immunodeficiency Virus (HIV) is a viral infection that attacks the body’s immune system i.e the body’s ability to fight infections, thereby making the body more susceptible to infections. HIV can lead to AIDS. HIV is transmitted via unprotected sex, transfusion of infected blood, sharing of sharp objects, mother-to-child during pregnancy, labour or nursing. There are approximately 37.9 million  people worldwide living with HIV at the end of 2018, over two-thirds of this live in Africa (25.7 million).

The increase in accessibility and use of Antiretroviral Therapy (ART) has resulted in people living with HIV/AIDS to live long and healthy lives with the need for lifelong care and treatment. 

Tuberculosis (TB) is the number one cause of death among people Living with HIV/AIDS in Africa. Measures that can be taken to reduce this risk include but are not limited to: routine TB screening at each health care visit, early initiation of ART, isoniazid preventive treatment and TB infection control. The risk of developing TB is estimated to be between 16-27 times greater in people living with HIV/AIDS than among those without HIV infection. Other common infections among people living with HIV/AIDS are: cryptococcal meningitis, hepatitis B and C viruses, and human papillomavirus. HIV positive persons who become infected with hepatitis B or C virus are at increased risk for chronic hepatitis. WHO recommends that HIV positive individuals are vaccinated as early as possible with HBV vaccine. 

The transmission of HIV by HIV-positive mother to her child either during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. WHO advises that all HIV-positive pregnant and breastfeeding women should receive ART regardless of clinical stage of disease, CD4 count or viral load. Early initiation of ART for the mother (preferably before pregnancy, depending on when diagnosed HIV positive), a short course of ART for the baby(first 6weeks of life or first 12weeks of life for high risk babies) as well as appropriate breastfeeding practices are proven ways to prevent mother-to-child transmission. ART are safe to use during pregnancy and generally don’t increase the risk of birth defects. Babies born to HIV positive mothers are healthy as long as prevention of mother-to-child transmission practices are strictly adhered to. Mothers living with HIV who are on ART and adherent to therapy should breastfeed their babies exclusively for the first 6months. Women living with HIV can have a healthy pregnancy just like every other woman by ensuring regular antenatal care visits, regular intake of ART,  healthy diets, exercise and rest. Mode of delivery for a woman living with HIV is highly individualized, there’s no one size fits all.

Unfortunately, there are still some incidences of HIV transmission via rape, use of infected needles on unsuspecting individuals or even in accidental needle prick/occupational hazards. This is indicative of the need for increased awareness at the grassroots/rural communities of the availability of post-exposure prophylaxis (to be commenced within the first 72hours of the incident). Post-exposure prophylaxis is free and can be accessed in hospitals that offer antiretroviral therapy clinical services. It is taken daily for a duration of one month. 

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Pre-exposure prophylaxis (PrEP) is the daily intake of some antiretroviral drugs by individuals who are at a very high risk for HIV e.g. serodiscordant partners (sexual partners where one is HIV negative and the other HIV positive ), injection drug users. PrEP is highly effective when taken daily and much less effective when it is not taken as such (reduces the risk of getting HIV from sex by about 99% when taken daily and by about 74% in people who are injection drug users).

The continuous promotion, protection and advocacy of the human rights of people living with HIV/AIDS at all levels, will help to ensure inclusion and maximum participation in accessing available opportunities per time, as well as curb stigmatization.

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