India beats SA on AIDS:UN report

The Indian subcontinent is a major cause of concern in the global AIDS epidemic, with India alone accounting for two-thirds of HIV cases in the whole of Asia, according to a new report by the United Nations released today. The world's second-most populous nation has overtaken South Africa as the country with the most people living with the HIV virus, the specialised agency UNAIDS said.

An estimated 5.7 million Indians were infected by the end of 2005, the Geneva-based body said in its biennial study of the global epidemic. That compared with an estimated 5.5 million people in South Africa, which is grappling with one of the hgihest infection rates per capita in Africa, the hardest-hit continent, said UNAIDS. However, India's overall rate of adult infections paled compared to South Afric's because of the relative size of the population of the two countries.

While 18.8 percent of South African adults were living with HIV, the figure in India was 0.9 percent. Overall, Indian HIV cases accounted for two-thirds of Asia's total. Estimates of total deaths in India since AIDS was first indentified globally in 1981 range from 270,000 to 680,000. Most of the infections there were caused by unprotected heterosexual intercourse, according to unaids. States in southern India have traditionally been the hardest hit by the disease: in Tamil Nadu, for example, HIV rates of 50 percent have been found among prostitiutes. However, these regions have also made strides in fighting the disease. Tamil Nadu scaled up prevention efforts in the 1990s.

In northern states, injecting drug use was the main driver of HIV infection, and there was little or no progress in cutting rates there even though they were lower than in the South, said UNAIDS. Nationwide, only 7 percent of Indians who needed antiretroviral HIV/AIDS drugs were actually being treated last year.
Source:The New Indian Express,May 31,2006

HIV/AIDS Treatment

Over the past 10 years, several drugs to fight both the HIV infection and its associated infections and cancers have become available.
Reverse transcriptase inhibitors: They interrupt the virus from making copies of itself. These drugs are AZT (zidovudine [Retrovir]), ddC (zalcitabine [Hivid], dideoxyinosine), d4T (stavudine [Zerit]), and 3TC (lamivudine [Epivir]). These drugs may slow the spread of HIV in the body and delay the onset of opportunistic infections.
Nonnucleoside reverse transcriptase inhibitors (NNRTIS): These medications are used in combination with other drugs to help keep the virus from multiplying. Examples of NNRTIS are delavirdine (Rescriptor) and nevirapine (Viramune).
Protease inhibitors: These medications interrupt virus replication at a later step in its life cycle. These include ritonavir (Norvir), a lopinavir and ritonavir combination (Kaletra), saquinavir (Invirase), indinavir sulphate (Crixivan), amprenavir (Agenerase), and nelfinavir (Viracept). Using both classes of drugs reduces the chances of developing resistance in the virus.
Fusion inhibitors: This is the newest class of anti-HIV drugs. The first drug of this class (enfuvirtide [Fuzeon]) has recently been approved in the United States. Fusion inhibitors block HIV from entering the human immune cell.
The antiretroviral viral drugs do not cure people of HIV infection or AIDS. They stop viral replication and delay the development of AIDS. However, they also have side effects that can be severe. They include decrease of red or white blood cells, inflammation of the pancreas, and painful nerve damage. Other complications are enlarged liver and fatty liver, which may result in liver failure and death.
The common side effects from protease inhibitors include nausea, diarrhea, and other gastrointestinal symptoms. These drugs can interact with other drugs and result in serious side effects.
Presently, a combination of several drugs called highly active antiretroviral therapy (HAART) is used to treat people with HIV. This treatment is not a cure. The virus still persists in various body sites, such as in the lymph glands.
People infected with HIV are prone to opportunistic infections. Various drugs are available to treat these infectious complications. These drugs include foscarnet sodium (Foscavir) and ganciclovir (Cytovene, Vitrasert) to treat cytomegalovirus eye infection, fluconazole (Diflucan) to treat yeast infections, and trimethoprim and sulfamethoxazole (Bactrim, Septra) to treat Pneumocystis carinii pneumonia.
Treatments for Kaposi sarcoma or other cancers include radiation, chemotherapy, and injections of alpha-interferon.