Opinion: World AIDS Day — Understanding The Link Between HIV And Other Infectious Diseases

As HIV progresses, the immune system becomes increasingly compromised, leaving individuals vulnerable to infections that a healthy immune system would normally be able to fend off. 

School students make a 'red ribbon' formation on the eve of World AIDS Day (December 1), in Surat. The 'red ribbon' is the universal symbol of awareness and support for those living with HIV.

Source : PTI

Dr Ameet Dravid 

HIV (Human Immunodeficiency Virus) weakens the immune system, making individuals more susceptible to a wide range of opportunistic infections. These infections, including tuberculosis (TB), hepatitis, and other viral or bacterial diseases, are particularly problematic in countries like India, where both HIV and infectious diseases are prevalent. 

HIV And Opportunistic Infections

As HIV progresses, the immune system becomes increasingly compromised, leaving individuals vulnerable to infections that a healthy immune system would normally be able to fend off. These include:

• Tuberculosis (TB): TB is one of the most common co-infections among people living with HIV. In India, which has the highest TB burden in the world, the co-infection rate is alarmingly high. HIV-positive individuals are far more likely to develop active TB than those without HIV, making TB a leading cause of death in this group.
• Hepatitis B and C: These viral infections are especially prevalent among people who inject drugs. They can cause severe liver damage, which complicates HIV treatment and can accelerate liver failure.
• Pneumonia and Fungal Infections: These conditions are common in HIV-positive individuals, as their weakened immune systems cannot effectively combat pathogens that would normally be contained.

Challenges In HIV And Infectious Disease Management

The dual burden of HIV and co-infections presents several challenges for India’s healthcare system. HIV treatment, in the form of antiretroviral therapy (ART), is crucial to manage viral loads and prevent further immune system deterioration. However, co-infections like TB require their own specific treatment regimens, often complicating management for individuals who need to take multiple medications simultaneously.

Moreover, the stigma associated with HIV can prevent individuals from seeking timely medical care. This is especially true for high-risk groups who already face societal discrimination, adding a layer of complexity to the effective treatment and prevention of both HIV and co-infections.

To address the challenges posed by HIV and its associated co-infections, India has been focusing on improving access to healthcare services, particularly in underserved regions. Initiatives like widespread ART distribution, education on prevention methods, and the integration of TB and HIV services are essential in controlling the spread of both diseases. Reducing stigma, enhancing healthcare access for marginalised groups, and ensuring continuity of care during emergencies like pandemics will be key to improving health outcomes for people living with HIV.

India’s continued focus on integrated care for HIV and other infectious diseases is crucial to reducing the overall burden of these diseases. Achieving better health outcomes for HIV-positive individuals and preventing the spread of infectious diseases requires coordinated efforts across the healthcare system and communities.

The relationship between HIV and other infectious diseases is a complex and ongoing challenge, especially in countries like India, where both HIV and diseases like TB, hepatitis, and pneumonia are prevalent. Addressing these challenges requires a multifaceted approach, including increased healthcare access, better integration of services, and a concerted effort to reduce stigma. Only through sustained efforts can we improve the lives of people living with HIV and prevent the further spread of these deadly co-infections.

The author is MD (Internal Medicine) A.A.H.I.V.S (American academy certified HIV specialist), and practises at Ameet Dravid Clinic, Pune.

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