Hiv hcv killer twins

HIV- HCVThe Killer Twins

Ó Neeraj Mahajan 2009 1

HIV

HCV

This is the story of two infectious diseases – HIV and Hepatitis C i.e. HCV. Both have many things in common…

Both are merciless & silent killers posing several difficulties in detections and no cure in sight…

Both are SMART viruses – masters in the art of deception & disguise

They cripple the body’s defenses before silently causing maximum damage deep inside…

We might call them the killer twins…

But before we begin let’s get few thing clear…

HIV & HCV- What’s Common ?


3

• HIV is not the same as AIDS.

• HIV= Human Immunodeficiency Virus

• HIV leads to AIDS or Acquired Immunodeficiency Syndrome, also called Slim Disease.

• HIV is the virus that causes AIDS.

HIV Virus

HIV & HCV- Basic Issues

Ó Neeraj Mahajan 2009

HIV may lead to many other secondary infection

• Bacterial- Tuberculosis (TB), MAC, bacterial pneumonia and septicaemia (blood poisoning)

• Protozoal diseases such as toxoplasmosis, microsporidiosis, cryptosporidiosis, isopsoriasis and leishmaniasis

• Viral- Kaposi Sarcoma, Herpes, Influenza (flu)

• Parasitic- Pneumocystis carinii

• Fungal- Candida, Cryptococcus, PCP and penicilliosis

• Malignancies such as Kaposi's sarcoma, lymphoma and squamous cell carcinoma.

• Gastrointestinal malignancies -including pancreas cancer, breast cancer, and skin cancer

Most of these are diseases that a normal person could easily fight off but may prove fatal for an HIV infected person because of weak immune system

HIV: Not Just A Disease…But Series of Medical Complications


Both HIV & Hepatitis C or HCV are serious concerns for India: • Almost 0.7% of Indian population are HIV+.• Close to 600 people are infected with HIV in

India every hour• Approximately 630,000 people died from

AIDS-related illnesses in 2006. • A World Health Organization report describes

HCV as a "viral time bomb".


HIV-HCV : Why Serious Concerns for India

• Both are blood-borne diseases, caused by RNA viruses.

• Both are known to cause irreparable damage internally—till its too late.

• Both are such smart virus that manage to disguise their presence and not only hood-wink the body's defense mechanism but also make it totally useless.

• There is no complete cure or vaccine for both HIV & HCV and none likely to come out in the foreseeable future.

• Both HIV & HCV can be symptomless for a long time.

• Medications can only keep the infected people alive, longer and healthier. If a patient misses even one dose, the virus may become resistant to the medicines causing them to lose their effect. Even in patients who take every dose, the medicines may stop working after some time.

• These drugs are very expensive and some of them are known to cause severe adverse reactions.


HIV-HCV : Similarities

• Both HIV & HCV are smart and lethal invaders – masters in the art of camouflage, deception and hidden combat. They do their job after silently crippling the defenders – inside the human body.

• According to a World Health Organization projection HCV already infects approximately 180 million people worldwide. Despite all this HCV remains a largely unknown disease in India.

• While there are specific organization to control TB, Malaria, Leprosy, or AIDS— there is no organization which is on a lookout for HCV or has it on its preventive Health radar screen—like HIV/AIDS and India is so far yet to declare a “High Alert” against the killer HCV


HIV-HCV : Ignorance is not bliss !!

• Both HIV and HCV virus replicate at an alarming rate, inside the body. While the HIV virus replicates anywhere between 10 billion new viral particles per day. HCV produces even more nearly 10 trillion new viral particles each day.

• HIV is a fragile virus which dies quickly outside the human body. HCV virus on the other hand is a tougher virus which can live for days outside the human body.

• According to WHO more than double i.e. against 5.1 million Indians suffering from HIV, around 12 million have HCV. As many as half of all people with HIV are likely to be co infected with HCV which is four times more prevalent and ten times more infectious than HIV, which causes AIDS. HCV or hepatitis C is known as "silent killer".

• Deaths from HCV are expected to triple in the next 10-20 years. The death toll is likely to surpass that of AIDS and could reach more than a million by 2020


HCV is many times more dangerous than HIV or AIDS

• The issue is how do we fight against a disease we know little about?

• Already about 18 million people in India are estimated to be infected with HCV— most of whom do not know they are infected.

• A quarter of them are likely to develop chronic liver disease in the next 10 to 15 years.

• When treatment for Hepatitis C cost about Rs. 13,000 a week - or at least Rs. 2 lakh for a six-month course— how many people can afford to undergo treatment that too when they cannot be sure that it will cure them.

• Can you imagine the cost when each Liver transplants costs about $200,000 in the US and patients need expensive drug and other treatments for the rest of their lives.


Key Issue: How Do We Combat An Unknown Disease

The seriousness of this problem can also be assessed from the fact that only less than 1 % population of India get themselves tested for HIV-HCV even once in the lifetime and worst still up to 27 % HIV infected people remain undiagnosed… It’s a world wide trend that many HIV infected -- medically undiagnosed people are walking the on streets blissfully unaware of their HIV+ve status. Such people continue infect others while leading normal lives simply because–

• They do not have any visible or apparent symptoms of HIV/AIDS - HCV

• They never felt the need to get tested

• It is not a fashionable for people to get HIV – HCV tests done, even once a lifetime

• Stigma attached with going for a HIV test (what will people say!), unless unavoidable


PROBLEM: Many medically undiagnosed people are walking the on streets blissfully unaware of their HIV+ve status

• They are like potential Human Time Bombs that can explode any moment causing irreparable damage by actually infecting 100s of other innocent and unsuspecting people.

• The moot question therefore is whether India can be left to the mercy of these killer twins- HIV & HCV?

• This is not a just medical but human rights issue. An issue concerning right to live and stay away from any accidental HIV –HCV contamination


PROBLEM: They are like Human Time Bombs that can explode any moment

• Another thing that both HIV & HCV share in common is the window period i.e. the early stage of the infection when none of the available tests can detect their presence.

• The incubation period of HCV infection is 2-26 weeks i.e., the symptoms may take this much time to appear after a person has been infected. It may take as long as 5-10 years for an infected person to develop chronic liver disease after exposure to the virus.

• Early and confirmed diagnosis of HIV/HCV – may prove to be a turning point for better management of the infection besides U-turn towards damage control and possible recovery.


CORE ISSUE: Shortening the Window Period


Window Period: HIV Infection and Antibody Response

6 month ~ Years ~ Years ~ Years ~ Years

VirusAntibody

---Initial Stage---- ---------------Intermediate or Latent Stage-------------- ---Illness Stage---


Window Period: HIV Infection and Antibody Response


HIV-HCV Window Period: Which segments of the Society need to be Concerned?

• Defense Services, Police & Para- Military forces

• Blood Banks & Blood Transfusion Sector


HIV-HCV Window Period: Why should each segment of the Society be Concerned?


HIV-HCV Window Period: Why should Blood Banks & Blood Transfusion Sector be Concerned?


HIV-HCV Window Period: Why should IDUs, Prostitutes, Gays and other High Risk Categories be Concerned?


HIV-HCV Window Period: Why should Doctors, Hospitals & Other Healthcare Employees be Concerned?


HIV-HCV Window Period: Why should Pregnant Woman, New Born Babies and other faceless Indians be Concerned?


HIV-HCV Window Period: 360 degrees of Circle of Concern


HIV-HCV Window Period: Rationale for National Awakening

Hiv hcv killer twins

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