HIV Positive Cases In Tripura: How HIV Affects Body, 5 Ways In Which It Can Be Prevented

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Recently, resports of a devasting HIV outbreak in Tripura among students where 828 students have tested HIV-positive and 47 have died and this was driven largely by injectable drug use in circulating in media. However, Government of Tripura has clarified that the report is misleading because the total figures are cumulative from April, 2007 to May, 2024.

'We have so far registered 828 students who are HIV positive. Out of them, 572 students are still alive and we have lost 47 people due to the dreaded infection. Many of the students have migrated out of Tripura for higher studies in coveted institutions across the country,' said a senior official of the Tripura State AIDS Control Society (TSACS) during a media workshop jointly organized by the Tripura Journalist Union, Web Media Forum and ISACS, a report initially published by TOI.

Needle Sharing And HIV Transmission

HIV/AIDS remains a significant global health issue, with a notable link to intravenous drug abuse. Needle sharing among drug users is a primary mode of HIV transmission, facilitating the spread of the virus through blood-to-blood contact. In many regions, such behavior accounts for a considerable proportion of new HIV infections.

One of the few factors contributing to this link include risky injection practices, limited access to sterile needles, and marginalization of drug-using populations. Sharing needles, syringes, or other injection equipment increases the likelihood of HIV transmission exponentially, as the virus can survive outside the body in residual blood.

Antiretroviral Therapy

"Till May 2024, we have registered 8,729 people in the ART (Antiretroviral Therapy) centres. The total number of people who are alive with HIV is 5,674. Among them, 4,570 are males, while 1,103 are females. Only one patient among them is a transgender," as per an official.

Antiretroviral therapy (ART) is the cornerstone treatment for HIV/AIDS. It consists of a combination of medications that suppress the replication of the virus in the body. By inhibiting viral activity, ART helps maintain low levels of HIV in the blood (known as viral load), preserving immune function and preventing progression to AIDS.

This therapy doesn't cure HIV but effectively controls it, allowing people with HIV to live longer and healthier lives. Adherence to ART is crucial for its effectiveness; it requires daily medication intake as prescribed. Continued research aims to improve ART regimens for better outcomes and reduced side effects.

Reasons Behind High Infection Rates

The Tripura AIDS Control Society has identified students from as many as 220 schools and 24 colleges and universities who take injectable drugs. "So far, 220 schools and 24 colleges and universities have been identified where students are found to be addicted to intravenous drug abuse. We have collected data from a total of 164 health facilities across the state," said a Joint Director at TSACS.

"In most cases, children belong to affluent families who are detected positive for HIV. There are families where both parents are in government service and don't hesitate in fulfilling their children's demands. By the time they realise their children fell prey to drugs, it was too late," he added.

Let us know more about Human Immunodeficiency Virus (HIV), its causes, symptoms, diagnosis, treatment, and ways to prevent it.

What Is HIV?

HIV, or Human Immunodeficiency Virus, is a virus that attacks the body's immune system, specifically the CD4 cells (T cells), which are crucial for fighting off infections. If left untreated, HIV reduces the number of these cells, making the body more susceptible to infections and certain cancers. Over time, HIV can lead to the development of AIDS (Acquired Immunodeficiency Syndrome), the final and most severe stage of HIV infection, where the immune system is badly damaged, and the body becomes vulnerable to opportunistic infections.

How HIV Affects The Body

Once HIV enters the body, it targets and binds to CD4 cells. The virus fuses with the cell membrane, releasing its RNA into the host cell. Using reverse transcriptase, the virus converts its RNA into DNA, which is then integrated into the host's genome. The infected cell produces new viral particles, which infect more CD4 cells.

Over time, the continuous replication and destruction of CD4 cells weaken the immune system. A healthy adult typically has 500-1,500 CD4 cells per cubic millimeter of blood. HIV-positive individuals experience a significant decline in CD4 cell count, impairing their immune response.

Without treatment, HIV can progress to AIDS. This stage is diagnosed when the CD4 cell count drops below 200 cells per cubic millimeter, or when specific opportunistic infections or cancers occur. At this point, the immune system is severely compromised.

HIV And Its Transmission

HIV is primarily transmitted through contact with certain body fluids from a person who has the virus. These fluids include blood, semen, vaginal fluids, rectal fluids, and breast milk. The most common ways HIV is spread include unprotected sexual contact, sharing needles or syringes, and from mother to child during childbirth or breastfeeding.

Knowing the modes of transmission is essential for implementing effective prevention strategies.

1. Safe Sexual Practices

One of the most effective ways to prevent HIV transmission is through safe sexual practices. Unprotected sex is the most common method of HIV transmission, making it crucial to adopt protective measures.

a. Use of Condoms

Condoms are a highly effective barrier method that prevents the exchange of body fluids during sexual intercourse. When used correctly and consistently, condoms significantly reduce the risk of HIV transmission as well as other sexually transmitted infections (STIs). Both male and female condoms are available, and they should be used during vaginal, anal, and oral sex.

b. Regular Testing and Treatment

Regular HIV testing and treatment for sexually transmitted infections are vital. Early detection of HIV allows individuals to seek treatment and reduce the risk of transmitting the virus to others. Additionally, treating STIs can reduce inflammation and open sores that increase the likelihood of HIV transmission.

c. Pre-exposure Prophylaxis (PrEP)

PrEP is a medication taken daily by HIV-negative individuals who are at high risk of contracting the virus. When taken consistently, PrEP is highly effective at preventing HIV infection. It is especially recommended for people with HIV-positive partners, individuals who engage in high-risk sexual behaviors, and those who inject drugs.

2. Safe Needle Practices

Sharing needles or syringes is a significant route of HIV transmission among people who inject drugs. Implementing safe needle practices can drastically reduce this risk.

a. Needle Exchange Programs

Needle exchange programs provide clean needles and syringes to individuals who inject drugs, reducing the risk of HIV transmission through shared equipment. These programs also offer safe disposal methods for used needles and often provide access to addiction treatment services and HIV testing.

b. Safe Injection Practices

Educating individuals about safe injection practices is crucial. This includes using a new, sterile needle for each injection, not sharing needles or syringes, and properly disposing of used needles. Public health campaigns and community outreach programs can play a significant role in spreading this knowledge.

3. Mother-to-Child Transmission Prevention

Mother-to-child transmission of HIV can occur during pregnancy, childbirth, or breastfeeding. However, with appropriate interventions, the risk can be significantly reduced.

a. Antiretroviral Therapy (ART)

Pregnant women living with HIV should receive antiretroviral therapy (ART) to reduce the viral load in their bodies, which lowers the risk of transmitting the virus to their babies. ART should be continued during pregnancy, labor, and breastfeeding.

b. Safe Delivery Practices

Healthcare providers should adopt safe delivery practices, such as opting for cesarean delivery when appropriate, to reduce the risk of HIV transmission during childbirth. Additionally, immediate postnatal care and continued ART for the newborn can further minimize the risk.

c. Safe Breastfeeding Alternatives

For mothers living with HIV, breastfeeding alternatives such as formula feeding can prevent the transmission of the virus through breast milk. In cases where formula feeding is not feasible, continuing ART during breastfeeding is crucial.

4. Regular HIV Testing and Early Treatment

Regular HIV testing and early treatment are fundamental components of HIV prevention. Knowing one's HIV status helps individuals take necessary precautions to prevent transmission.

a. Access to Testing

Increasing access to HIV testing is essential. Community health centers, mobile testing units, and home testing kits can make testing more accessible. Routine testing in healthcare settings, especially for high-risk populations, should be encouraged.

b. Early Antiretroviral Treatment

Early initiation of antiretroviral treatment for those who test positive for HIV can reduce the viral load to undetectable levels, effectively preventing the transmission of the virus to others. This concept is known as "undetectable = untransmittable" (U=U).

5. Public Awareness and Education

Public awareness and education are key to preventing the spread of HIV. Misconceptions and stigma surrounding HIV can hinder prevention efforts, making it vital to educate communities about the virus and how to prevent it.

a. Comprehensive Sexual Education

Implementing comprehensive sexual education programs in schools and communities can provide young people with accurate information about HIV and safe sexual practices. These programs should cover topics such as condom use, consent, and healthy relationships.

b. Community Outreach and Engagement

Community outreach programs can engage vulnerable populations and provide them with information and resources to prevent HIV. This includes working with community leaders, healthcare providers, and peer educators to disseminate accurate information and combat stigma.

c. Media Campaigns

Media campaigns can raise awareness about HIV prevention and encourage individuals to get tested and seek treatment. Social media, television, radio, and print media can all be used to reach a broad audience and convey important messages about HIV prevention.

Symptoms Of HIV

HIV symptoms vary depending on the stage of the infection:

1. Acute HIV Infection: Occurs 2-4 weeks after exposure, presenting flu-like symptoms such as fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. This stage is also known as acute retroviral syndrome (ARS).

2. Chronic HIV Infection: Also known as clinical latency or asymptomatic HIV infection. The virus is still active but reproduces at low levels. Individuals may not have symptoms or only mild ones. This stage can last several years with appropriate treatment.

3. AIDS: The final and most severe stage. Symptoms include rapid weight loss, recurring fever or profuse night sweats, extreme and unexplained tiredness, prolonged swelling of lymph glands, diarrhea that lasts for more than a week, sores of the mouth, anus, or genitals, pneumonia, red, brown, pink, or purplish blotches on or under the skin, and memory loss, depression, and other neurologic disorders.

HIV Diagnosis and Treatment

Diagnosis

HIV is diagnosed through blood or saliva tests that detect the presence of the virus or the antibodies produced in response to it. Common tests include:

a. Antibody Tests: Detect antibodies to HIV in blood or saliva. Most rapid tests and home-use tests are antibody tests.

b. Antigen/Antibody Tests: Detect both HIV antibodies and antigens (a part of the virus) in the blood. This test can detect HIV infection before an antibody test.

c. Nucleic Acid Tests (NATs): Detect the actual virus in the blood. This test is expensive and not routinely used for screening but can be used for high-risk cases or when recent infection is suspected.

Treatment

While there is no cure for HIV, antiretroviral therapy (ART) can control the virus. ART involves taking a combination of HIV medicines (antiretrovirals) every day. This treatment reduces the viral load to undetectable levels, helping individuals live longer, healthier lives and reducing the risk of transmission to others.

Eventhough, HIV remains a significant global health issue, but advancements in medical science have transformed it from a fatal disease to a manageable chronic condition.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.