This post is for all health care providers and Social workers in India.
You know an HIV positive person who needs medical help.What to do?
First thing you have to make sure is whether he/she is really 'positive'. Three positive rapid tests detecting antibody is considered confirmatory. These tests are done virtually free of cost at all major Government Hospitals. The person can go directly there to the testing centre and get tested.No need for a doctor to order the test.
If he/she do not want to test in a Government testing centre you can ask him/her to get tested in a good private lab. There the more costly Western Blot test is usually done to confirm the diagnosis.
If the diagnosis is confirmed the most important thing is to reassure the patient that HIV/AIDS is a treatable condition now and the treatment is available free of cost at ART Centres attached to certain major Hospitals. Before starting treatment few other blood tests also have to be done to assess the immune status and overall health of the patient.
It is important to note that all positive persons do not need treatment.If there are no illness and if the person's immunity status is good[meaning the CD4 count is more than 200], treatment is not started immediately.The person needs to follow up regularly to check his immune status.
What do you mean by Immune status?
It is a measure of the ability of the person's body to fight against infections. HIV virus slowly destroys the ability of the body to fight against infections.Such an immune compromised individual can get infections easily.
Why treatment is delayed till the immunity is destroyed?
In early stages of infection especially the first 5 years the body partially win the battle against HIV. Slowly but surely the virus get the upper hand [in most of the positive persons] and the body's immune system gets destroyed. Only at this stage the person becomes ill. We start anti HIV treatment at that time so that we can prevent the person falling ill due to various infections.
Starting treatment before that do not give much benefit.As of now we can only reduce the multiplication of the virus to a minimum.We cannot eradicate the virus. Also the anti HIV medicines have many side effects.There is also chance of drug resistance if the dosages are missed. Considering all this treatment initiation early in the course of HIV infection is not very useful.
It is also important to test the spouse of the person.If the mother is positive the children if any also have to be tested.
If there is a pregnant positive woman, she needs treatment to prevent her child getting infected. This also is provided at ART centres.
Compassion and good advise is what that is needed for a newly detected 'positive' person.