Tag Archives: prevention

How to Prevent HIV/AIDS?

Disease and Treatment, , , , , ,

The world’s leading public health challenge is the HIV virus that leads to AIDS. In 2018, around 37.9 million people were infected with HIV/AIDS and approximately 1.7 million more joined the club worldwide. Only 79% of the affected numbers were aware of their HIV status and the remaining 21% did not even have access to HIV testing services. The death rate associated with AIDS has reduced from 1.7 million in 2004 to 770,000 in 2018 [1,2,3].

A brief summary on the HIV epidemic is presented in the Figure 1 [2]

Figure 1: Global HIV Epidemic [2]

Despite the advances in our healthcare sector and availability of a wide range of effective prevention tools, a large number of individuals with HIV or at risk of HIV do not have access to the prevention, care, and treatment [1]. A study reported that majority of the current HIV transmission is done via people who inject drugs, occurring in the majority of low and middle-income countries [4].

The advances in science have provided many tools to prevent HIV these days. However, to protect oneself from a disease one should be aware about the cause of the disease, with an understanding of how the virus spreads. HIV virus can be passed in the following ways [5]:

  • Having sexual intercourse with an HIV infected person
  • By sharing contaminated needles such as through blood transfusion or drug use
  • From an HIV infected mother to the foetus during pregnancy, or through breast feeding

Anyone and everyone is vulnerable to the HIV virus, but preventive measures can help one to reduce the risk of getting infected. Key approaches for the prevention of HIV are listed below:

HIV Prevention Medication [6,7]

Pre-exposure prophylaxis (prEP) and post-exposure prophylaxis (PEP) can greatly reduce the risk of contracting the HIV infection. According to the federal guidelines, prEP is considered for HIV-negative or people at a very high risk of HIV. It consists of daily medication and regular visits to a healthcare professional. This includes:

  1. Anyone who is in sexual contact with a HIV positive person
  2. A man who has sex with both women and men
  3. A heterosexual man or woman who have had sexual intercourse with partners of unknown HIV status.

PEP can prevent you from becoming infected with the virus once you are exposed to it. For this medication to work, it must be started within 72 hours after a possible exposure. It should be taken once or twice daily for 28 days. Use of condoms and safe injection practices is recommended during the medication.

An HIV-negative person has the following ways to protect himself/herself from getting infected:

Figure 2: Steps of Prevention for HIV-negative person

Treatment as Prevention [7]

This refers to the use of HIV medication to prevent transmission of the infection to others. An HIV infected person taking the medications as prescribed and has regular follow-ups to keep an undetectable viral load are at no risk of transmitting HIV to their HIV-negative partners. Antiretroviral therapy (ART) to suppress the virus should be taken regularly as it prevents the virus from growing in our body that keeps us healthy and prevents illness. Women infected with the virus are recommended to take the treatment to minimize the risk of transmission to the foetus during pregnancy or delivery. After conception, the new-born receives HIV medications for 4 to 6 weeks. Figure 2 shows the actions to be taken to prevent HIV from passing to others.

Figure 3: Steps for Prevention for HIV-positive person

The United Nations organized the Joint United Nations Programme on HIV/AIDS (UNAIDS) with an ambitious target to treat HIV with a 90-90-90 goal. By 2020, 90% of the people living with HIV will be aware of their HIV Status. 90% of the people diagnosed with HIV will receive a proper antiretroviral therapy (ART). 90% of people on ART will have viral suppression [1,7].

Turacoz Healthcare Solutions aims to spread awareness about HIV/AIDS. We urge the people to be aware about the condition. Following the preventive measures and seeking counseling is the best way to avoid this condition. However, for the HIV infected individuals it is best to continue with the ART and maintain a healthy diet. Nevertheless, with love and support from family and friends they can lead a happy and long life.

If you wish to contact us, click here.

References

  1. Retrieved from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics [Accessed on 26th December 2019]
  2. Retrieved from: https://www.who.int/hiv/data/en/ [Accessed on 26th December 2019]
  3. Retrieved from: https://www.unaids.org/en [Accessed on 26th December 2019]
  4. Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, Wodak A, Panda S, Tyndall M, Toufik A, Mattick RP. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet. 2008 Nov 15;372(9651):1733-45
  5. Retrieved from: https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/hiv-aids/treatments/prevention.html [Accessed on 26th December 2019]
  6. Retrieved from: https://www.cdc.gov/hiv/basics/prevention.html [Accessed on 27th December 2019]
  7. Retrieved from: https://www.hiv.gov/hiv-basics/hiv-prevention/reducing-sexual-risk/preventing-sexual-transmission-of-hiv [Accessed on 27th December 2019]
  8. Retrieved from: https://www.unaids.org/en/resources/909090 [Accessed on 26th December 2019]
  9. Retrieved from: https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/hiv-treatment-as-prevention [Accessed on 27th December 2019]

HIV Awareness

Awareness Day/Month, , , , , , , , ,

The human immunodeficiency virus (HIV) invades the immune system and damages the host’s defense system and causes it to weaken against all kinds of minor and significant infections and cancers. Thus, gradually leading to immunodeficiency, which in turn makes the body susceptible to opportunistic infections. CD4 cell count typically measures immune function. As stated by global statistics about 37.9 million people were HIV infected in 2018, with a prevalence of 0.8% in adults.

The advancement to a stage of acquired immunodeficiency syndrome (AIDS), takes 2 to 15 years to occur if not treated, depending on the individual.

Signs and symptoms

The symptoms of HIV depend on the stage of infection. It’s noteworthy that people with HIV infection are highly contagious during the initial period. However, most individuals aren’t aware of this until the later stages. People may experience no symptoms or influenza-like illnesses, including headache, rash, fever, and sore throat. The progressing illness leads to advanced symptoms and signs, like diarrhea, fever, cough, without treatment; tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, swollen lymph nodes, weight loss, and cancers such as lymphomas and Kaposi’s sarcoma.

Transmission

Transmission of this dreadful disease occurs through the exchange of a variety of bodily fluids such as blood, breast milk, semen, and vaginal secretions from infected people, and from a mother to her child during pregnancy and delivery. Individuals cannot become infected through regular day-to-day contacts such as kissing, hugging, shaking hands, or sharing personal objects, food, or water.

Risk factors

Behaviors and conditions that put individuals at higher risk of contracting HIV include:

  • Unprotected anal or vaginal sex
  • Drug abuse
  • Sexually transmitted infections (STI) like syphilis, gonorrhea, bacterial vaginosis, herpes, and chlamydia
  • Use of contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs
  • Unsafe blood transfusions, injections, using contaminated and unsterilized needles, and tissue transplantation
  • Experiencing accidental needle stick injuries, including among health workers

Diagnosis

HIV diagnosis is made through rapid diagnostic tests that provide same-day results. These tests dramatically facilitate early diagnosis and treatment. There are self-diagnostic tests available to help test for HIV infection; however, a confirmatory test is always required, conducted by a qualified and validated health worker at a community center or clinic. The WHO pre-qualified tests are the most accurate for diagnosing HIV infection. These tests detect the antibodies produced from the infected individual. People develop antibodies within 28 days of infection. This period is called window period, during which a person does not experience any symptoms; however, he/she might transmit the disease to others.

All the HIV positive patients should be retested before enrolling for the prescribed treatment, to rule out any testing or reporting error.

While testing for babies born to HIV-positive mothers, the virology test is the test of choice and should be performed at birth or 6 weeks of age. New technologies are being available to help perform these tests more accurately along with delivering the results on same day.

HIV testing services

HIV testing should be voluntary and the right to decline testing should be recognized. Mandatory or coerced testing by a health care provider or authority, or by a partner or family member is not acceptable as it undermines good public health practice and infringes on human rights.

All HIV testing services must follow the WHO-recommended principles known as the “5 Cs”:

  • Informed consent
  • Confidentiality
  • Counseling
  • Correct test results

Connection (linkage to care, treatment and other services)

Prevention

Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, are listed below.

  • Male and female condom use
  • Testing and counseling for HIV and STIs
  • Testing for HIV and other STIs
  • Testing and counseling, linkages to tuberculosis (TB) care
  • Voluntary medical male circumcision (VMMC)

Prevention benefits of ART

WHO based on the results of a study conducted in 2011 recommended that all the HIV infected individuals should receive ART to prevent the transmission of this deadly condition. Also, a study conducted in 2019 reported negligible transmission risk of HIV in individuals on ART.

Pre-exposure prophylaxis (PrEP) for HIV-negative partner

Pre-exposure prophylaxis is recommended for all the individuals who are at a greater risk of HIV infection such as, trans-genders, hetero and homosexual couples, drug abusers, pregnant and lactating women.

Post-exposure prophylaxis for HIV (PEP)

Post-exposure prophylaxis should be used within seventy-two hours of being exposed to HIV. This includes testing, counseling, treatment with anti-retroviral for 28 days.

Harm reduction for people who inject and use drugs

Individuals who use the injections can follow the below-mentioned interventions as prevention:

  • needle and syringe programs
  • opioid substitution therapy for people dependent on opioids, and other evidence-based drug dependence treatment
  • risk-reduction information and education, and provision of naloxone to prevent opioid overdose

Elimination of mother-to-child transmission of HIV

HIV infection can be transmitted to the child or the unborn fetus through the mother during pregnancy or breastfeeding. This is called a vertical mother to child transmission (MTCT). However, this can be prevented with the treatment using antiretroviral therapy during pregnancy and breastfeeding.

Treatment

Treatment comprises of combination therapy with three or more anti-retroviral drugs. This therapy helps suppress the condition and does not completely cure it. Hence WHO recommends all the individuals suffering from HIV to take lifelong medication to lead a normal life.

The clinical research and health care system is continuously working to develop ARTs with better efficacy, tolerability. Use of dolutegravir-based or low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second line as recommended by WHO.

Making the access to the treatment and prevention is the core goal for the upcoming year. And this aims to bring the world back on track to end the AIDS epidemic by 2030.

WHO response

The 69th World Health Assembly recommended a new “Global health sector strategy on HIV for 2016–2021”. The strategy comprises of five strategic directions that guide the countries and WHO to take necessary actions over six years.

The strategic directions are:

  • Information for concentrated action for the region/country
  • Interventions designed to have an impact on the variety of services needed
  • Delivering services equally to cover the population in need
  • Financing for the sustainability of the services in terms of cost
  • Innovation in acceleration towards future

WHO is a co-sponsor of the Joint United Nations Programme on AIDS (UNAIDS). Where it directs the activities on HIV treatment and care and the coinfection. It also jointly organizes with UNICEF, the work on elimination of MTCT of HIV.

Prevention is always better than cure! Follow these tips to notice a change in your lifestyle.

Turacoz Healthcare Solutions aims to spread awareness about HIV/AIDS. We urge the people to be aware about the condition. Following the preventive measures and seeking counseling is the best way to avoid this condition. However, for the HIV infected individuals it is best to continue with the ART and maintain a healthy diet. Nevertheless, with love and support from family and friends they can lead a happy and long life.

If you wish to contact us, click here.

 

#PsoriasisAwarenessMonth: Management and prevention

Awareness Day/Month, , , ,

Psoriasis is not all of you, it is just a part of you like everything else

Psoriasis is generally classified based on the severity of the disease from mild to severe with a Psoriasis Area Severity Index (PASI) scale. Based on this severity index treatment is given to the patients.

The score comprises of 3 features of psoriatic plaque:

  • Redness
  • Scaling
  • Thickness, which are assigned a number from 0 (none) to 4 (worst).

The extent of involvement of each region of the body (12 regions) is scored from 0 to 6. The total score is a range of 72. There are many studies that quote the improvement with this index which help to know the drug’s effectiveness. For example, if a patient cleared 75% of his psoriatic lesions then it is described as “PASI 75”. These scores are used by clinicians to follow their patient’s progress.

Psoriasis Management:

Some general recommendations for treatment of psoriasis,

  • Topical application of corticosteroids in the form of ointments, creams, gels, liquids, sprays etc. Example: Keratolytics and calcipotriene, others include anthralin and tars.

Over-the-counter topical medications include, salicylic acid foams or ointments, Coal tar, Zinc pyrithione.

  • UVB is a safe, effective and cost-effective.
  • PUVA (psoralen plus ultraviolet A) is also an effective treatment.
  • Conventional treatment methods:
  • Usage of methotrexate, which is an effective therapy in the majority of patients but has the potential for hepatotoxicity and is contraindicated in some situations.
  • CyA (cyclosporine), another immunosuppressive medication, also an effective treatment for psoriatic patients.
  • Acitretin, a systemic agent which is effective and used for the treatment of psoriasis.
  • Biological agents are proteins that are extracted from animal tissue or can be produced by recombinant DNA technology that possesses pharmacological activity.
  • Few biologics that target pathogenic T cells include Alefacet and Efalizumab.
  • Few other biologics target TNF inhibitors for the treatment of psoriasis include Adalimumab Etanercept, and Infliximab.

Psoriasis can also be managed by education and advocacy. Also should promote awareness and understanding of the disease, ensuring access to treatment and supporting research that can lead to effective management.

Psoriasis Prevention:

Psoriasis is a chronic disorder that requires long-term monitoring for treatment response, adverse events and new comorbidities. Also there is a poor adherence to treatment to obtain good results for patients with psoriasis. Hence, there is no way to completely prevent or avoid the occurrence of psoriasis instead taking some precautionary steps can improvise the symptoms and help reduce number of psoriasis flare-ups. Few preventive measures that a psoriatic patient can do to reduce the flare ups.

  • Taking care of the skin, scalp, and nails and other areas where psoriasis can spread.
  • Trying some psoriasis creams or ointments that can keep the body moisturized all the time.
  • Taking sunbath for some time also helps in reducing the psoriatic skin cells.
  • Try to avoid few medications which can flare up the disease.
  • Psoriasis can spread easily in cold, dry climates and it is always better to avoid such environmental conditions.
  • Quit smoking and reduce alcohol consumption.
  • Lifestyle interventions where symptoms can get worse with stress and anxiety so need to avoid such situations. To avoid such conditions patients can start their day with yoga, meditation, and other exercises.
  • Taking a well-balanced diet.

Some health tips to bring symptom relief:

  • Keep the skin moist all the time by applying moisturizers
  • Take warm bathes that helps in skin soothing
  • Expose the body to small doses of ultraviolet light in the sunlight
  • Do not irritate or scratch the psoriatic skin patches
  • Limit intake of alcohol and stop smoking
  • Start the day with stressbusters like yoga or meditation to relieve from tensions and emotions
  • Consider some dietary changes by reducing the intake of sugars, white flour, gluten, caffeine, oils etc.

Diagnosis of psoriasis is not the end but the journey continues with normal ups and downs as with anyone else. Having a disease is not a battle lost but losing hope is defeat. So keep up hope and there are answers to every problems and let’s keep finding them and spreading them.

Turacoz Healthcare Solutions is a socially responsible medical communication company which delivers high quality medical content related to scientific publication (manuscript, review, poster, abstract, case report), regulatory documents (protocol, CSR, narratives, clinical trial disclosure, web synopsis) and marketing documents (print and digital).