Expert calls for concerted effort to fight HIV as cases are on the rise

The year 1981 marked the first known appearance of a disease that did not have a name, no clear origin and with no known procedure on how to test it, much more treat it. And the saddest part of it all is that patients die in a span of a few months.

Eventually, it was identified to be a human immunodeficiency virus or simply HIV, which wreaks havoc on one’s immune system, making the human body susceptible to an array of infections, even some forms of cancer.

If not treated early and effectively, HIV infection over the years can become more advanced, leading to what is called Acquired Immunodeficiency Syndrome or simply AIDS, which can inflict infections and other severe long-term medical problems.

And don’t even attempt to take it lightly because AIDS has already claimed the lives of 40.1 million people more than 40 years ago, making it a truly major global public health issue.

HIV: what is it really?

According to Dr. Sybil Lizanne Bravo, Division Chief, Infectious Disease, Clinical Associate Professor, Department of Obstetrics and Gynecology, UP College of Medicine, during the recent webinar titled “HIV sa Panahon ng Covid-19” organized by the University of the Philippines together with UP Manila NIH National Telehealth Center and in cooperation with UP Philippine General Hospital, HIV is an infection that attacks the immune system, specifically the white blood cells, and weakens an individual’s immunity against the so-called “opportunistic” infections, those that happen or are more severe in people with weakened immune systems than those with healthy ones such as tuberculosis, fungal infections, severe bacterial infections, select types of cancers.

Up to now, there’s still no known cure For HIV which can progress to AIDS if not treated. But with advanced medical care, AIDS can now be suppressed through proper medical care and prevent the infection from spreading, allowing HIV-infected people to live long, healthy lives and protect their partners through effective HIV treatment.

There are two HIV types, the most common being HIV1 while HIV2 is the rare one. There are also many risk factors like having multiple sexual partners, unprotected sex, sexually transmitted infection, even accidental needle stick injuries, among others. Most common symptoms include sore throat, fever, night sweats, swollen lymph nodes, chills, fatigue, rash, and muscle aches. There are three stages: acute HIV infection on the first stage, followed by chronic HIV infection, then AIDS, which is the third stage.

Testing can be done through Rapid HIV Diagnostic Algorithm (rHIVda), while the other is a confirmatory test that combines two or three Rapid Diagnostic Test (RDT) formats done in parallel or in sequence.

How is HIV in the country during the pandemic?

Currently, the Philippines has the fastest-growing HIV epidemic in Asia so that’s really shocking news, according to Dr. Bravo. She said there was a 237-percent increase in annual new HIV infections from 2010 to 2020, and AIDS-related deaths increased by 315 percent.

“We see that the estimated number of people living with HIV will triple in about eight years or by 2030 and reach more than 330,000 so that’s really bad news,” she said.

According to the HIV/AIDS and ART Registry of the Philippines as of July 2022, there were 1,346 total reported cases in July 2022, with 41 average cases per day from January to July 2022. There were 1,273 males and 73 females infected, with 399 having advanced HIV disease, and 70 total reported deaths. The top four regions are Metro Manila, Calabarzon, Central Luzon and the Visayas region, and male-to-male mode of transmission is the highest at 65 percent, with eight cases among newly diagnosed pregnant women.

“In the PGH, the peak was in 2019 just before the pandemic with 40 patients in one year. Now, during the pandemic, it slowed down, which we attributed to decreased testing and delivery in tertiary centers,” Dr. Bravo pointed out.

With the HIV situation now in this pandemic, Dr. Bravo said they noted lower condom use in the general population from 26 percent down to 17 percent, and amid community restrictions, there was still a sustained elevated level of high-risk behavior, particularly among men who have sex with men (MSM).

“Because of the pandemic, there were disruptions in service delivery where HIV testing decreased since many primary-care facilities and tertiary-care institutions were converted to Covid-19 hospitals, so treatment rates really dropped,” she continued.

Even if the HIV situation in the country can be quite depressing, Dr. Bravo said there is still hope in reversing the trend of new infections by reducing new cases to below 7,000 this year.

“With all sectors working hand-in-hand, we should be able to achieve the ‘90-95-95’ (90 percent prevention coverage, 95 percent diagnosis coverage, 95 percent treatment coverage) plan of the World Health Organization to prevent this epidemic from becoming the worst in the history of all infections. We should also revive HIV care facilities and diagnostics and hope to be able to reverse the HIV epidemic,” she said.

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