Hiv hcv killer twins

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Hiv hcv killer twins

  1. 1. HIV HCV HIV- HCV The Killer Twins Neeraj Mahajan 2009 1
  2. 2. HIV & HCV- What’s Common ?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 andno cure in sight…Both are SMART viruses – masters in the art of deception & disguiseThey cripple the body’s defenses before silently causing maximum damagedeep inside…We might call them the killer twins…But before we begin let’s get few thing clear… Neeraj Mahajan 2009 2
  3. 3. HIV & HCV- Basic Issues HIV Virus• 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. Neeraj Mahajan 2009 3
  4. 4. HIV: Not Just A Disease…But Series of Medical ComplicationsHIV 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 Kaposis sarcoma, lymphoma and squamous cell carcinoma.• Gastrointestinal malignancies -including pancreas cancer, breast cancer, and skin cancerMost of these are diseases that a normal person could easily fight off but may prove fatal for anHIV infected person because of weak immune system Neeraj Mahajan 2009 4
  5. 5. HIV-HCV : Why Serious Concerns for IndiaBoth HIV & Hepatitis C or HCV are seriousconcerns 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". Neeraj Mahajan 2009 5
  6. 6. HIV-HCV : Similarities• 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 bodys 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. Neeraj Mahajan 2009 6
  7. 7. HIV-HCV : Ignorance is not bliss !!• 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 Neeraj Mahajan 2009 7
  8. 8. HCV is many times more dangerous than HIV or AIDS• 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 Neeraj Mahajan 2009 8
  9. 9. Key Issue: How Do We Combat An Unknown Disease• 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. Neeraj Mahajan 2009 9
  10. 10. PROBLEM: Many medically undiagnosed people are walking theon streets blissfully unaware of their HIV+ve statusThe seriousness of this problem can also be assessed from the factthat only less than 1 % population of India get themselves tested forHIV-HCV even once in the lifetime and worst still up to 27 % HIVinfected people remain undiagnosed… It’s a world wide trend thatmany HIV infected -- medically undiagnosed people are walking the onstreets blissfully unaware of their HIV+ve status. Such people continueinfect 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 Neeraj Mahajan 2009 10
  11. 11. PROBLEM: They are like Human Time Bombs that canexplode any moment• 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 Neeraj Mahajan 2009 11
  12. 12. CORE ISSUE: Shortening the Window Period• 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. Neeraj Mahajan 2009 12
  13. 13. Window Period: HIV Infection and Antibody Response---Initial Stage---- ---------------Intermediate or Latent Stage-------------- ---Illness Stage--- Virus Antibody 6 month ~ Years ~ Years ~ Years ~ Years Neeraj Mahajan 2009 13
  14. 14. Window Period: HIV Infection and Antibody Response Neeraj Mahajan 2009 14
  15. 15. HIV-HCV Window Period: Which segments of theSociety need to be Concerned?• Defense Services, Police & Para- Military forces• Blood Banks & Blood Transfusion Sector Neeraj Mahajan 2009 15
  16. 16. HIV-HCV Window Period: Why should each segment ofthe Society be Concerned? Neeraj Mahajan 2009 16
  17. 17. HIV-HCV Window Period: Why should Blood Banks &Blood Transfusion Sector be Concerned? Neeraj Mahajan 2009 17
  18. 18. HIV-HCV Window Period: Why should IDUs, Prostitutes, Gaysand other High Risk Categories be Concerned? Neeraj Mahajan 2009 18
  19. 19. HIV-HCV Window Period: Why should Doctors, Hospitals &Other Healthcare Employees be Concerned? Neeraj Mahajan 2009 19
  20. 20. HIV-HCV Window Period: Why should Pregnant Woman, NewBorn Babies and other faceless Indians be Concerned? Neeraj Mahajan 2009 20
  21. 21. HIV-HCV Window Period: 360 degrees of Circle of Concern Neeraj Mahajan 2009 21
  22. 22. HIV-HCV Window Period: Rationale for National Awakening Neeraj Mahajan 2009 22

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