Last night my husband went to the Society of Malawi meeting. On this particular night there was a Malawian expert talking about HIV, AIDS, and ARV (Anti Retro Viral) drugs used to treat AIDS.
I have never known the difference between HIV and AIDS and always thought of it as one and the same. Last night the speaker clarified the difference: HIV is when the blood CD4 (proteins that make up the immune system) drop to 500 and AIDS is when CD4 drop to 200.
When a person gets HIV his CD4 just keep going down. As the sickness progresses the patient will get ailments like shingles and thrush and will experience weight loss. After the CD4 level drops all the way to 200 more serious sicknesses like TB and some forms of meningitis will occur. After that point the patient has less than a year left to live. Right now in Queen Elizabeth Hospital in Blantyre, Malawi, most of the beds are taken up with the AIDS patients. If a patient comes in with Malaria he or she is simply given outpatient treatment and sent home.
The very first ARV drugs could add about a year to one’s life and the patient would have to take 20 to 30 tablets daily. Later on new drugs came that reduced the amount of drugs to 3 tablets per day and eventually to 1 tablet that contained 3 different types of medicines in it. There are about 22 ARV drugs in the world. In Malawi there are 4 to 5 ARV drugs that are available to patients for free. Those drugs are donated for free by different aid organizations. Also in private clinics 4 to 5 other types of drug are available for sale. Why so many? Because AIDS has different strains and they require different drugs to combat them. There are also different levels of toxicity in the drugs and they can have different side effects. Five percent of patients taking these drugs have an adverse reaction. In Western countries these kinds of medicines will not be used but Africa will gladly take anything it can get. The Malawi government decided that it would be better for 5% of infected people to get this reaction than for 100% to have no hope at all. One common side effect is skin rash that makes patients look as if they had been burned.
The new ARVs can add decades to the patient’s life if taken properly. People do not realize that if they start on ARVs they have to take the complete course of medication at the appropriate time. AIDS can build up resistance to the drug if the treatment is interrupted or administered incorrectly. In Malawi, out of 1 million infected people only 200,000 are receiving ARVs. One of the reasons is that the supply of ARVs does not come in consistently. Sometimes when the hospitals run out there are periods of 3 to 4 months when there are no drugs available.
Another important fact is that some may test negative for HIV after a period on ARVs, but this does not always mean that the patient is cured. The virus stores itself in one’s brain, liver, or lymph nodes and can return later should the patient stop taking regular treatment.
Some of the people in the Western countries think that since ARV drugs are so available, AIDS is not such a serious threat any more. But they need to realize that AIDS is still a major killer all over the world. Right now scientists are trying to find a cure that will heal people from AIDS completely and make this pandemic history!
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