ANSWERS TO QUESTIONS FROM SCHOOL STUDENTS IN INDIA

ANTI-RETROVIRAL DRUGS AND TREATMENT

by Rajan Gupta

There are many benefits of anti-retroviral (ARV) therapy. Firstly, ARV reduce the HIV viral load in the body. This means that

• The patient's immune system gets a chance to recover.
• They are then less suceptible to dangerous opportunistic infections (OI).
• They are less likely to transmit HIV and various possible OI like TB to others.
• Their life span is extended and they can take better care of their family.
• They have more energy, better health, and can therefore remain productive citizens.
• They can become peer-educators, making others aware of the dangers of risky behavior.

Second, there also are many societal benefits.

• Providing ARV therapy is the surest sign of the governments commitment to eradicating HIV/AIDS, i.e., a demonstration of political will.
• It will engage the medical community (doctors, nurses, hospitals).
• It will remove the stigma associated with it (only immoral people get HIV).
• More people will get tested because they know there is help (and better health) available in case they are infected. By knowing their status they can change their behavior and thus reduce further spread.

All known ARV drugs are very toxic and can have very serious side effects. A trained doctor has to carefully monitor the reaction of a particular combination of ARV in each patient, and adjust the diet, dosage and combination of ARVs to find one that the patient can tolerate and which reduces the viral load. The facilities for testing the viral load and CD4 cell count are expensive and not readily available in India. Most doctors will therefore provide ARV simply based on symptoms and will not have the ability to monitor the side-effects or efficacy. In some patients the side effects may cause more harm than the benefits due to controlling HIV load. Also, if the drugs are given indiscriminately, the chances of generating drug-resistant mutations of HIV become very high, in which case these drugs will soon become ineffective globally. In short, the drawback is India's inadequate health care system rather than the drugs themselves.

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