Medical experts say effective use of Antiretroviral Therapy popularly known as ART adds at least 33 years to the lifespan of people living with HIV and are on the therapy. They stated that given the effectiveness of ART, the Joint United Nations Programme on HIV/AIDS and other stakeholders in the fight against the infection think that it is possible to announce an end to the AIDS epidemic by 2030. The researchers assured that the days of HIV infection as a dreaded disease are numbered; affirming that with effective use of ART by people living with the disease, Nigeria and the rest of the world would be able to get to a point where no new infection will occur—epidemic control. Although there is currently no effective cure for HIV, the physicians, the senior medical practitioners, however, assured that with proper medical care, HIV can be controlled, stressing that people with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.
The World Health Organization says HIV treatment involves the use of combined ART to effectively suppress the viral load, preserve (or improve) immune function, and reduce the risk of opportunistic infections and cancers commonly associated with the infection. It noted that the main objective of HIV treatment is to reduce the mortality and morbidity caused by the virus and associated conditions, increase survival, improve the quality of life, and prevent HIV transmission. People living with HIV are more likely than others to become sick with tuberculosis and worldwide, TB is one of the leading causes of death in HIV/AIDS, according to the WHO. The global health body stated that HIV suppression with ART also decreases the inflammation caused by the immune activation associated with chronic HIV infection that contributes to an increased occurrence of cardiovascular, renal, neurological, and other end-organ diseases that are prevalent in people living with HIV.
Delivering the 14th Inaugural lecture for the 2023/2024 academic session of the University of Lagos recently titled, “The virus and the malnourished red cells: It is only a matter of time; Humanity is set to have the last laugh over the virus”, a Professor of Hematology and Blood Transfusion at the College of Medicine of the university, Sulaimon Akanmu, said the advent of ART provided a pillar of hope for a cure. Akanmu said, “What the virus has done to humanity, God almighty has given humanity the knowledge to be able to tackle the virus.” I spoke about what we call achieving epidemic control by which we mean that with effective use of retroviral therapy, we would be able to get to a point where no new infection will occur. “Because everybody that is HIV infected and is on effective ARTs will be incapable of infecting another person and when that happens, it will be the beginning of what we refer to as epidemic control.”
The Sustainable Development Goal 3.3 calls for an end to the AIDS epidemic by 2030, which involves a reduction in incidence worldwide. HIV epidemic control is defined by the WHO as the reduction of disease incidence, prevalence, morbidity, and/or mortality to a locally acceptable level as a result of deliberate efforts. Giving insight into the importance of achieving HIV epidemic control which he said was possible through effective use of ARTs, Akanmu said, “Effective ART adds at least 33 years to the life span of persons living with HIV on therapy. “Since viral load becomes undetectable, it is calculated that a person living with HIV on effective treatment will be able to infect less than one person in 33 years. These are metrics, and more are now being achieved in many countries and very soon in Nigeria too. “That is why we say the Incidence Prevalence Ratio of 1/33 must be achieved. The day we achieve that is the day we will say indeed, we have arrived at the destination where we would say we have truly achieved epidemic control. But that also implies that we must be able to say that no new infection is occurring.”
The former president of the Nigerian Society for Hematology and Blood Transfusion, unless it is confirmed that no new infections are occurring, achieving epidemic control remains uncertain. He stressed that it is essential to differentiate between new infections and existing ones among those testing positive.”
He said, “And the technology that we can use to determine when somebody is newly infected or not is what I suggested as a very strong recommendation to the Federal Ministry of Health and NACA. “We can only do that if the country adopts what we call fourth-generation screening kits for testing HIV antibodies moving forward in the country.” According to the National Agency for the Control of AIDS, no fewer than 1.8 million persons are estimated to be living with HIV in Nigeria, out of which about 1.63 million are already on the lifesaving medication ART.
Speaking with PUNCH HealthWise, Dr. Dan Onwujekwe, says HIV-positive pregnant women must be placed on HIV treatment and encouraged to deliver in health facilities to reduce the burden of mother-to-child transmission of the infection. The researcher noted that HIV can be transmitted from an infected mother to an unborn child during pregnancy, childbirth, and breastfeeding if no treatment has commenced. Onwujekwe, who is a retired Chief Research Fellow at the Nigerian Institute of Medical Research, Yaba Lagos, told our correspondent that it is also compulsory to test all pregnant women for HIV when they come for antenatal clinic, stressing that it helps in the prevention of motor-to-child transmission. “If we can provide antenatal care to every pregnant woman and during the antenatal care we offer them HIV testing, we would be able to detect those who are HIV positive and put them on treatment. “And if they are treated three to six months before they deliver, it is likely they will not transmit HIV infection to their babies. “But we have so many babies being born with HIV in Nigeria because their mothers were not tested during pregnancy. “If pregnant women access antenatal care, those who are HIV positive would be discovered during screening and placed on treatment,” he said.
