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HIV in Pakistan – An alarming Threat

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Sabeeka Zafar
Sabeeka Zafarhttps://scientiamag.org
Sabeeka Zafar is a Bioinformatician-to-be with a passion to be a significant part of the great revolution in the near future in the field of Bioinformatics specifically and that of Science generally. Sabeeka is a social activist, enjoys working with people for the betterment of the society and loves to read and to write.

During this pandemic outbreak, as we all are frightened by the upsurge spread of coronavirus in our communities, some other viruses will soon be an alarming threat to all of us if we continue to keep an ostrich-like attitude towards them; HIV is one of them. 

According to the recent reports of UNAIDS, Pakistan is ranked as the 11th country with a high prevalence of HIV/AIDS. According to the available data of 2018, 160,000 HIV cases had been reported, and out of these, around 110,000 were men; 48,000 women; and 5,500 children under the age of 15, having a provincial distribution of 

1. Punjab – 75,000,

2. Sindh – 60,000, 

3. Baluchistan – 5000,

4. KPK – 15000.

The marginalized communities are the main target of this epidemic, including sex workers, drug addicts, transgender, and homosexuals. The poverty and hunger that prevail in our society have increased the prostitution rate, forcing young girls to work as sex workers, sent to the middle east by the mafias, where they contract AIDS and then become a means for the spread of disease. Transgender people are also the victim of the devastating economy of this country that compels them to work as sex workers and contributes to 7.6% of AIDS-infected patients. Homosexuals are another target and add almost 85,000 patients of AIDS

But, unfortunately, even this statistical estimate is not compelling enough to open the eyes of authorities, urging them to break the taboos, making people take it seriously and talk about it when its annual spread has reached 20,000 patients per year. Instead of taking substantial measures to combat the spread of this detrimental disease, our federation is busy playing the blame game, making the figure of patients a dispute between provinces; that whether the highest number of AIDS patients are in Punjab or Sindh. In 1987, a National AIDS Prevention and Control Programme (NACP) was launched by the federation, with the main target of blood screening along with health promotion and HIV education activities for the general public. Still, it ended up being a total flop because of the lack of funding and proper strategy needed to run the program. No special funds are allocated for the treatment of HIV patients, and people are not even aware of this virus or about its spread. This is the root cause of why the number is effectively declining in other countries but keeps on aggravating in our country by leaps and bounds.

What is HIV?

HIV (human immune deficiency syndrome) is a virus that attacks cells of the body (CD4 cells, often called T cells) fighting against the disease, damaging the immune system, making it vulnerable to life-threatening opportunistic infections.

There is no effective cure for HIV; once you get it, you have to live with it your whole life. The only treatment for HIV is antiviral therapy (ART) that can prolong the life span, effectively make the viral load undetectable with no risk of transmitting HIV to an HIV-negative person.

Stages of HIV

If HIV is left untreated, it progresses in stages, getting worse with time. HIV mainly has three stages 

There are several stages in HIV infection. Source: NIH
There are several stages in HIV infection. Source: NIH

Stage 1: Acute HIV infection

Being the earliest stage, it develops within 2 to 4 weeks after infection, with mild symptoms of flu, fever, headache, and rash. The level of HIV in the blood greatly increases during this stage, attacking and destroying the CD4cells of the immune system and multiplies rapidly throughout the body, increasing the risk of HIV transmission. 

Stage 2: Chronic HIV infection

During chronic HIV infection (also known as symptomatic HIV infection or clinical latency), the virus spreads slowly with the patient having not any particular HIV related symptoms. People being treated with ART can remain in this stage for decades, and having an undetectable viral load makes them less to nearly non-prone to transmit the virus to an HIV-negative partner through sex. But those without ART may get AIDS in 10 years or longer depending on the progression of the disease.

Stage 3: AIDS

AIDS is the final stage of HIV, chronic; potentially life-threating infers when HIV completely damages the immune system, making the body prone to all opportunistic infections (Infections that affect the body having a weak immune system rather than having a healthy one). People having AIDS have a CD4 count of fewer than 200 cells/mm3. People diagnosed with HIV have a very high viral load, with a significant risk of transmitting it to others. The patient’s survival rate is not more than three years if left untreated.

How HIV spreads?

HIV can only be transmitted via certain body fluids from a person having a detectable viral load. These fluids include

  • Blood
  • Semen (cum) and pre-seminal fluid
  • Rectal fluids
  • Vaginal fluids
  • Breast milk

The fluids that have HIV get into the bloodstream of an HIV negative person via a mucous membrane (found inside the rectum, vagina, penis, and mouth.), cuts, or direct injection for transmission to occur. Major activities that lead to its transmission include unprotected sex; through sharing injecting equipment, from mother-to-baby during pregnancy, birth, and breastfeeding; and through contaminated blood transfusions. 

How it hijacks the immune system?

“HIV is like a jack-in-the-box,” says Sriram Subramaniam, a biophysicist at the National Cancer Institute who peers at HIV with electron microscopes.

3D-Model of HIV
3D-Model of HIV

HIV has a round-shaped shell studded with spikes that encapsulates the genetic material of the virus. Virus’s genetic material needs to get into the cell to infect it, which requires the shell to pop open. When HIV enters the body, it bumps into the T4 cells, the primary target of HIV. T cells got finger-like projections, including one CCR5 that fixes on HIV spikes, exploits its machinery, and uses it to multiply inside the host cell.  

At the initial stage, the body copes against the virus by increasing the production of CD4 cells. But when it fails to produce enough amount of CD4 cells, the amount of virus multiplies in the body to an amount that becomes uncontrollable. Then the virus destroys the patient’s immune system, making it unable to fight the infectious diseases, leading to sickness.

How to contain the spread of HIV?

As it is evident from the statics that the number of patients is snowballing every single day and if we continue to act ignorant to the threat this virus has posed on us, we will soon have to deal with an uncontrollable catastrophic situation.

But it is still not too late if especially our government shows an act of responsibility and takes some preventive measures, their vital role can prove very efficient in eradicating this virus- making it an HIV free environment for us. Some important actions the government should immediately take are

  • Reuse of syringes should be wholly banned instead replace them with auto-disable syringes
  • The government should announce an extra budget for HIV/AIDS patients along with the reservation of a fixed number of beds for these patients in every hospital.
  • In high schools, colleges, and universities, there should be a compulsory drug addiction test of students. All drug addicts must be screened for AIDS; those with a positive test should be sent to treatment centers.
  • The government should strengthen the NACP department by providing them with proper funds and keeping it under appropriate check and balance.
  • The special program should be launched by the government that looks after all the factors involved in the spread of this disease and takes the necessary measures needed to eliminate them from society.
  • Print and Electronic media should be used effectively to spread awareness of this virus among the masses.

No government can alone combat this deadly virus if each of us will not play our due part. Like polio, we cannot own another virus for the coming decades when the rest of the world has eradicated every single trace of it from there land. Pakistan is a third world country with the two-third of our population below the poverty line, we have far more severe issues to deal with, where we are not ready to face another catastrophic situation like this. It is the need of the time to take this issue seriously, take all the effective measures to prevent this virus from consuming us all wholly.

Also Read: Your ultimate guide to Covid-19

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