Asha (name changed) just completed her tenth standard examination recently. She hopes to finish in flying colours. She came to the Dr N.T.R. Government General Hospital (GGH) ART (anti-retroviral therapy) centre to pick up her monthly quota of medication.
Asha was born with HIV along with her elder sister. Her sister is now 21 years and is studying B.Tech. Over the years, her immunity has grown. Her CD4 count is good and she does not need to take medication anymore. This does not mean she is cured of the virus.
She has to continue to keep checking the CD4 count every six months for the rest of her live and go back to medication if the count falls.
Asha hopes one day she would become like her sister and stop taking medication at the centre. But 15,285 others are not so fortunate and have to make monthly trips to the centre. They will have to be on medication for the rest of their lives.
As the medication is expensive, they will have to come to the GGH every month to take it free. The medication keeps them health and protects them from succumbing to infections. Even a common cold can kill them if they do not take the medication properly.
The ART centre opened in Vijayawada in September 2006 with 24 people, and in eight years, the number increased to 13,777. “Clinical failure (develop symptoms), immunological failure (drop in CD4 count) and treatment failure (no relief from secondary infection) are the indications for changing the drug regimen from first-line to second line.
Over 200 persons who have been clinically identified for regimen change have not undergone the tests for various reasons, including lack of kits at the time of their visit, and only 300 are on the second-line regimen after 10 years. For many of the patients, making a monthly visit to pick up medication is a formidable task. Many of them work in the transport industry and are constantly on the move. Only four extra doses are given in a month.
They have to take the medication without missing a single dose. Even missing a single dose reflects on their longevity. The virus in their body becomes resistant to the drug. General Medicine HOD and ART Nodal officer Dr. K. Satyanarayana Rao says: “If a person misses his or her medication for two days, drug resistance increases by 15 per cent, if a person fails to take it for a month, the drug resistance increases by 50 per cent.
A person living with HIV becomes completely resistant to first-line ART regimen on an average in seven or eight years. If the person does not have any secondary infection, it will take 10 to 15 years to develop drug resistance, Dr. Rao said.
