Curbing the spread of HIV

Curbing the spread of HIV

Although it may have been well-meant, Chris Green's article in
The Jakarta Post on Feb. 19, 2003, titled AIDS can be treated!
Don't get it wrong makes some assertions that should not go
without comment.

First, under certain circumstances, treatment for HIV should
be commenced before the onset of AIDS. One obvious case is when
treating to prevent mother-to-child transmission, where the
benefit to the unborn child from treating an HIV-positive
pregnant woman -- who has not developed AIDS -- is well proven.

But more than this, it is not at all clear that AIDS patients
benefit more from antiretroviral treatment than those newly
infected with HIV. In fact, recent expert opinion advocates that
the best time for aggressive therapy is when the viral load,
which is the quantity of the virus in the patient's blood, is
low. This corresponds to the period early in the infection and
not at the onset of AIDS, when the viral load is typically high.
Early treatment, it is said, effectively weakens the virus,
giving it less opportunity to take hold while at the same time,
improving the patient's own immune system the capacity to fight
the infection.

I was also alarmed to read about the plight of Sulasi, who has
to contend with the lack of specialist medical care in Malang.
While medical practitioners who care for patients like Sulasi
should be highly commended, HIV infection is a complex disease
requiring regular expert intervention if it is to be properly
managed.

Specialist education for such doctors should therefore be a
high priority for any government aiming to curb the spread of
HIV.

DAVID BEINS, Jakarta