Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

HIV or Human Immunodeficiency Virus is a type of immune disorder which attacks the immune system of the body and slowly destroys it overtime. The HIV virus targets the immune system and makes the body susceptible to other diseases. HIV infection can progress to AIDS although it may take up to 10 or 12 years to fully go into the last stage.

Risks and Causes
HIV is a communicable disease which spreads through only the following methods

    It can spread from one person to another by means of unprotected sexual intercourse due to the exchange of bodily fluids.
    The virus spreads if you share drug needles with someone who is already contaminated with HIV virus. It can also occur due to improperly trained medical staff that may reuse syringes although this is very uncommon.
    The HIV virus transmits from the mother to the child during pregnancy through the placenta.
    Any exchange of blood in significant amounts such as blood transfusion from a contaminated patient will result in infection as well although this is very rare.

Any other form of contracting the disease such as through kissing or food is a untrue and only propagates due to ignorance.

Symptoms
The initial symptoms of HIV infection are noticed after a few weeks although it can take a few months to come up as well. The initial symptoms may include
1. Severe headache along with intense pain in the muscles and the joints of the body.
2. Frequent appearances of rashes
3. inflation of the lymph nodes
4. Itchy skin
5. Disorders which stay for sustained periods such as an upset stomach or a cold.

The early symptoms disappear within 2 to 3 weeks without any treatment. The later symptoms might appear after few years (sometimes up to or more than a decade), which will stay. This is usually the time HIV is diagnosed. The symptoms now may also include
1. severe muscle fatigue
2. severe loss in body weight,
3. High fever and recurrent instances of sweating at the night time.
HIV is suspected if the later symptoms tend to last for a long time without any other diagnosable cause.

Treatment
HIV can be treated by means of antiretroviral therapy which reduces the rate at which the virus multiplies. However, there is no cure for HIV as of yet.
Prevention
In order to prevent yourself from getting HIV, you should adopt the following precautionary measures:
1. You should use protection every time when engaging in sexual intercourse and if you are unsure of your partner s HIV status.
2. You should use new blades in barbershops for shaving purposes in order to prevent yourself from HIV as well
3. If you are diagnosed with HIV/AIDS while you are pregnant, to prevent spreading it to your unborn baby, you might immediately need undergo a medical check-up and follow the doctor s advice.
4. Ensure that disposable syringes are used whenever they are being use for medical tests or treatments.

HIV / AIDS - Things You Should Remember About It

Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?


- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

Acquired Immune Deficiency Syndrome(AIDS) is caused by a virus called Human Immunodeficiency virus (HIV). It should be remembered that it is not necessary that a person having HIV is suffering from AIDS or will inevitably result in it. The illness damages the immune system of the person and makes them more vulnerable to diseases and infections. As the syndrome progresses, opportunistic infections attack the patient, ultimately causing their death.

What are the causes of AIDS?
The virus is spread by person-to-person contact like:
1. Through sexual contact.
2. By sharing the same needle or through blood transfusion.
3. The disease can be spread from mother to the newborn child.

What are the symptoms of AIDS?
1. You may have a high fever or suffer from constant diarrhea which may last for weeks.
2. Red rashes may appear on your skin.
3. You may feel weak and tired all the time.
4. You may have excessive sweating, particularly at night.
5. Your muscles and joints may ache.
6. Your swollen glands don t heal for weeks.

What are the complications related to AIDS?
During the last stage of infection, there is a high risk of having life-threatening diseases.These include:
1. Infections to the nervous system like meningitis, peripheral neuropathy.
2. Inflammation in the lower end of the esophagus.
3. Cancers like cervical cancer, neck cancer, and lymphomas.
4. Tuberculosis.

Can AIDS be treated with homeopathy?
Homeopathic treatment can be of a great help for such patients. It can boost up not only physical health but mental health too. It can combat opportunistic infections very effectively by boosting up the immunity of the patient. There are marvellous results with homeopathic medicines tried in Africa (an epidemic zone for AIDS). Many patients of AIDS are still waiting to die after using homeopathy and their quality of life has improved drastically. Homeopathy works by modulating the immunity which is an important factor in AIDS patient. Some of the homeopathy medicine used to treat symptoms of AIDS are:
1. Syphilinum
2. Arsenic iodum
3. Sulphur
4. Silica,
5. Tuberculinum
6. Kali carbonicum
7. Calcaria iodum
8. Bacillinum
9. Arsenica Album
10. Phosphorus
These medications can be used in conjuction with ART or antiretroviral therapy along with other treatments and has been shown to be very effective in alleviating some of the commonly encountered symptoms of AIDS related complications. But utmost care must ensured and these medicines should not be taken without consulting a homeopathic doctor.

HIV / AIDS - Can Homeopathy Medicines Helps in Treating it

Certain diseases are a major cause of concern as often these diseases can cause severe health complications. Various campaigns and awareness have been spread both by the government and NGOs for practicing safe sex to fight against these sexually transmitted diseases. Here are a few tips on how to avoid contracting sexually transmitted diseases.

1. Selective Abstinence: Selective abstinence is when people indulge in certain sexual activities, but limit in what they do to avoid the chances of contracting sexually transmitted diseases. People who do practice selective abstinence run a lower risk of contracting sexually transmitted diseases, which is also dependent on the type of sexual activity they indulge in as certain sexual acts have a higher chance of spreading STDs than others.

2. Using condoms: Using latex condoms decreases the chances of contracting sexually transmitted diseases. If you use lubricants, make sure that they are water based. Condoms are however not 100% effective at preventing sexually transmitted diseases, but reduce the chance of infection to a great extent. It is highly advised to learn how to properly use condoms.

3. Mutual monogamy: Another way to avoid getting infected by STDs is to practice mutual monogamy. If you and your partner do not have sex with anyone else, then it greatly reduces the chances of getting infected with sexually transmitted diseases.

4. Getting tested: Getting tested for sexually transmitted diseases as well as asking your partner to do so decreases the chances of transmitting sexually transmitted diseases. Refrain from having sex if either of you test positive.

5. Avoid alcohol and recreational drugs: Avoiding the usage of recreational drugs and alcohol reduces the chances of contracting STDs. Indulging in sexual activities while being highly intoxicated can both cause you to forget practicing safe sex.

6. Practicing healthy habits: Practicing certain healthy habits also reduces the chances of contracting sexually transmitted diseases. These include avoiding sharing towels and undergarments, washing before and after sexual intercourse and getting a vaccination for hepatitis B.

7. Low risk and high risk activities: Certain sexual activities such as open mouth kissing and hand to genital contact have a lower risk of infection. Other activities such as oral sex, vaginal intercourse, and genital to genital contact have a higher chance of infection. Understanding the risks better would allow you to avoid contacting diseases easily.

7 Tips to Avoid Sexually Transmitted Diseases

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