Treating patients with HIV
Your issue on treating people with HIV discusses a very important subject. (1) I started my medical career around the time that HIV was first detected. My first personal encounter with the disease was some years ago, when a fellow physician and personal friend was diagnosed as HIV positive. The problems in treating a HIV positive patient were becoming clear at the time. Unfortunately, they remain the same today.
Even well-off people with HIV find it difficult to continue treatment in the long term. For others, it is just impossible. This is true even after the costs of drugs has come down. Only one of the 300 or so patients I have treated could afford HAART therapy (three drugs including a protease inhibitor). Therapy must often be administered to an entire family. Monitoring tests are also expensive. Add to this the loss of pay for patient and attendants. Other problems: the family is stigmatised, immunodeficient people in the hospital are at risk of infection from nearby patients and passing resistant infections to others, and health professionals are given inadequate protection against infections of all sorts.
Dr. Anurag Bharadwaj, Associate Professor, Department of medicine, Kasturba Medical College, Manipal 576119.
- Health professionals and HIV. Issues in Medical Ethics 2002; 10: 79-95.