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Dr.T.V.Rao MD
WHERE ARE WE
The HIV pandemic identified as Global health crisis, But AIDS pandemic brought in Global unity of
sharing knowledge on science, technology and remedies to the existing crisis. In 2013, there were 35
million [33.2 million37.2 million] people living with HIV.
Since the start of the epidemic, around 78 million [71 million87 million] people have become
infected with HIV and 39 million [35 million43 million] people have died of AIDS-related illnesses.
Today there are no regions in the world, not touched by the pandemic of AIDS. A few Countries are
shy to share their problem with other Nations. In the beginning it was though it was a male
dominated disease, the recent epidemiological trends show women were more burdened, now it
makes up to 42 % were women. Prevention of Mother to Child transmission gained top priority as it
has already left many AIDS orphans in Africa, UNAIDS championed the cause with several
collaborators and partners joined and supported HIV/AIDS as global concern. The voice of concern
has not reached many rural poor, and sects with dogmatic ideas. And many continue to be victims of
the preventable Disease. Controversies continue on sex education. Even in Developed countries
many people are unaware of their HIV status, and spread the disease in ignorance. The real
achievements lie in Diagnostic advances reached every nation .With little training and few
instruments one can make an Optimal Diagnosis. The Positive side of HIV pandemic contributed to
elimination of unnecessary blood transfusions, voluntary donor programs and initiation to screening
all Blood donors for Life threatening viral diseases, were made mandatory.
make 100 % accurate detection with detection of antibodies. The limitation of the serological tests is
detection of infection during the primary infection and in Infants younger than 18 months who
might have maternal HIV antibodies persisting. And need quantization of viral RNA or detection p24
antigen remain the only options. The 3rd generations ELISA systems with methodology of sandwich
are gradually taken over older generations of testing kits. More recently need is felt for 4th
generation ELISA methods for detection of antibodies along with detection of p24 in same run.
Public interest litigation of missed diagnosis is making the necessity for 4th generation
methodologies. Need for confirmatory tests arose to make a specific diagnosis and fulfil the legal
obligations. Western Blot methodology stood the test of time and most accepted confirmatory
assay. many consider it as Gold standard, for validation of HIV test results in particular situations to
rule out false Positive from ELISA and Rapid methods .Polymerase chain reaction emerged as a
exquisite toll for defining sensitivity by artificially replicating Nucleic acid sequence .Recent century
has seen various advances in PCR modification, PCR based COBAS - AmpliScreen HIV 1 (By Roche)
test has gained the high popularity. Cost remains the real limitation in Developing Nations.
Other supporting tests are of gaining Importance which include CD4 estimations and RNA levels in
helping the prognosis, linked to effectiveness of antiretroviral drugs, and early decisions on
preventing opportunistic infections, many of the newer generation Diagnostic tools are unaffordable
in resource poor nations. The solution remains with technology transfer and public health
supporting systems.
10 The testing protocols should not miss the Detection of HIV2 infections.
11 Newer and safe Microbicide and Male circumcision needs more motivation and research.
12 Ongoing education and curing of other sexually transmitted diseases should be priority in war on
AIDS.
Every Living Human should put best efforts, and our efforts are certain to succeed as the Future of
Human race is linked with more understanding and preventing the Pandemic of AIDS
Revised article Published in Articleset.com (2007)
Dr.T.V.Rao MD Professor of Microbiology Freelance writer