Prof. Sulaimon Akanmu of Haematology, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, says evidence abound that rate of transmission of HIV/AIDS in Nigeria has dropped.
Akanmu made this known in an interview with the News Agency of Nigeria (NAN) in Lagos on the challenges that HIV/AIDS had taken a back stage in 2020 due to emergence of COVID-19 pandemic.
According to him, on the whole, we have evidence that the rate of transmission of the virus in the community as a whole has come down.
“This is not because sexual behaviour of human beings have slightly change.
“It is because of effectiveness of a number of biomedical interventions, preventive biomedical prevention that have been put in place.
“This is why you will also notice that prevalence of the virus has actually come down in nearly all communities, including Nigeria,’’ he said.
The haematologist said the decrease in the transmission of HIV from one person to the other was not because human beings have changed their behaviour significantly, particularly, hetero sexual sex and disloyalty in marriages.
“It is not as if human beings have better their behaviour. We essentially believe that the changes we have seen is as a result of successes that biomedical intervention in the areas of prevention has been able to achieve.
“In particular, our successes in being able to prevent a woman from transmitting the virus to her child born and unborn, which we refer to as the prevention of mother to child transmission of HIV services.
“We essentially believed that the availability of anti-retroviral therapy today leads us to achieve a very, very important goal of therapy. Today, we now have very, very effective anti-retroviral drugs.
“If we go back to the early 1998, 1999, year 2000, 2001 up to 2005, you will see that the prevalence of HIV in Nigeria was as high as 5.8 per cent.
“It means that approximately five per cent of Nigerians in the age bracket that are easily HIV infectable, aged 50 to 49 (5.8 per cent) of that particular population are HIV infected in Nigeria.
“But, that figure has gradually climbed down from 5.8. I think around 2003, it was five to 4.6 through 3.5, 3.2, 2.8 to what we now have in 2018,’’ he said.
Akanmu said that Nigeria has the most fantastic, the most robust survey that is looking at what was the magnitude of HIV in the country.
“We now believe that the prevalence of HIV in Nigeria, among the age stratum that is easily infectable, is 1.4 per cent.
“It translates to the fact that the total number of people that we now estimate in Nigeria that are living with HIV/AIDS is about 1.94 million people, but that is still a very large number.
“The problem with HIV/AIDS is that once an individual has it, we run into trouble, because we do not have the mechanism of ridding the body of that virus.
“We are going to continue to live with the virus for the rest of our life.’’
According to him, at least with the present knowledge, we do not have a situation where an individual is HIV infected, and he or she is able to get rid of the virus from the body.
He said: “We have only two cases so far in the world, where you are proven to become HIV infected, and at the end of the day, you are no longer HIV infected.
“We know about the Berlin patient; we know about the London patient; these are the two patients in the whole world that have become HIV positive and now truly HIV negative.
“That was as a result of unusual intervention; due to other diseases, these people were transplanted for other diseases, and with cells of other human beings whose cells can never become HIV infected.
“And so, that is how these people were able to get rid of that. The methodology that was used to achieve absolute cure in those two patients is not what can be made available to other people.
“It is something completely out of routine, clinical or medical practice. So, the problem we have with HIV is don’t get it.’’
Akanmu assured the public that, if for one reason or the other, you are HIV infected today, “we are able to tell you that HIV/AIDS should not be the cause of your death.
“In fact, we now have on data that the causes of death in people who are currently living with HIV, is no longer different from the causes of death among people who do not have HIV infection.
“The simple reason is that today, we now have very, very effective anti-retroviral drugs.
“And for those who are taking this active drug, the way it is prescribed, they are lucky, not to develop toxicity to eat what is not allowed; with these people we achieve the goals of anti-retroviral therapy.
“The goal is if an individual is taking anti-retroviral drug, the drug is capable of bringing the level of the virus in the blood so low, so that most the powerful detection technique in the laboratory may not detect that the virus is still there.
“And that goal is what we call virological goal of therapy; that is, you are taking the drug and you are able to achieve that virological goal, it means we will look for the virus in your blood, we will not find it.
“And, if you are able to achieve that goal, which is not likely achievable in many people, who have swallow anti-retroviral drugs too far across, it means you will not be able to infect a sex partner.
“That is a very good preventive method, and we call it treatment as prevention,’’ he said.
Analysing the goals of anti-retroviral therapy, he explained the virology goal as when one takes the drug, the virus would not be detected in the patient’s blood.
On immunological goal, he said the drug would bring down the virus level, while immunity would come up and be able to fight the opportunistic infection.
Also, the expert described the clinical goal as when the immunity comes up, and the patient becomes clinically well, while the viruses in the body are no different from any other person.
The fourth goal, according to him, is Epidemiological goals, saying when the patient is taking the drug, and a virus is no longer detectable in the blood, he or she is not infectious to a sex partner.
“That is why we say for every one person that is effectively treated with anti-retroviral drugs, five to 10 new infections have been prevented in the community,’’ he said.
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