Infectious diseases
Q1 What is Infectious Diseases?
Infectious Diseases stands for human immuno deficiencies virus. It is a virus that attacks the body’s immune system. If not treated it can lead to Infectious Diseases.
Q2 What is AIDS?
AIDS stands for acquired immunodeficiency syndrome. It is a condition in which a group of symptoms appear as the immune system becomes very weak. It could take years from the time of Infectious Diseasesentry into the body to develop Infectious Diseases.
Q3 What is the difference between Infectious Diseases & AIDS?
Infectious Diseases is a virus that attacks the body’s immune system. If Infectious Diseases is not treated, it can lead to AIDS. Doctors call it AIDS only when people with Infectious Diseases infection begin to get severe opportunistic infections (OIs), due to lower immunity, or when CD4 cell counts fall below 200 cells/mm3 and Infectious Diseases viral load increases to >1,000 copies/ml. Being diagnosed with Infectious Diseases does not mean a person will also develop AIDS, because AIDS is preventable with Infectious Diseases treatment.
Q4 What is Viral Load count?
Viral load (VL) test measures how much Infectious Diseases is in the blood and to know if the Infectious Diseases treatment is working well or not. An important goal of antiretroviral therapy is to suppress a patient’s VL to an undetectable level – a level too low for the virus to be detected in blood by a VL test.
Q5 What is CD4 count?
A CD4 count tells you how many CD4 cells there are in a drop of blood. The more there are, the better. CD4 and viral load test results give essential information about the effect sexually transmitted is having on your body.
Q6 How can Infectious Diseases be transmitted?
Most people get Infectious Diseases through anal or vaginal sex or sharing needles, syringes, or other drug injection equipment. It can also be transmitted through blood transfusions or from a mother living with sexually transmitted to her child through childbirth or breastfeeding. Infectious Diseases doesn’t spread through ordinary social contact; for example, by shaking hands, traveling in the same bus, eating from same utensils, by hugging or social kissing, etc.
Anti-retroviral therapy (ART)
Q1 Is there a cure for Infectious Diseases?
There is no cure for Infectious Diseases, but you can control it with safe and effective Infectious Diseases treatment which should be started as soon as someone is diagnosed with Infectious Diseases. When treatment is taken regularly as prescribed, Infectious Diseases live long, healthy, productive, and active lives and can protect their partners.
Q2 What is antiretroviral therapy (ART)?
Antiretroviral therapy (ART) refers to the combination of medicines to treat sexually transmitted infection. ART stops multiplication of virus and stops it from making more viral copies. When taken regularly as prescribed, ART can suppress the level of virus in the blood (called viral load) and rebuild the immune response (including CD4 immune cells). The current ART require you to take the drugs daily. ART does not prevent or treat other sexually transmitted diseases, like chlamydia and gonorrhoea.
Q3 What are the benefits of ART?
Infectious Diseases treatment can make the viral load very low (viral suppression). Viral suppression means when viral load, after initiation of ART is less than 1,000 copies/ml and remains less than 1000 copies/ml. If your viral load goes down after starting Infectious Diseases treatment, that means treatment is working and your body is staying healthy. Most people have viral suppression after six months of taking medication regularly, but it is important you continue to take your Infectious Diseases treatment as prescribed even after viral load is decreasing/suppressed. Stopping treatment may make you sick and could also cause the virus to change (or mutate), resulting in other health complications including medication resistance and limiting your options for effective ART.
Q4 I am newly diagnosed with Infectious Diseases, when should ART be initiated?
It is important to start Infectious Diseases treatment as soon as possible after diagnosis. Make sure you tell your healthcare provider about all other medicines you are taking (including over the counter supplements), your other medical conditions, and any symptoms you may be feeling. Your healthcare provider may also do some tests at your initial visit. All Infectious Diseases should take Infectious Diseases treatment, no matter how long they’ve had Infectious Diseases or how healthy they are.
Q5 What do you mean by the term Opportunistic Infections (OIs)?
Opportunistic infections (OIs) are illnesses that occur more frequently and are more severe in people with Infectious Diseases . This is because they can have damaged immune systems if they are not on effective treatment. Taking Infectious Diseases medicine as prescribed is the best way to prevent getting OIs. Infectious Diseases medicine can keep your immune system strong and healthy. Examples of OIs include tuberculosis and certain pneumonias. If you develop an OI, talk to your health care provider about how to treat it.
Q6 What if I missed my dose?
In most cases, you can take your pill as soon as you realize you missed a dose. Then take the next dose at your usual scheduled time (unless your healthcare provider has told you otherwise). However, never take two doses the next day to make up for a missed dose on the previous day.
Q7 What are some of the common side effects of ART?
New drugs are safe and effective. Few people may experience stomach upset from starting a new medication, though this usually resolves after a few weeks by itself. Some drugs may also rarely cause lack of sleep, headache, dizziness, tiredness, and allergic reactions. Some people may experience weight gain as well. If you experience any side-effects, consult with your healthcare provider immediately.
Q8, Can I stop taking ART once my health improves?
No. ART needs to be taken lifelong. Taking ART regularly keeps people with Infectious Diseases healthy and prevents Infectious Diseases transmission. Taking ART every day as prescribed also reduces the risk of drug resistance.
Q9 How can we know that the ART is working?
To know if the treatment is effective, one needs to take Infectious Diseases medication the right way every day as prescribed for at least 6 months. One also needs to get a VL test done. If the viral load is suppressed, that is below 1,000 copies/ml it indicates that the ART is working. Continue to take your Infectious Diseases medicines as prescribed.
Q10 What is TND in a viral load test?
All viral load tests have a cut-off point below which they cannot reliably detect Infectious Diseases viral particles. This is called the limit of detection. When your viral load is below the level of detection of the specific test that is being used, it is said to be undetectable or “Target not detected” (TND).
Q11 If my viral load comes out to be TND, does it mean I am cured of Infectious Diseasesand can stop taking Infectious Diseases medications?
No, just because the level of Infectious Diseases is too low to be measured doesn’t mean that Infectious Diseaseshas disappeared completely from your blood. It might still be present in the blood, but in amounts too low to be measured. Continued ART is necessary to ensure that the viral load remains undetectable.
Q12 What should I do if my VL is ≥1000 copies/ml (unsuppressed)?
Patient with viral load 1000 copies/ml should undergo step-up adherence counselling for at least three months. ART centre counsellor should guide and provide counseling support to improve adherence. Repeat viral load testing should be done once treatment adherence is >95% for three months in continuation. If repeat viral load report is <1000 copies/ml, patient should be continued on same ART regimen. If repeat viral load report is 1000 copies/ml, patient should be referred to State AIDS Clinical Expert Panel (SACEP) for further management
Q13 What does U=U mean?
U=U stands for Undetectable equals Untransmittable. Undetectable means that the amount of Infectious Diseases in your blood is too low to be detected on a viral load test. An undetectable VL for U=U is less than 200 copies/ml or TND (target not detected). If you take your ART daily and maintain an undetectable viral load, you will not pass Infectious Diseases to your partners through sex. You need to continue to take your ART every day and have your viral load checked as advised by your doctor, to be sure your viral load stays undetectable. Undetectable does not mean that your Infectious Diseases is cured; it means that you are taking ART regularly and the ART is working well and has stopped the virus from growing.
Q14 When is my ART adherence adequate?
If ART adherence is more than 95% in a month, it is termed as good adherence. Ideally, you shouldn’t miss any dose, you should take ART every day as advised by your doctor.
Q15 What is advanced Infectious disease?
For adults and adolescents, and children older than 5 years, advanced Infectious Diseases is defined as CD4 cell count <200 cells/mm3 or WHO stage 3 or 4. All children younger than 5 years of age (who are not already receiving ART and are clinically stable) with Infectious Diseases are considered as having advanced Infectious disease.
Q16 Why do we need an Advanced Disease Management (ADM) package?
Nearly 30-35% of patients present late to Infectious Diseases care with an AIDS defining illness or advanced immunosuppression. Infectious Diseases -associated morbidity and mortality remains high in this group. ADM is a special package of services provided to Infectious Diseases with advanced Infectious Diseases disease to reduce morbidity and mortality by early diagnosing, treating, or preventing opportunistic infections.
Co-infections/Opportunistic Infections
Q1 What are the routes of transmission of Hep B & Hep C?
Hep B & C are transmitted like Infectious Diseases i.e. through sex, contaminated blood transfusion, sharing contaminated needle etc.
Q2 If I am diagnosed with hepatitis B, how am I treated?
Some ARV drugs help in the management of Hep B. Drugs that are active against both Infectious Diseases and HBV include Tenofovir (TDF), Lamivudine (3TC), Dolutegravir (DTG), Emtricitabine (FTC) etc.
Q3, Can I take vaccination for prevention of Hepatitis B?
Yes. Infectious Diseases can take vaccination for prevention of Hepatitis B after consulting his/her healthcare provider.
Q4 What is the Hepatitis B vaccination schedule?
For adults, 3 doses should be taken at 0, 1 and 6 months.
Q5 What are the 4 symptoms (4S) for TB screening among children and adult Infectious Diseases?
The 4S symptoms for TB screening among adult and adolescent Infectious Diseases include current cough, fever, weight loss, and night sweats. In children the 4S symptom screening includes current cough, fever, poor weight gain, and history of contact with a TB case.
Q6 Who is eligible for Tuberculosis Preventive Therapy (TPT)? What are the criteria for initiating TPT? Does TPT completely prevent TB?
Infectious Diseases who are 4S negative and do not have any other indications like active TB disease, hepatitis or history of DR-TB or contacts of DR-TB can be given TPT. TPT helps in preventing the progression of latent TB to TB disease. It does not prevent you completely from getting TB. If you are diagnosed with TB during TPT, you should take ATT along with ART for a period of six months.
Q7 When should TPT be started?
All the 4S negative should be assessed by the medical doctor to determine eligibility for TPT. If found eligible and there are no contraindications, then TPT should be initiated immediately for a period of six months.
Q8 Is TPT mandatory for everyone?
It is not mandatory, but since TB prevalence is very high among Infectious Diseases , it is recommended for all eligible Infectious Diseases to take TPT.
Q9 Should all pregnant women get tested for Infectious Diseases?
It is recommended that all pregnant women should be tested for Infectious Diseases and, if found to be infected, must be offered treatment for themselves to improve their health and to prevent passing the virus to the infant before, during, or after childbirth. Hence, all pregnant women should get tested for Infectious Diseases and treatment should be started immediately if found Infectious Diseases positive.
Q10 When to conduct VL testing in a pregnant woman?
Apart from the usual VL testing, in pregnant women VL testing should be conducted between 32 and 36 weeks of pregnancy to see the viral load suppression which will determine the ARV prophylaxis of child depending on the risk of transmission.
Q11 Are some sexually transmitted infections associated with Infectious Diseases?
Yes, some of the STI/RTI increase the risk of acquiring/transmitting Infectious Diseases infection. These infections include syphilis, gonorrhea, herpes, chlamydia etc. If you are sexually active, then using condoms regularly, limiting the number of partners, and choosing less risky sexual activities can lower your chances of getting Infectious Diseases.
