Advanced HIV disease threatens to wither away the gains made in fight against AIDS

Shobha Shukla – CNS
Contd from previous issue
TB LAM point-of-care test is based on the detection of mycobacterial lipo-arabino- mannan (LAM) antigen in urine.
We have progressed but major gaps remain
In India, as per government’s Sankalak report, in 2022, a little over 1.2 million viral load tests and 930,000 CD4 tests were done (when number of people on antiretroviral therapy was 1.68 million in 2022).
In India, TB screening for people living with HIV is done verbally for 4 classic symptoms of TB of the lungs. Even in general population, government’s TB prevalence survey shows that over half of people with active TB disease were asymptomatic (and found only
when x-ray screening was done and all those found with presumptive
TB were offered a confirmatory TB test). So, why are we not finding TB with best of science and technology (such as artificial intelligence-backed ultraportable handheld x-rays that can be used by community health workers to screen people for TB) among those who are a heightened risk of TB (such as people with HIV)? Risk of extrapulmonary TB is also higher which will warrant stronger action to find all TB, treat all TB and prevent all TB among people with HIV.
Cryptococcal meningitis: one of the most horrific ways to die
“As mortal human beings (with or without HIV), we all have to confront the reality that we are going to die eventually, but people with advanced HIV disease often develop
cryptococcal meningitis. It is the most horrific ways to die. You cannot see, you cannot hear… It is a very painful disease,” shared Loon.
"We must ask ourselves who we are advocating for. Do our organisations only represent healthy people living with HIV or are we working where we are needed most, for people with advanced HIV disease? We must ensure that everyone benefits from the scientific advances we have access to, but the reality is that we seem to have forgotten these people," said Loon.
"We will talk about advanced HIV disease at this conference (#AIDS2024) but when we go home, we need to remember that advanced HIV disease is real, and it is killing our friends. We need to advocate for the diagnostics required for advanced HIV disease, cryptococcal meningitis and drug-resistant forms of TB - along with equitable access to latest treatment regimens - and full cascade of care," summed up Loon.

(Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate.
She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for
Health and Development (APCAT Media) and Global AMR Media Alliance (GAMA). Follow her on Twitter @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)
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