Duh, it is feared that HIV cases will surge because ARVs are increasingly rare

Harianjogja.com, JAKARTA – The Covid-19 pandemic makes it difficult for people living with HIV / AIDS (PLWHA) to get access to antiretroviral drugs (ARV).

According to the rapid survey on the needs of PLHIV in ARV treatment on April 23-30 2020, 8.3 percent of the 660 respondents reported a decrease in the number of ARVs received, while about 50 percent reported changes in HIV services.

One of the researchers, Anindita Gabriella Sudewi said that PLWHA had to return to their hometown because they ran out of ARVs in their city of residence and had difficulty moving clinics or puskesmas to access these drugs.

Also read: Get to know Biotechnology, the Branch of Science in the Manufacture of Covid-19 Vaccines

Yes, according to a survey with respondents aged 30-40 years, on average or 47.7 percent of PLHIV received ARVs from government hospitals, 35.7 percent from puskesmas, 10.6 percent from private hospitals, 2.4 percent from private clinics , 2 percent from pulmonary centers, and 1.4 percent from clinics or through non-governmental organizations (NGOs). Of all that, 93 percent of respondents get ARV for free.

However, from the results of this survey, it was found that there are PLWHA JKN holders who have to pay to access ARVs. In addition, changes in the operation of the clinic / puskesmas have resulted in PLWHA having to queue longer and with shorter consultation times. Even though PLWHA is a group vulnerable to contracting the corona virus.

Gabi said, indeed, currently the government is focused on tackling the Covid-19 pandemic. However, it is also necessary to pay attention to sufferers of high-risk diseases such as PLWHA, to access medicines and health services.

“The Indonesian health system needs to anticipate health imbalances or inequalities in vulnerable groups,” he said.

Also read: Corona in Bantul Nowadays 383 Cases, This is the Latest Data for Each District

Nevertheless, said Gabi, there is still room for change in providing ARV access for PLHIV. For example, providing more ARV supplies and using courier services to deliver them.

“This kind of change brings hope to the existence of HIV services beyond clinics, including a community-based health service model, which involves resources outside the government-based service structure,” said Gabi.

Likewise, Epidemiology from the University of Indonesia, dr. Pandu Riono agrees that there is a need for innovation in addressing health services for vulnerable groups in the midst of the Covid-19 pandemic.

“There are no ways before the pandemic. We must have new innovations to overcome services in the midst of a pandemic,” he said.

Pandu added that during this pandemic the possibility of an increase in people living with HIV because prevention and treatment was disrupted. “Because there are PSBB everywhere, the logistics chain for drugs will break. Because if there is an interruption, it can increase resistance. This becomes complicated,” he said.

As for Pandu said, until May 2020, the estimated number of people living with HIV in Indonesia was 640,443 people. A total of 394,769 were HIV positive, 202,919 of whom started taking ARVs, while 134,032 people were still on ARV therapy.

Source: Bisnis.com

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experts explain why obesity “helps” coronavirus

– Has long been known that overweight people have lowered immunity, says head of the Department of endocrinology of the medical faculty Russian national research medical University. N. And. Pirogov Tatiana Demidova. Research and practice show that in these patients increases the risk of atherosclerosis sharply increases the risk of heart attacks, strokes and heart failure. Increased risk of endocrinological, oncological diseases, joint diseases, psychological disorders.

Epidemic COVID has added another item to the list of high threats to people who are overweight. It turned out that when infected with coronavirus patients with obesity more often require hospitalization, fall into the ICU, on the ventilator (artificial lung ventilation). Alas, is growing and the risk of death.

– If the original messages from China on the most severe cases COVID it was mainly about the older people with severe chronic diseases, according to the latest data from Europe and USA the risk group includes people with obesity – says Tatiana Demidova.

FACTS AND FIGURES

In what diseases most often develop complications due to coronavirus

90% of patients admitted with severe COVID-19 US hospitals, were the following comorbidities:

– hypertension — 49.7%,and

– obesity or 48.3%,

– chronic lung disease — 34,6%,

– diabetes type 2 diabetes was 28.3%,

– cardiovascular disease — 27,8%.

Thus, obesity is second among the States in which CouId be severe.

CORONAVIRUS, INFLUENZA, AND HIV, “LIKE” ADIPOSE TISSUE

Visceral adipose tissue, that is, one that is in the abdomen, is, in fact, highly individual body, experts explain. This body affects the immune, endocrine system and metabolism in the body as a whole.

– People who are overweight fat cells are much larger. So, is synthesized in much more of various hormones and inflammatory cells. Among them, including interleukin-6, interleukin-1, tumor necrosis factor, and others, – says Tatiana Demidova. Often in the body, there is a creeping inflammation.

At the same time observed that many viral infections and especially COVID-19 amplify the effects cytokines and lead to the extension of the generalization of inflammation. “It was proved that adipose tissue serves as a reservoir for some viruses, such as influenza, HIV and cytomegalovirus. Also, according to the latest data, it can be activated and coronavirus,” adds Demidov.

INSULATION NEEDS TO BE LONGER?

Studies have shown one more feature of coronavirus. As it turned out, he is able to spread rapidly in adipose tissue surrounding internal organs – lungs, liver, kidneys, heart, etc. because Of this, developing severe damage to these vital organs and people with excess weight, excess amount of adipose tissue increases the risk of death from multiple organ failure.

There is evidence that such patients are also unable to stay longer carriers of the virus, require longer hospital stay and isolation, said Tatyana Demidova.

AFTER INFECTION — DIABETES

There is evidence and that not less than one-third of patients hospitalized with COVID-19 in China, European countries and the United States, the infection resulted in damage of the pancreas. This was confirmed by elevated enzymes amylase and lipase, and glucose levels in the blood plasma.

– This is a very disturbing circumstance. Since we talking about high risk of developing diabetes type 2 diabetes in people with the original obesity after recovery from infection, says Dr. Demidov.

It is not excluded that after the break the pace of the epidemic COVID, we will see a worldwide surge in the incidence of diabetes, experts say.

So now, when the opportunity walks, sports, seasonal ripe fruits and vegetables rich in fiber, doctors suggest the obese individuals to exert their maximum effort for getting rid of really dangerous extra pounds.

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Nobel Prize Virologist Montagnier: New corona virus comes from the laboratory

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French virologist Luc Montagnier, who received the Nobel Prize in 2008 for the discovery of human immunodeficiency virus (HIV), believes that the novel Sars-CoV-2 coronavirus is artificial in origin and was developed in a laboratory.

“We have come to the conclusion that the virus has been tampered with,” said Montagnier in an interview with CNEws. According to the researcher, HIV particles were added to the Covid 19 pathogen.

“The virus is not of natural origin, but a result of the work of molecular biologists,” said the researcher. “The purpose for which this was done is unclear. (…) My job is to provide facts. I don’t blame anyone, I don’t know who did it and why. They may have wanted to develop an AIDS vaccine, ”Montagnier said.

In an interview for the “Pourquoi docteur” portal, the scientist said: “This virus comes from the laboratory in Wuhan.”

On March 11, the World Health Organization classified the outbreak of the novel coronavirus infection Covid-19 as a pandemic. According to the latest WHO data, over two million cases of infection have been registered in the world. More than 154,000 people died.

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Could SARS-CoV-2 have been created in the laboratory and escaped?

A Nobel laureate in medicine, Professor Luc Montagnier, affirms this, establishing a link between Covid-19 and HIV, of which he is the discoverer.

Two researchers at the P4 laboratory in Wuhan.
Two researchers at the P4 laboratory in Wuhan. Johannes EISELE / AFP

THE QUESTION. For several days, across the Atlantic, the possible involvement of China in the origin of the Covid-19 has been mentioned, more or less explicitly, by the press, but also by the political authorities. The Washington Post notably had access to “memosOf American diplomacy: two years ago, the American embassy in China would have warned Washington of security risks at the Institute of Virology of Wuhan. “We are conducting a full investigation into everything we can learn about how this virus has spread, has infected the world”, reacted in the aftermath the head of American diplomacy, Mike Pompeo.

Emmanuel Macron also made enigmatic remarks in an interview with Financial times . “There are obviously things that have happened that we don’t know”, explained the President of the Republic. Still on the French side, the main accusation came from a Nobel Prize in medicine, Professor Luc Montagnier, discoverer of the AIDS virus,

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The Supreme Court acquits an HIV patient from contagion to his partner because she could deduce that he was a carrier | My rights

The Supreme Court has acquitted an HIV patient who infected his partner with the crime of injury, on the understanding that she was aware of his condition. Although there is no record that the man communicated at any time that he was a carrier, the court considers that there is evidence that shows that the complainant was aware of the situation, and therefore, by having agreed to have unprotected sex with him, the transmission of the Illness “cannot be worthy of criminal reproach.”

According to the ruling, the couple began their relationship in 2012. A year later, she was diagnosed with HIV. In 2014, the couple had a strong argument at the home they both shared in Madrid, which led the woman to file a complaint for assault. However, in the text that he presented to the authorities, he made no mention of the spread of the disease, despite the fact that he already knew that he was a carrier. It was three months after this fact that he decided to denounce his partner for the transmission of the disease. The case was brought before a court of violence against women and, subsequently, to the Provincial Court of Madrid. Both bodies acquitted the accused.

Now, the Supreme Court rejects the woman’s appeal, considering that her testimony “is not consistent with the rest of the tests that have been carried out.” In this sense, they take into account the statements of several witnesses. On the one hand, one of the couple’s friends, who reported that the entire neighborhood knew that the accused was a carrier of the virus, so “she should have known.”

The Chamber also considers relevant the statement of the accused’s sister, who stated that she had warned the complainant to “protect herself and take measures”, to which she replied that nothing was wrong. Although the sister admits that she did not indicate what she had to protect herself from, she considers that from the context of the conversation it was clear, adding that “when a girl talks to another girl about protecting herself, they implicitly understand each other.” In addition, the court notes that the complainant herself acknowledged that in the neighborhood where they lived and grew up, the man’s health status was discussed, although she clarified that when she asked him, he denied it. In addition, he acknowledged that several people specifically alerted him to such a circumstance.

Consume narcotics, an extra risk

On the other hand, the magistrates stress that both were consumers of high-risk narcotic substances, so it is “evident” that the complainant should be aware of the risk to which she was subjected, “not only with the practice of sexual intercourse but also by the mere fact of the consumption of narcotic substances of such entity ”.

In addition, according to a medical report presented during the trial, the defendant had “itchy penile lesions”, which worsened when he had sex. For the court, these are external evidences of the disease “that the complainant should have perceived”, especially considering that she herself had similar symptoms months later.

For all these reasons, the Supreme Court concludes that there is a “margin of doubt in favor of the accused” that is decisive for his acquittal. Precisely, this is one of the guarantees that incorporates the right to the presumption of innocence, since our law establishes that the guilt of the accused must be demonstrated beyond any reasonable doubt.

The spread of disease as a crime

In 1822, the Penal Code punished the spread of diseases, considering it an infraction against public health. Specifically, article 378 condemned “those who introduce or spread contagious diseases or contagious effects, and those who break quarantines and sanitation cords, or evade the lazaretos”. In addition, in 1928 a specific provision was introduced that qualified the spread of venereal diseases as a crime against life, bodily integrity and the health of people.However, this precept was repealed in the 1995 reform, so the transmission of diseases or permanent health deterioration (such as the acquired immunodeficiency syndrome or AIDS) became a crime of injury, which broadly condemns all those behaviors or that impair a person’s bodily integrity, physical health or even mental health.

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the doctor said why there are few coronavirus cases in Samara

The number of patients with coronavirus in the Samara region since the beginning of April has grown by three people. It’s really a bit, but the situation around is more like preparing for combat action. New infectious beds are constantly being prepared in the region, doctors are being trained, hospitals are being re-equipped. Residents perplexed: “More patients? They don’t tell any information? ” In fact, there is no need to look for a dirty trick: citizens are honestly told about how the situation is developing. But what comes next is difficult to predict. Associate Professor of the Department of Infectious Diseases of Samara State Medical University, Chief Specialist of the Ministry of Health of the Samara Region on the Problems of Diagnosis and Treatment of HIV Infection, Infectious Disease Doctor with 30 Years of Experience Elena Strebkova now helps to organize an infectious diseases hospital at the hospital named after Midpoint “There are no patients here, but who knows if they will appear tomorrow.” She told in an exclusive interview to a journalist “KPSamara”, Why the whole branch of medicine is working so hard today, although the numbers of cases and the inhabitants seem low, are Samara residents at risk of picking up a coronavirus and why is COVID-19 more dangerous than“ ordinary flu ”.

– Elena Alekseevna, why is such mass training, reprofiling of hospitals necessary?

– The measures taken by the government of the country and the region, and now allow us to prevent a surge in incidence. If not for them, we would be faced with a situation that is now happening around the world. Thanks to the measures taken for isolation and sanitation, a large number of cases of infection do not appear. This is done so that all our medical organizations have time to prepare. We see that new cases of infection and new cases appear daily, and we must be prepared to provide highly qualified medical assistance to the residents of the region. Like all my colleagues, we will be happy if we do not have to. But we must be prepared.

– How are hospitals preparing to receive coronavirus patients, what is the peculiarity of interacting with such patients?

– Infectious diseases that we usually deal with in the Samara Region are caused by microorganisms that do not require special preparation from a doctor. And COVID-19 is a particularly dangerous infection. Therefore, all protective measures in hospitals converted to infectious hospitals, for example, in SOKB named after V.D. Seredavina, taken for this class of pathogenicity. For this, doctors put on protective suits, masks, goggles – a person must be fully protected, because even small aerosol drops that remain in the air after coughing or sneezing can get on it and then lead to infection.

– How are doctors trained to resist the coronavirus?

– Doctors at hospitals that are converting to infectious hospitals are currently undergoing training. First of all, they are taught to wear and take off protective clothing correctly. Because the physician must first protect himself from infection, otherwise there will be no one to help people.

In addition, doctors are told how the virus is transmitted and how to protect themselves; they explain all the rules for disinfection. Of course, we study the clinical forms of the disease, how it manifests itself, what supporting signs of coronavirus infection, what indicators you need to pay attention to in order to make a diagnosis and assess the severity of the patient.

Why is it important now to stay at home.Why is it important to stay at home during coronavirus? That’s what the doctors say about it

– And as for lung ventilation, for example? Is she taught to do it?

– Naturally, such a huge number of resuscitators, infectious disease specialists, pulmonologists, which may be needed in case of a surge in incidence, is not in the healthcare system. Therefore, if necessary, infectious disease specialists and pulmonologists will work as consultants. One infectious disease specialist and pulmonologist per 100 patients – this will be quite hard work.

Under their guidance, doctors of all other specialties, after training, will be able to work with such patients. But the main burden will fall on resuscitators. Here, one resuscitator with two nurses will work for six people. Although basic training in mechanical ventilation and resuscitation will still pass all the doctors. For example, the staff of Seredavin Hospital is almost completing such training.

– How large, in your opinion, is an infectious disease specialist with 30 years of experience in the likelihood of a scenario when 100 coronavirus patients fall on one pulmonologist?

– We all want to hope that this probability is low, but we should always be prepared for this. It’s impossible to deploy an infectious diseases hospital in a hospital that was not intended for this; deploying such a huge number of resuscitation beds is impossible. The preparations that are currently underway will allow us to avoid the so-called “Italian scenario” – the very help that is needed will be immediately provided to the patients. IN Italy such a difficult situation was due to the large number of patients at the same time. Quarantine was announced late in the country; the healthcare system was not ready for such an arrival of patients who need ventilation support. In our country, the health system managed to prepare.

– Explain why we have so few patients and how relevant is self-isolation in this situation?

– These are the rules for the development of the epidemic. Why in Moscow so many sick? Not only because there are more people. But also because people from different countries flocked there and only then were distributed among the regions. Therefore, a huge number of sources of infection fell precisely in the capital. Naturally, there is the largest percentage of cases. But people from Moscow came here, and now the virus is spreading here. And now it doesn’t have to be contact with a person who came from abroad. This may be contact with a person who has not left the territory of the Samara region, who himself does not suspect that he is a source of infection.

The virus already exists in the urban environment, and it was for this reason that self-isolation measures were taken to protect people from each other. The closer we are to each other, the greater the likelihood of becoming infected, and the biggest danger is that this will happen at the same time, giving a greater burden on the health system.

“How can the virus spread if we all sit at home?”

– Let’s really look at things. You are not sitting at home. Anyway, you go to the store, to the pharmacy, where to whatever. The main distribution path is through door handles, through the buttons of elevators, in contact with trolleys in stores. These are transmission routes that no one has canceled. And with close contact at a distance of less than two meters, infection from person to person is also possible.

– They say that coronavirus is less dangerous than ordinary flu, it has less mortality, there is no reason for panic?

Coronavirus prevention: 10 tips by Gennady Onishchenko.“The epidemic will end soon and we will return to a happy life,” Gennady Onishchenko reassures. And for the prevention of coronavirus, he gives the Russians 10 simple tips

– Mortality from influenza was also quite high until the moment of mass vaccination. Now vaccination saves us from a large number of deaths with the flu. And we expect the appearance of a coronavirus vaccine only by the end of the year. Therefore, people are not protected. And since the virus is new, it first appeared this year, we have no immunity. And since no one has immunity, there is no layer that would restrain the explosive nature of the epidemic. Explosive is when several thousand cases appear at one moment. According to some experts, the main surge in the incidence may occur next week. The medical system must be prepared for this.

– In social networks, KP-Samara asked readers why, in their opinion, in the Samara region such a low incidence of coronavirus. It turned out that most are sure: we just have little testing for coronavirus. How do you rate coronavirus testing in the region? Are they enough?

– We test as much as necessary, except Rospotrebnadzor A laboratory has been deployed at the AIDS Center. They test those who came from abroad and are in quarantine, all patients with pneumonia, with severe forms of acute respiratory infections, pregnant women – volumes are large.

“And the main question that worries everyone is when will it all end?”

– So far, the measures taken are designed for the next three months. But we will all be happy if everything ends earlier.

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86 HIV-infected children born in Bashkiria since the beginning of the year

Since the beginning of the year, 636 HIV-positives have been recorded in Bashkiria
cases. Moreover, more than half of male patients – 373. Status data
incidence rates in the republic are published by the Republican Center for
AIDS prevention and control.

As of the end of March, 108 were recorded in the region
pregnant women with HIV status. Of these, 86 women were born. Everything
these children were also born with HIV infection.

Per
one week at the end of March, 36 cases of HIV were detected in Bashkiria. Of them
the largest number was found in Ufa – 12. In several other cities and
In areas the indicators are much lower: Kumertau – 2, Oktyabrsky – 1, Sibay – 1,
Sterlitamak – 2; Alsheevsky district – 1, Arkhangelsk district – 1, Askinsky district
– 1, Baymak district – 2, Bakalinsky – 1. Annunciation – 1, Gafuri –
1, Duvan – 1, Dyurtyulinsky – 1, Zianchurinsky – 2, Karmaskalinsky – 1,
Meleuzovsky – 1, Mechetlinsky – 1, Salavatsky – 2, Sterlitamak – 1,
Sterlibashevsky – 1, Tatyshlinsky – 1.

Photo: Internet

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London patient: Second HIV patient likely cured – science

For a long time, the “Berlin Patient” was the only person who was considered cured of HIV. Now there are new results from a London patient who was probably liberated from the AIDS agent with a special therapy.

It is only the second case in the world: the HIV patient referred to as the “London patient” is probably cured.

A functional HIV virus was no longer detectable in the patient about two and a half years after the end of anti-HIV therapy, reports a group led by medical doctor Ravindra Gupta from the University of Cambridge (Great Britain) in the trade journal “The Lancet HIV“.

The patient, who had blood cancer in addition to HIV, had previously received a special stem cell donation. The researchers emphasize that stem cell therapy is a high-risk treatment that is out of the question for most HIV patients.


Read now: Today's edition of your daily newspaper as an e-paper.

Read now: Today’s edition of your daily newspaper as an e-paper.


To date, a cure for AIDS is fundamentally not possible. With the help of antiretroviral drugs, the pathogen can be kept in check and the outbreak of AIDS can be prevented in the long term.

In the “London patient” as well as in the “Berlin patient” Timothy Brown, who has been cured since 2011, the immune system was rebuilt through stem cell therapy. The stem cell donor had a rare mutation that made him immune to the HI virus. The result is that the cells do not form a CCR5 receptor, which most HI viruses need to dock to a cell in which they could multiply.

“Our results show that the success of stem cell transplantation as a cure for HIV, which was first reported in the Berlin patient nine years ago, can be repeated,” says Gupta. The Berlin patient also had some form of blood cancer.

Gupta’s team examined numerous fluid and tissue samples from the London patient. The scientists found parts of the genetic makeup of HI viruses in some samples. However, they assume that these are “fossil” strands of DNA that do not belong to a reproductive virus. Many other data, such as the sharp decline in the number of HIV-specific antibodies, indicated that the virus had disappeared from the patient’s body, the researchers write.

In a comment, also in “The Lancet HIV”, Sharon Lewin and Jennifer Zerbato from the University of Melbourne (Australia) ask when an HIV patient can be considered cured. Medicine now knows that most viruses that survive anti-HIV therapy are defective and cannot multiply. “A cure for HIV could be better defined as” no intact virus “than” no detectable virus “”, write the doctors. The study by the team around Gupta was encouraging, but in the end time had to show whether a cure could actually be spoken of. (dpa)

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The combination of HIV medications fails as a treatment for severe COVID-19 in the Chinese study

A pill containing two HIV drugs that was touted as a potential treatment for the new coronavirus was not effective, according to a study published in the New England Journal of Medicine last Wednesday.

A test conducted on Chinese patients with severe COVID-19 disease found that the 99 who received Kaletra from AbbVie Inc., a combination of lopinavir and ritonavir, were no better than the 100 who received standard care.

The people who received the combination showed small improvements over time to clinical improvement and 28-day mortality, but the differences were not statistically significant. People taking medications showed clinical improvement after a median of 15 days compared to 16 days with standard care, a difference that researchers called “significant, albeit modest”.

The study results were published online in the New England Journal of Medicine.

The lopinavir-ritonavir combination also produced more side effects, prompting treatments to be discontinued in 13.8 percent of patients.

The combination of drugs has not been tested against a placebo, which is the gold standard in evaluating the effectiveness of a treatment. All patients had pneumonia and were treated at the Jin Yin-Tan hospital in Wuhan, the city where the pandemic began.

The treatment “was not associated with clinical improvement or mortality in seriously ill patients with COVID-19 other than that associated with standard therapy alone,” concluded the team, led by Dr. Bin Cao of the National Clinical Research Center for Respiratory Diseases.

The test “was a heroic effort,” said Dr. Lindsey Baden and Dr. Eric J. Rubin, editors of the New England Journal of Medicine, in an editorial in the Journal. “Unfortunately, the test results have been disappointing.”

The treatment “had no visible effect” on virus replication, and that’s how therapy should work, they said.

The combination therapy for HIV has been used by doctors from various countries in the hope of being effective. The Ministry of Health of the Indian Union recommended the treatment.

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