Ask Dr. Rachna Pande

Does exposure to STIs like gonorrhoea increase one’s chances of getting HIV? Yes. Exposure to sexually transmitted infections (STIs) increases risk of one getting HIV. This happens because both are acquired through unprotected sex. Sexual intercourse weakens and disrupts the protective inner lining of genital parts, thus facilitating easy entry of HIV inside the body. So, the number of episodes of gonorrohoea or another STD raises the chances of acquiring HIV. *** What are the available options for preventing mother-to-child transmission of HIV? Regarding prevention of mother-to-child transmission (PMTCT), the World Health Organisation guidelines released in September 2015 recommend Option B+, giving anteretroviral treatment in form of triple treatment to all pregnant women living with HIV/AIDS or tested positive for HIV regardless of clinical stage or CD4 count. This is started as soon as a woman is diagnosed with HIV, and continues for life. Other plans are; Option B-, considered starting anteretroviral treatment (ARV) as soon as possible if CD4 count is below 350/cu.mm and continued for life. If CD4 count is below 350/cu.mm, Triple ARV therapy is started as early as 14 weeks of gestation and continued till one week after stopping breast-feeding in the post partum period. Option A-triple ARV is started as early as possible if CD4 count is less than 350/cu.mm and continued for life. If CD4>350/cu.mm. then antepartum AZT is started around 14 weeks of gestation. At onset of labor other drugs are given. For the babies, they are always tested for HIV and given prophylactic ARV drugs depending on whether the baby is breast feeding or not/mother;s adherence to her ARV treatment during pregnancy and breast feeding, viral load of the mother and other factors. *** Are there people who can’t catch HIV and why? Recent scientific studies have brought out some interesting results regarding variability in acquiring diseases including HIV, when exposed to the virus. A case in point is why it happens that among two individuals exposed to HIV through unprotected sex, one tests positive after three months and another remains negative. The discrepancy is explained by genetic variation in immunity. It is said ancestors who acquired and suffered from diseases had gradually developed genetic mutations, making the person resistant to acquire the disease. Now when these genes are passed on to the offspring, resistance to the disease is also passed on and they have a natural resistance to the disease. The resistance is much more when resistant genes are acquired from both parents and weak when only from one parent. CCR5-A32 is one such genetic mutation that prevents the HIV virus from entering the cells. This is said to occur in ancestors suffering from recurrent plague. It is found in people of central Europe, particularly Scandinavian. *** What is the best diet for people with HIV/AIDS? People who are HIV+ need to have a balanced diet that fulfills requirement of all necessary nutrients to help them live longer and have a good quality of life. This should include fresh green vegetables, fruits, whole grains, milk and meat products including fish. If malnourished and cachexic, they need to increase amount of calories to add on weight. Proteins should be in adequate quantity in the diet to help in repair of tissue damage and build up immunity. Vitamins like A, B.complex and C help to strengthen various body functions, eyes and nervous system. They also help in increasing immunity. Minerals help in strengthening bones and smooth functioning of various body processes. An HIV-positive person if sick or on antiretroviral drugs is likely to have reduced appetite with or without nausea and vomiting. His diet needs to include frequent small meals Special diet plans should also consider situations such as chronic anemia, where he would need iron rich food. The meals should be prepared very hygienically.