On use of ART in India

[Guest guest]

Dear Forum members,

This is in response to

Dr. Kulkarni's posting. Thank you for your kind

wishes towards my speedy recovery.

I read your response towards my mail and once again I

have been compelled to respond on couple of things. In

the first place, I totally agree with you that we need

more trained Physicans who could combat the epidemic

in the sub-continent. There is no doubt about it.

I also acknowledge that there are side effects with

every meds. But the point to be noted here is, not

every one who is taking every meds have suppressed

immunity. Not every one have take 10 to 20 asprin like

meds every day, except in rare cases. Not every meds

taken by every one has the serious side effects like

HAART has, which only affects your kidney, liver,

pancreas, central nervous system, heart, brain and all

other essential body organs, if you have left any,

after taking HAART.

I totally agree that we need to prevent mother to

child transmission and in that case and I am not

saying that we should ban HAART. It is NOT and NEVER

HAS BEEN MY POINT OF OPINION. HAART has to be

prescribed on the situation of absolute necessity,

such as prevention of mother to fetus/child

transmission and the individuals who are sick and when

we know HAART can bring them back to the fullness of

life.

Unlike in US, where we have nearly 25 meds to choose

from,in India, as far as I know, we get only, if at

all, couple of anti-retroviral drugs. If we have

prescribed those meds, and if the individuals

developed resistance to those drugs or has a virus

that are resistant to those meds, what options we have

for the very individual's life whom we are interested

in saving?

And before we prescribe HAART, we need to establish an

effective Case Management system, so that we can be

sure that individual have adequate social support and

has his basic survival necessities are covered.

Without any of these things in place, and when there

is no need for individuals to be on meds (meaning when

the PHA is healthy), if we go ahead and prescribed

HAART, then it is a prescription for disaster.

Sincerely

Sathia Krishnamoorthy

Email:<sathyakrishna@...>

[Guest guest]

Dear All,

This is in response ART discussion.

One must weigh the harm to life by HIV infection and that to ART, what ever

is lesser choose it . All patients with HIV who want to start ART needs

strong counseling. Ultimate decision should be of the patient.

HAART's guidelines are ever changing and treating physician should update

himself frequently. For misuse, drugs should not be blamed.

Like wise lake of adherence is a problem of the person then physician.

And, properly used ART under the Guidence of experienced Physician is

far better then HIV treated by quackes.

Rashmikant

E-mail:<rashmis@...>