[건강 플러스] HIV-infected hidden due to COVID-19, prompt treatment is important

People at high risk for HIV should have regular screenings once a year.
You can stop the spread of HIV by taking regular treatment… ‘Social bias’ is a barrier to treatment

AIDS image. Courtesy of Getty Image Bank

The human immunodeficiency virus (hereafter, HIV) is the cause of the acquired immunodeficiency syndrome called AIDS. AIDS patient refers to an HIV-infected person with advanced disease and immunodeficiency among HIV-infected persons.

Globally, the number of newly infected people with HIV is on a steady decline. The number of newly reported cases of HIV in Korea was ▷1,8 in 2017, ▷989 in 2018, ▷1,6 in 2019, and then decreased to 818 in 2020, when the COVID-19 epidemic began, and to 734 in 2021.

Experts pointed out that there is a high possibility that new infections may not be diagnosed as public health centers, which play a pivotal role in HIV diagnosis, are paralyzed by COVID-19 work.

◆ Reduced domestic HIV infection due to COVID-19

According to the ‘Report on the National Health Center’s HIV Screening Tests for the Last 10 Years (2011-2020)’ released by the Korea Centers for Disease Control and Prevention last year, the average number of HIV screening tests was 443,609.

Then, in 2020, when the COVID-19 spread, the number of tests was 178,653, a decrease of 59.4% from the average annual number of the past 10 years.

Professor Kim Shin-woo of the Department of Allergy and Infectious Diseases at Kyungpook National University Hospital said, “It is estimated that the number of new infections reported has decreased as the number of diagnoses at public health centers has decreased due to the impact of COVID-19. It is important to have regular inspections once a year,” he emphasized.

◆ If the virus is not detected, it cannot be spread.

The universally accepted concept in HIV treatment is ‘U (Undetectable) = U (Untransmittable, not contagious)’. This means that the virus will not be transmitted unless virus levels are detected in an infected person.

Recently, antiretroviral drugs that suppress HIV are so effective that even an infected person cannot transmit the virus. For this reason, it is important that HIV-infected people receive treatment with antiviral drugs regularly to prevent the virus from being detected.

Professor Kim said, “There is already a lot of evidence for the concept of ‘U = U’. It means that ‘HIV-infected people are not dangerous to society’ and ‘we have no reason to discriminate on the basis of HIV infection'” “It’s important to know that HIV is at risk of spreading to undiagnosed people, and people who are diagnosed and taking medications are not at risk,” he said.

◆ Treatment of HIV

Around the world, rapid initiation of treatment in the early stage of infection through high-intensity antiviral therapy has become a principle of treatment for HIV. The American International Association of Antiviral Association (IAS) recommends that most HIV-infected people start antiviral therapy as soon as possible.

In the past, HIV-infected people took 5 to 20 pills a day for antiviral effects. However, recently, treatments have been developed enough to treat and manage HIV with just one pill the size of Tylenol.

Recent HIV treatments include ‘Biktarvi’ (Gilliard Science) and ‘Dovato’ (Glaxo-SmithKline).

Regarding this, Professor Kim said, “Antiviral effect and safety are important in selecting a treatment. Among recent treatments, there is a drug that can be prescribed relatively easily on the same day without much consideration, such as ‘Biktarvi’.” “In the past, HIV-infected people were diagnosed with It took some time because it took a while because it needed to be tested before prescribing treatment for liver and kidney function, but recently, same-day treatment is trending.”

He added, “It gives patients peace of mind to give medicines through same-day treatment. The medicines are easier to take than before, and there are not many side effects.”

◆ Eliminate ‘prejudice’ in HIV treatment barriers

Even with the development of HIV treatment, social prejudice and discrimination against the disease still remain as treatment barriers. The lack of access to HIV testing in Korea is also due to social discrimination and prejudice against high-risk groups of HIV.

In particular, in the 1980s and 1990s, when HIV was first discovered, there was a time when people who were infected were considered badly because HIV was a deadly disease. Professor Kim emphasized, “HIV is a disease that anyone can get. It is not a mature society for someone who has done the same thing to not be criticized because they have not been infected and to be criticized because they have caught it.”

The reason for prejudice and discrimination against HIV is the defense mechanism of ‘fear of infection’. However, it is not spread by eating, showering, or sharing food with an HIV-infected person. In order to resolve discrimination against HIV, it is necessary to know correct and accurate information about the disease.

In particular, experts emphasized that ‘infected people taking treatment should have the perception that there is no risk of infection’. This is because HIV treatment must be recognized as treatment for hepatitis B, hepatitis C, and diabetes so that high-risk groups or infected people do not hesitate to test and treat.

Professor Kim said, “Actually, tobacco and diabetes are much more dangerous, and if you take medicine, AIDS is nothing. HIV is just a chronic disease if you look at it with a shift in thinking.” It is up to you to think of it like the story of Wonhyo, who said that when he opened his eyes, it was skeleton water. It is not like seeing an infected person as a worm or an alien,” he said.

“With quick diagnosis and treatment, it will be possible to reduce the risk of infection and complications, as well as reduce the risk of infection and maintain health,” he said.

Help Shin-Woo Kim Professor, Department of Allergy and Infectious Diseases, Kyungpook National University

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