Dr A Suresh Kumar, Limca Book of Record Holder /Infertility Specialist IVF Ashoka Superspeciality Hospital, Raipur, Chhattisgarh says ‘The serodiscordant couple can easily take fertility treatment and have their own bundle of joy without any fear. They can also enjoy the parenthood happiness as technology today has reached to that height to help them to bear their own child with reduced risk of transmission of HIV infected virus to the baby’
If you are one among the serodiscordant couple and want to have a child of your own , then fertility treatments are there which can assist you to have your own bundle of joy. The serodiscordant couple in which one partner is HIV positive and other is HIV negative, there is a possibility that they can benefit from IVF (invitro fertilisation), IUI (intra-uterine insemination) and ICSI (intracytoplasmic sperm injection). With help of these fertility treatment the risk of the woman being infected with HIV is greatly reduced, thereby reducing the risk of vertical transmission(transmission from mother to child) as well.
There are two ways to take fertility treatment forward. One being the DONOR SPERM option wherein to conceive the HIV negative women will be using the screened donor’s sperm which is somewhat similar to the process which she might have undergone if her husband was infertile.
SPERM WASHING the other method is now successfully being used by many couples who were looking forwad for the male partner to be the genetic father. The theory behind this procedure says that the HIV infected material is carried mainly in the seminal fluid ejaculated , rather than in the sperm. The man ejaculate is collected and washed in the laboratory in order to remove the infectious seminal fluid. After that it is stored till the time when women starts ovulating and it can transferred to her womb by intra-uterine insemination (or if either partner has fertility problems, perhaps IVF or ICSI)
Q1. What is HIV and how it is different from AIDS?
Ans. AIDS is a condition. HIV is a virus that may cause an infection, but AIDS is a condition or a syndrome. Being infected with HIV can lead to the development of AIDS, which stands for acquired immunodeficiency syndrome. AIDS develops when HIV has caused serious damage to the immune system.
Q2. Common symptoms of AIDS
HIV is a virus that affects the immune system, specifically the CD4 cells. The CD4 cells help to protect the body from illness. Unlike other viruses which the immune system can normally fight off, HIV can’t be eliminated by the immune system.The symptoms of HIV can vary from person to person. However, an HIV infection will generally follow this pattern:
- acute illness
- asymptomatic period
- advanced infection
- A) Early Symptoms of HIV and AIDS
- Skin rashes and skin sores
- Swollen glands
- Fever and night sweats
- Bacterial and yeast infections
- Sexually transmitted infections (STIs)
- Menstrual Changes in women
- Pelvic inflammatory disease (PID)
B ) Advanced symptoms of HIV and AIDS
- nausea and vomiting
- weight loss
- severe headache
- joint pain
- muscle aches
- shortness of breath
- chronic cough
- trouble swallowing
Q3. The First step if anyone get positive to HIV test?
A follow-up test will be conducted. If the follow-up test is also positive, it means you are HIV-positive.If you had a rapid screening test, the testing site will arrange a follow-up test to make sure the screening test result was correct. If your blood was tested in a lab, the lab will conduct a follow-up test on the same sample.
It is important that you start medical care and begin HIV treatment as soon as possible after you are diagnosed with HIV. Antiretroviral therapy or ART (taking medicines to treat HIV infection) is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART slows the progression of HIV and helps protect your immune system. It can keep you healthy for many years and greatly reduces your chance of transmitting HIV to your sex partner(s) if taken the right way, every day.
Q4. As there is no permanent cure to Aids? How much helpful is “prevention is better than cure” in the context of AIDS.
“Prevention is better than cure”, is a well-said quote ,nevertheless, before we understand this quote in terms of health, we first need to know what prevention is and what is cure. Prevention is the promotion of constructive lifestyles and norms that discourage drug use. It is an ongoing process that must relate to each emerging generation.
To get prevention from diseases we must know how to live healthy. At end of the day, living healthy is your prevention. When we stuck up on diseases, we usually go for medication that is a process of cure. Therefore, before going to discuss about how prevention is better than cure, we need to know the ways to get healthy in our life.
Q5. How is HIV transmitted to child from infected Aids parents ?
HIV/AIDS may be vertically transmitted from a mother to her child. This means the infection may spread during pregnancy, labor, delivery, or breastfeeding. 70% of transmissions are believed to occur during delivery when the baby comes into direct contact with the mother’s infected blood or genital secretions/fluid in the birth canal. 30% of infections occur in utero during the pregnancy with 66% occurring within the last 14 days of a pregnancy. The mechanism for in utero infection is not well .The current belief is that infected maternal secretions may cross the placenta during the pregnancy.
The risk of HIV transmission from a mother to child is most directly related to the plasma viral load of the mother. Untreated mothers with a viral load >100,000 copies/ml have a transmission risk of over 50%. For women with a viral load < 1000 copies/ml, the risk of transmission is less than 1%. In general, the lower the viral load the lower the risk of transmission. For this reason, ART is recommended throughout the pregnancy so that viral load levels remain as low as possible and the risk of transmission is reduced.
Women with an established diagnosis of HIV often begin ART before becoming pregnant to treat the infection. It is recommended that all pregnant women begin ART regardless of CD4 counts or viral load to reduce the risk of transmission. The earlier ART is initiated, the more likely the viral load is to be suppressed by the time of delivery. Some women are concerned about using ART early in the pregnancy as babies are most susceptible to drug toxicities during the first trimester. However, delay in ART initiation may prove less effective in reducing infection transmission.
Q6. How do the IVF work to prevent child from infected Aids parents?
IVF include treatments in which both eggs and sperm are handled.In present scenario HIV infection has changed from lethal to chronic illness and also availability of HA-ART . IVF helps by decreasing the number of exposures necessary to conceive and also by increasing the chances of conception. (Read the article attached to know “ How IVF work to prevent child getting infected” in detail)
Q7. What are the failure chances in IVF in preventing child from HIV ?
The failure chances are :
- Lack of Perinatal transmission can’t be guaranteed
- Horizontal transmission risk of available procedures is uncertain
Q8. Can we get HIV/AIDS with casual contact (like hand shaking, hugging etc.)?
We cannot get HIV/AIDS with casual contact. One can get or transmit HIV only through specific activities. Most commonly people get or transmit HIV through sexual behaviours / needles or syringe use. Only certain Body fluids – blood, semen, pre-seminal fluids, vaginal fluids and breast milk- from a person who have HIV can transmit HIV. These fluid comes in contact wioth mucous membrane or damaged tissue or be directly injected into the bloodstream for transmission to occur.