Re: Medical transmission of HIV in India

[Guest guest]

Dear Dr ,

I appreciate the eye opoening arguements.

But I want to differ about certain terminologies. Medical

transmission of HIV is not correct and meant differently. It is used

to be referred as Occupational hazards or occupational risk among

health care providers.

Likewise the nosocomial infections also meant hospital cross

infections acquired within the premises of a hospital , the organisms

exposed to all antibiotics and highly resistant and difficult to

treat.

That also is not very much applicable to hospital sharps acquired HIV

infection.

Regarding transmission though needles, ear piercing, shaving etc are

theoratically possible , but the transmission efficiency is very much

low. Moreover in dry conditions the highly friable virus are not able

to retain its infectivity for no longer than minutes and in wet

conditions not more than hours especially in corpse and in hollow

needles. That too not very long in a tropical country like ours.

 

The information given by you only make the normal community more panicky, HIV

TRANSMISSION IS FAR LESS THAN THAT of HBS, HCV virus.

So we must be little more conscious about all these possibilities.

ROUTE EFFICIENCY %OF TOTAL

SEXUAL INTERCOURSE  0.1-1.0%  80-90%

BLOOD TRANSFUSIONÂ  > 90%  3 - 5 %

INTRAVENOUS DRUG USE 0.5-1.0 5-10%

EQUIPMENT/NEEDLES < 0.5  < 0.1%

PERINATAL 15-45% < 0.1%

Otherwise I totally agree with you regards the various aspects of

sexual transmission.

Thanking you.

Dr S.Murugan

Consultant HIV pHYSICIAN

(Former HOD , STD Dept)

CCC Medical officer , Tirunelveli

Tamilnadu

e-mail: <muruganyes@...>

[Guest guest]

Dear FORUM,

Re: /message/9874

This is an excellent point made by . Infact, I feel that we need to revise

the standard tranmission message a little. Presently, the message for

transmission broadly lists 4 points, viz,

 

1. Through unprotected sexual intercourse with infected person/partner

2. Through infected syringes

3. Through Infected blood

4. From an Infected woman to her baby while delivery /breastfeeding

Here, the point 2 and 3 will have to be detailed, mentioning Infection from

infected blood, blood products and procedures involving open cut or wounds.

Would love to know what can be the alternate message.

Ayan Chakravarty

Ph: 91 9839 121368

E-MAIL: <chakravarty.ayan@...>

[Guest guest]

Re: Medical transmission of HIV in India

/message/9879

Thank you for your input Ayan.

In the Beijing Global Forum for Health Research meeting where I

presented on HIV and the Bias Free Framework (Nov 2007

www.globalforumhealth.org) and I raised the issue of HIV transmission in health

care, (it's available on the web)

I also attended the Session on patient safety (where I was not

speaking), but Pr N.K Arora was, who was the leader in the investigation of

unsafe injections practices by INCLEN in India.

In the largest such investigation, revealing about 50% unsafe

injections, I asked him if he thought the DECLINE in HIV cases, in the post

2005 period, - compared to projected number of cases by the UN in the 2002-2004

period for 2005-6, might not be due to measures taken by Indian authorities to

beginning to clamp down on these unsafe injection practices after INCLEN

published its findings, rather than changes in sexual behavior.

He answered that indeed, and it was not fortuitous if the HIV rates were highest

in India where injection practices were the worse, as in the State of Tamil Nadu

Ayan, Please tell us more of what you do Sir, and join our network of

concerned researchers, health care givers, PLWAS, journalists and other

individuals

Nance

e-mail: <g_upham@...>

[Guest guest]

Dear FORUM,

This is in response to Dr Murugan's posting

Re: /message/9900

I am involved in training and advocacy against nosocomial infections for more

than 25 years.

It is very problematic to be as assertive as you are when your

definition of what is a nosocomial infection is as erroneous as the one you

give!

A nosocomial infection or a hospital acquired infection is any kind of infection

which the patient acquires during the process of his/her care in hospital /

health center.

It has nothing to do with bacterial resistance to treatment which is a different

matter.

An infection contracted in health care may be or may not be drug resistant.For

example, both 'regular' tuberculosis, and multi-drug resistant TB, or even

Extreme drug resistant TB can likewise be nosocomial infections.

In the case of HIV, nosocomial transmission of HIV has been documented ever

since the epidemic began, and today, we begin to see cases of ARV resistant HIV

being transmitted through care.

Does that make it clearer?

Nance Upham

e-mail: <g_upham@...>