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Incorrect use of HIV drugs could worsen things

Several studies have shown that specialists, sub–specialists and generalists treating HIV/AIDS patients in India lack in–depth training on the pandemic’s uniquely Indian attributes, infectious disease expert Sanjay Pujari said, adding that doctors in India rely on Western guidelines, which inadequately address the disease’s attributes here.

Infectious disease experts Sanjay Pujari, Atul Patel, and N Kumarasamy announced the launch of their NGO called the HIV Medicine Association of India, or HIVMAI in the city on Sunday. Their website www.hivmai.org was also launched.

Speaking at a quarterly symposium hosted by Pujari’s Institute of Infectious Diseases, the three doctors explained the needs that prompted them to start this NGO.

“In our mission statement we have emphasised that all people in India with HIV/AIDS deserve uniform, quality care. And while there are many NGOs working in the field of HIV/AIDS in India, none were started specifically by doctors, and none focus on developing India–specific, evidence–based treatment guidelines for patient management,” said Pujari. In addition, HIVMAI will offer in–depth clinical training to its members.

“amFAR (Foundation for AIDS Research) and TREAT Asia (Therapeutics Research, Education, and AIDS Training in Asia have recognised this training gap and a shortage of HIV specialists. Our own needs assessment showed that over 90 per cent of the doctors treating AIDS/HIV patients agree that more training and India–specific guidelines are necessary,” said Pujari.

The amFAR report was very clear that using HIV drugs incorrectly could actually make the epidemic much worse in India. “As per the report, a combination of increasingly available drugs to treat HIV and the lack of trained doctors to administer them could lead to widespread misuse and eventually to drug resistance, eradicating years of progress in treatment and prevention of HIV/AIDS across the region,” said Pujari.

“In future we plan to work with private companies and the government to promote effective treatment guidelines for people living with HIV/AIDS in India. No other HIV NGO in India offers these benefits,” Pujari said.

Kumarasamy spoke about the research agenda of the organisation, adding, “Because the epidemic is unique in India, we need to engage in India–specific clinical research and clinical trials, so that our treatment standards continue to improve.”

Kumarasamy explained that people with HIV in India suffer from a variety of conditions not seen as often in more developed nations, for example very high rates of TB and hepatitis. Resource constraints are another problem in India. Families can sometimes not even afford good nourishment so, for most, the cost of effective drugs and diagnostics is prohibitive.

“The website will be a resource to all doctors interested in HIV medicine, and the site also contains clinical information for people living with HIV/AIDS. In near future, members of the website will have be able to ask clinical questions to experts,” Patel said.

The new NGO has already engaged some international partners. HIV Treatment Resource and Initiative (HIVTRI), a UK–based NGO, will be the training partner, and will work with HIVMAI at least once a year to provide in–depth clinical training with Indian and international experts as instructors, said Patel.

The board of directors consists of other well–known HIV specialists, including Diamond Sharma Hidangmayum from Manipur, K S Satish from Bangalore, Rajeev Soman and Jehangir Sorabjee from Mumbai, Nalin Nag from Indraprastha Apollo hospitals, Delhi and R R Gangakhedkar from National AIDS Research Institute Pune.

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Source: Times of India

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