01 February 2011
By Pratibha Masand
This is not an ordinary achievement for J J staffers as not many hospitals are willing to 0take up HIV–positive pregnancy cases. "Most of the HIV–positive pregnant women who come to us are either denied admission by hospitals or are referred to us," said Dr Rekha Daver, head of obstetrics and gynaecology department at J J.
The incidence of the babies born with HIV–positivity also has been low, claims the hospital. "We cannot say exactly how many babies were born HIV positive, as many mothers do not return to get their babies tested. But our estimation says that of all the HIVpositive deliveries, 5–10% of babies get the mother–to–child transfusion," said Dr Daver, who is also the head of positive parent to child transfusion (PPTCT).
The hospital has achieved the feat with the help of a certain medicine and delivery method. "According to the guidelines, we give nevrapin before the delivery. We prefer doing a normal delivery–one without making any incisions–to avoid mixing of the mother’s blood with the baby’s. Also, we give the mother the choice to breastfeed, even though there’s a slight chance of virus transmission," added Dr Daver.
Maharashtra District AIDS Control Society (MDACS), however, agrees that the load of conducting deliveries of HIV–positive women has largely fallen on public hospitals. "Public hospitals get majority of HIV–positive pregnant women as private hospitals do not want to do these deliveries. While the number of HIV–positive women directly coming to the public hospitals is high, those referred from private hospitals is equally high," said Dr S S Kudalkar, project director of MDACS.
Dr Y S Nandanwar, head of obstetrics and gynecology at Sion Hospital said that they may have assisted in 1,000 positive deliveries too. "We do not have the exact record, but the incidence of conducting an HIV–positive delivery is 1% in our hospital. Since we conduct more than 10,000 normal deliveries in a year, we must be conducting around 100 HIV–positive deliveries," he said.
New treatments offer a ray of hope Thanks to the availability of new technology and medications, life has become easier for those who are HIV–positive. Take, for example, 32–year–old Nana Tambe, whose sunken cheeks give away his state of illness. His consistent low blood cell count had baffled the doctors treating him at J J Hospital’s antiretroviral therapy (ART) centre. But, with the availability of HIV–2 kits, doctors have now found the solution to Nana’s problems.
"Nana has been on the HIV treatment for quite a few years. But his immunity was consistently low. With the help of newer diagnostic technique, we found out that he was suffering from HIV 2 while we were treating him for HIV 1. As a result, he didn’t show any improvement. Now, we will start a second line of ART treatment, which will improve his condition," said Dr Alaka Deshpande, head of the J J’s ART centre.
HIV–2, the rarer subtype of the HIV virus, is less easily transmitted than HIV–1. The duration between infection and symptoms tends to be longer in case of HIV–2. But there are some who have been living with the virus for almost two decades. Shankar Nikam (55), has been HIV positive for the 20 years. "My wife died 20 years ago.
I had nowhere else to go," said Nikam, who has a 22–year–old daughter and a 20–year–old son. Both his children stay with their uncle, away from Nikam. While people like Nikam have broken–up families, there are others like Vandana (39) whose family has been her pillar of strength. Vandana, who has two grown up children, said, "I was detected with HIV in 2001. My husband and children know about it and they stand by me. We haven’t told anyone else in our family."
"Vandana’s husband is negative, so are her children. A couple where one is positive and the other is not is known as a discordant couple. What is important for such couples is to concentrate on not transmitting the virus to the spouse," said Dr Deshpande.