Developing vaccines is not easy. It requires extensive research and hard work from eminent scientists followed by clinical trials to check the efficacy of it. Millions of people across the globe wait for this vaccine which is a boon for AIDS. A vaccine is a therapeutic approach and the best preventive treatment that can work in preventing this fatal disease that is called AIDS. Acquired Immune Deficiency Syndrome is a chronic, potentially life-threatening disease caused by HIV, Human Immunodeficiency Virus. As the entire globe waits for the AIDS vaccine, we at Medicircle are conducting an awareness series on the occasion of World Aids Vaccine Day to educate people about AIDS and its preventive measures from eminent expert Doctors and Medical Professionals.

Dr. Vinay Vaman Kulkarni is a Dermatologist and an HIV Physician. As a Specialist, he has overall 36 years of experience in his field. Currently, he is associated with Prayas Amruta Clinic at Deccan Gymkhana and Dinanath Mangeshkar Hospital in Pune. Also, he is the Founder Trustee, Prayas, and Coordinator at Prayas Health Group.

Vaccine for HIV is hard to get

Dr. Vinay expresses, “We all are amidst this pandemic, and because we got a variety of vaccines in just one year, everybody expects that there should be a vaccine for everything. Unfortunately, this is not true for AIDS. There has been an effort going on for almost the last 25 - 30 years to develop a good vaccine or to develop a good strategy but none of them, unfortunately, are right up to the mark till now. There have been several ways in which the vaccine was tried to be prepared. There have been so many promising technologies, but they all have failed as regards HIV, one such was the prime and boost kind of thing on which trial is going on. But we have been able to control HIV AIDS through two strategies. If we go after biotechnological interventions like vaccines, we are unlikely to succeed in HIV. First, all the diseases which are linked with human behavior need a lot of awareness, so it is more important to have awareness about HIV because it's so easily preventable disease, you won't require a vaccine if you have safe sexual behavior. Second, if a person with HIV is on treatment, and his or her viral load is undetectable, the person cannot transmit. So, having more and more people getting detected, knowing about their status, going on treatment, and having their viral load undetectable, is another strategy for controlling HIV. Vaccine for HIV is hard to get,” talks Dr. Vinay.

Vaccine for AIDS is Prevention

Dr. Vinay speaks, “For HIV, we are not anywhere near a cure. There are several strategies and medicines which are being developed for the target but unfortunately, it's of no use. Why we should talk about cure for HIV? There are so many other diseases that require lifelong treatment and people are taking medicines for lifelong. So, for HIV also, treatment is not complex, it is just one tablet a day and that is available free in government programs. So, it is not very expensive also. One has to take the tablet and keep the viral load suppressed, and they can lead a normal life. So, I think we should move forward looking at strategies for the cure of vaccines. One vaccine is prevention, prevention from infection. There are some people who are trying therapeutic vaccines wherein you will require a minimum of medicines. But most of our patients are doing very well under treatment. Everyone who feels that one could be infected with HIV, should get tested, should approach a good physician and just go on treatment that would solve a lot of your problems,” says Dr. Vinay.

HIV attacks the immune system of the body

Dr. Vinay emphasizes, “For any infection, body's immune responses are of course important. The difference between other diseases and HIV is that HIV or Human Immunodeficiency Virus basically attacks your immune system itself. In any other infection, if it's targeting other organs, then your body immunity is fighting against that. If a person does not have immunity or have lesser immunity, then he would have a severe form of the disease. But the problem with HIV is that HIV attacks the immune system itself, so it is called an immune deficiency virus. The HIV virus attacks CD 4 cells, lymphocytes, which govern your immunity, and if you are left untreated, your immunity will go down.” 

CD 4 cells, lymphocytes govern immunity

Dr. Vinay advises, “There are two ways to maintain immunity. First is, don't allow the virus to kill your lymphocytes. So, take your medicines on time, medicines would take care of the virus and your CD4 white cells will be normal. If your CD4 white cells are normal, your immunity would be normal. If your lymphocyte cell count goes below 200, it is called Advanced Immunodeficiency. Previously it was very common, but now it’s very rare because no infected person goes to that stage if he takes treatment properly. The majority of the patients if diagnosed early would have very good CD4 counts 500 - 800 and with the treatment, it would be maintained at the same level. But if a person gets diagnosed very late then we call as AIDS or Advanced HIV disease where CD4 counts are less than 100 – 200, they have other opportunistic infections and it might take some time for the body to recoup to the best possible level. And once if it goes about 200 - 300, they can have a very good quality of life and it can reach 800 - 1000 also. Maintenance of immunity in HIV basically depends on your treatment and nothing else.”

Basic principles of good immunity

Dr. Vinay informs, “Four basic principles of good immunity –

A well-balanced diet that comprises carbohydrates, fats, proteins, vitamins, minerals. Doing adequate exercise every day to be fit, you can do yoga, pranayama, aerobics. Having peace of mind – people with HIV have to deal with a lot of social stigma and discrimination that can lead to a lot of psychological stress. Children with HIV are worried about their marriages, relationships, etc.  Try to avoid things that will harm your body.

There is nothing other than these principles which can actually boost your immunity. It is all basically your constitution and of course genetics.”

AIDS is a fatal disease is a myth

Dr. Vinay states, “The days are gone long back when AIDS was universally fatal. We have people who were diagnosed in 1991 and doing fine in 2021. So, people have survived 30 - 35 years and gradually we are seeing a lesser number of new cases. The majority of our patients are now entering middle and older age or becoming senior citizens. They are surviving well and doing fine, we should remove this myth that HIV AIDS is a killer. If your HIV infection is diagnosed very late with a severe opportunistic infection, i.e. CD 4 count is less than 50, then yes, some people may succumb to death but universally no. In fact, whenever we talk about awareness of HIV, we tell people that if you get diagnosed early and start treatment, we can assure you that you are not going to die of AIDS. There could be other problems with drugs that you are taking for lifelong which might affect your kidneys, metabolism, etc. So, that’s a complete misnomer that AIDS is a fatal disease.”

(Edited by Renu Gupta)