HIV/AIDS MANAGEMENT IN NIGERIA

By Jereaghogho Efeturi Ukusare

Over the years, the awareness creation on the prevalence of HIV seems to have been slowed down. In a country like ours where children grow into adults everyday, it is important to always keep the tempo on awareness high. However, the management of the condition in the country is commendable. Before delving into the management of the condition in Nigeria, it is quite pertinent to define the basic terms.

HIV is the short for Human Immunodeficiency Virus while AIDS is Acquired Immunodeficiency Syndrome. HIV is a virus that gradually attacks the immune system, which is our body’s natural defence against illness. When an individual gets infected with HIV, the individual will find it harder to fight off infections and diseases. This virus destroys a type of white blood cell called a T-helper cell and makes copies of itself inside them. T-helper cells are also referred to as CD4 cells. There are many different strains of HIV. An individual who is infected may carry various different strains in their body. These are classified into types, with lots of groups and subtypes. The two main types are:

HIV-1: the most common type found worldwide and

HIV-2: this is found mainly in West Africa, with some cases in India and Europe.

If left untreated, HIV can take around 10 to 15 years for AIDS to develop, which is when HIV has severely damaged the immune system.  AIDS is a syndrome caused by the HIV virus. It is when a person’s immune system is too weak to fight off many infections. It develops when the HIV infection is very advanced. This is the last stage of HIV infection where the body can no longer defend itself and may develop various diseases, infections and if left untreated, it results in death. There is currently no cure for HIV or AIDS.

The HIV virus attacks white blood cells, which are called T-helper cells or CD4 cells. These are important when it comes to having a healthy immune system as they help us fight off diseases and infections. HIV cannot grow or reproduce on its own. Instead, it makes new copies of itself inside T-helper cells which damages the immune system and gradually weakens our natural defences. This process of T-helper cells multiplying is called the HIV life cycle.

HIV cannot be transmitted through sweat, saliva or urine. According to a UK statistical data, the most common way for someone to become infected with HIV is by having anal or vaginal sex without a condom. You can also risk infection by using infected needles, syringes or other drug-taking equipment (blood transmission) , or from mother-to-child during pregnancy, birth or breastfeeding.

With early diagnosis and effective antiretroviral treatment, people with HIV can live a normal, healthy life. HIV is found in the following body fluids of an infected person: semen, blood, vaginal and anal fluids and breast milk. In Nigeria, the government is taking all necessary steps, including compulsory blood tests for hospital patients so as to diagnose the presence of HIV in a case where there is, early enough. The government has recorded tremendous success with this measure as thousands of cases have been detected early and treatment commenced immediately. 

The life cycle of HIV goes through various different steps that can happen over many years. Antiretroviral treatment works by interrupting the cycle and protecting the individual’s immune system. There are different drugs offered depending on the particular stage of the HIV life cycle.

Understanding the HIV life cycle helps scientists to know how to attack the virus when it is weak and reduce the risk of drugs no longer working (drug resistance). This happens when drugs fail to prevent the virus from multiplying.

There are various stages of the HIV life cycle and these include the following:

Binding and fusion
First, the HIV virus attaches itself to a T-helper cell. The spikes on the surface of the HIV particle stick to the cell and allow them to join together. The contents of the HIV particle are then released into the cell.
The type of drugs that can stop this part of the process are called Fusion or Entry Inhibitors.

Reverse transcription and integration
Once inside the cell, HIV changes its genetic material (called HIV RNA) into HIV DNA using an enzyme called transcriptase. HIV DNA can then enter the DNA in the nucleus of the T-helper cell and control it.
The type of drugs that can stop this part of the process are called NRTIs, NNRTIs and Integrase Inhibitors.

Transcription and translation
The HIV DNA then makes long strands of messenger RNA proteins, and transports them towards the edge of the cell. This is then used for producing more HIV.

Assembly, budding and maturation
Copies of HIV genetic material are contained among the strands of messenger RNA. These form new HIV particles, which are then released from the T-helper cell. These are then ready to infect other cells and begin the process all over again.

It is pertinent to know that antiretroviral treatment will keep the immune system healthy if taken correctly and therefore prevent the virus from developing into full blown AIDS. The government of Nigeria in its efforts has provided heart to heart centers across the length and breathe of the entire country. The National Agency for the Control of Aids in collaboration with the State Agencies for the Control of Aids effectively manage these heart to heart centres and provide free drugs to PLWHA (People Living With HIV/AIDS). The Nigerian Government also established the Society for Family Health (SFH) to work with NACA and the various SACA to effectively manage PLWHA. 

Currently, all seems well. However, the government of Nigeria has to take proactive steps in the area of advocacy. Campaigns have to be reintroduced to effectively prevent the occurrence of new cases and in the long run, put an end to the prevalence of HIV/AIDS in the society. 

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