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HIV Situation in India

HIV Situation in India. Dr Sunil Gaikwad. HIV/AIDS In India. Approximate population of India: 1.21 billion (Census 2011 ) 1986: First case of HIV detected in Chennai Estimated number of HIV/AIDS cases in India (2009) : 2.39 million [Females- 39% and children- 3.5% ]

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HIV Situation in India

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  1. HIV Situation in India Dr Sunil Gaikwad

  2. HIV/AIDS In India • Approximate population of India: 1.21 billion (Census 2011 ) • 1986: First case of HIV detected in Chennai • Estimated number of HIV/AIDS cases in India (2009) : 2.39 million [Females- 39% and children- 3.5% ] • Adult HIV prevalence: 0.31% • 10% of the world's HIV/AIDS population live in India • New annual HIV infections has declined by more than 50 percent during the last decade, 2.7 lakh in 2000 to1.2 lakh in 2009. • Majority of infected individuals are in 15 – 45 yrs age group, Male-female ratio – 2 : 1 • Every year in India, over 100,000 pregnant women with HIV give birth NACO Annual report 2010-11

  3. High prevalence states Four south Indian states Andhra Pradesh Maharashtra Karnataka and Tamil Nadu Contributes 55% of all HIV infections NACO Annual report 2010-11

  4. Routes of Transmission of HIV, India, 2010-11 NACO Annual report 2010-11

  5. National AIDS Control Programme Phase III (NACP III) 2007 - 2012: • Halt and reverse the epidemic in India by 2012 • Reduce new infections by • 60% in high prevalence states • 40% in vulnerable states • Increase proportion of PLHA receiving care, support and treatment • Strengthen the infrastructure, systems and human resources in prevention, care, support and treatment programmes at district, state and national levels. • Build strategic information management systems NACO Annual report 2010-11

  6. India’s response to the epidemic NACO Annual report 2010-11

  7. ICTC • Voluntary HIV testing with appropriate pre-and post-test counseling • Confidentiality • No Test & Treat Approach

  8. ART in India Free ART roll out programme – Dec 2004 • Current status [Jun 2011] • ART centers - 313 • PLHA receiving ART from Govt - 428638 including 25071 children , • PLHA receiving ART from private sector- approx1,50,000. • COE: providing second line ART : 10 centres of excellence and covers 1929 patients • PLHA registered : 40 % of the estimated 2.39 million pts. have been identified and registered in ART clinics across the country NACO Annual report 2010-11

  9. ART scale up in India NACO Annual report 2010-11

  10. Antiretroviral drugs available in India (2011) • NRTIs • Zidovudine • Stavudine • Tenofovir • Lamivudine • Didanosine • Abacavir • NNRTIs • Nevirapine • Efavirenz • PIs • Atazanavir • Lopinavir/Ritonavir • Darunavir • Indinavir • Nelfinavir • Integrase inhibitors • Raltegravir

  11. Antiretroviral drugs available free through the public health care delivery • First line antiretroviral therapy (therapy naïve) • Zidovudine/Lamivudine/Nevirapine • Stavudine/Lamivudine/Nevirapine • Zidovudine/Lamivudine/Efavirenz • Stavudine/Lamivudine/Efavirenz • Tenfovir/Emtricitabine/NVP or EFV* • Second line antiretroviral therapy (treatment experienced) : • Zidovudine/Lamivudine/Tenofovir/Atazanavir/Ritonavir * Alternative first line therapy

  12. NACO Guidelines 2007 • Preferred regimen • AZT + 3TC + NVP • Alternative regimen • AZT + 3TC + EFV • d4T + 3TC + NVP/EFV • Other options • TDF + 3TC/FTC + NVP/EFV • PI’s not recommended for first line therapy

  13. CRITERIA FOR STARTING ANTIRETROVIRAL THERAPY

  14. NACO 2009WHO 2010

  15. Challenges • Low Health seeking behavior • Stigma • Diagnosis of OI • Early diagnosis of PTB & EPTB in HIV • Diagnosis of MDR and XDR tuberculosis among PLHA • First line ART • Raising cut of for ART initiation to CD4 350 cells cu mm. • Need for introduction of viral load, drug resistance and TDM in the ART programme. • Resistance to first line ART drugs • PMTCT- Single dose NVP

  16. Thank you

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