Not everyone who is HIV positive needs antiretroviral therapy. Dr Khwezi Matoti runs the AIDS clinic at the Guguletu Day Hospital and explains when antiretroviral drugs become necessary.
DR. MATOTI: People who get ARVs according to our protocols are people who are at stage four of the disease or those who have low CD4 counts that are below 200.
THANDEKA: What is stage four? For a layperson.
DR MATOTI: Well, when we talk of stage four we talk of illnesses that are identified as opportunistic infections that attack people who live with HIV. The visible illnesses that makes us conclude that a person is on stage four are for example meningitis, TB, pneumonia (PCP), karposi sarcoma and so on.
THANDEKA: Can you take us through first, second and third stages of AIDS.
DR MATOTI: Basically the stage one people are normally not aware that they are HIV positive until they go for an HIV test and that’s when they first discover that they are HIV. Stage two usually is people who have problems of shingles, ulcers in the mouth and nay other rash in the body. In stage three the most common condition is TB, tuberculosis in the lungs, thrash in the mouth and in the ladies private parts although that does not mean that if you have vaginal thrash you’re HIV positive but it’s common in pregnant women or on diabetic.
THANDEKA: Do think that there’s a need for provision of ARVs?
DR. MATOTI: Ja, of course there’s a need for government to provide ARVs , this is something that needed to be done five years ago and not now for the simple reason that we have seen that these ARVs help the people to recover for example we have seen bed ridden people getting better basically what these ARVs are doing they improve the quality of life and prolong the lives of the people. This has many implications because the government saves lots of money instead of people going to doctors and admitted in hospitals all the time. The only thing we should guard against is that they should be given to the most needy and those who are in the right stage to get them and unfortunately it’s not everybody that will get them.
Another thing we need to note is that we need to have the right infrastructure we need to work towards training people especially health workers be it doctors or nurses to train them to handle these drugs because these drugs are obviously new and it’s not like taking a panado there’s a lot involved with anti retroviral.
Again we need to train the communities who are going to get the treatment people need to be educated in terms of knowing why are they taking these anti retroviral and what should they look at and what side effects are they going to come across. What they should do if they come across those side effects. People need to know and be taught what will happen if they default.
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