India - Study confirms merits;AIDS

A study involving more than 10,500 people, undertaken by the Tamil Nadu State AIDS Control Society, has conclusively demonstrated that providing micro- and macro-nutritional supplements to people with HIV/AIDS improves their health, and greatly delays the progression of the disease. The study covered both HIV-infected individuals who are on antiretroviral therapy (ART) and those who are not. The most important finding is that the CD4 count shot up. The increase was remarkable in those on ART — the figure rose from 113 to 402 at the end of the 18-month study period. The increase seen in HIV-positive people who do not require drugs, even if marginal, is significant in its own way. Since CD4 counts indicate how strong the immune system is, a higher count means it would take a longer time for therapy to become necessary. For those already on ART, an increase in CD4 translates to lesser risk of contracting AIDS-related illnesses. A marked reduction in the rates of tuberculosis co-infection and other opportunistic infections for those on ART best illustrates this. Though the advantages of a healthy lifestyle in delaying the progression of the disease are well known, the results of the Tamil Nadu study are powerful confirmation of this knowledge.

There are economic benefits also, as evidenced by the fact that the percentage of people on ART getting employed nearly doubled in six months, thanks to the nutrition supplement. Together, the twin benefits could change the entire dynamics of the health care of those afflicted with HIV/AIDS. It is commendable that the Tamil Nadu government decided, on the basis of six-month data, to incorporate nutritional supplementation in its HIV/AIDS strategy for those on therapy — there are about 25,000 people on ART and some 1,000 more are estimated to join their ranks every month. The government’s current programme covers only those on medicines. A vigorous campaign is called for to spread awareness among the HIV/AIDS-infected people on the proven merits of nutrition in putting off the contingency of medication. In this, the role of counsellors cannot be overemphasised. The findings of the study make a strong case for nutritional supplementation being included in the all-India programme run by the National AIDS Control Organisation. The additional cost it entails — Rs.900 a year per person — is eminently justifiable considering that the government may not have to spend money on treating thousands of people who would otherwise become co-infected with TB or get opportunistic infections.