KARACHI: There is an urgent need for educating people on the means of transmission and prevention of sexually transmitted diseases and address the social stigma and fear attached to HIV/AIDS. A potentially life-threatening disease, HIV/AIDS, has reached alarming proportions in the country, also reporting drug resistance in patients on medications.

These points were highlighted by Dr Saeed Khan, a professor of pathology associated with the Dow International Medical College, at the last day of a three-day conference titled PROBE (Physiology Resonates and Ozonizes Biological Existence) 2020 Conference organised by the department of physiology at Karachi University (KU).

“The Human Immunodeficiency Virus (HIV) is the causative agent of AIDS that causes patient’s immune system to become ineffective and exposes the body to secondary infections. In Pakistan, the HIV-1 subtype A has been observed to be more prevalent among different high-risk groups, including injection drug users,” said Dr Khan.

According to him, Pakistan, which was earlier reporting low prevalence of HIV/AIDS, now has concentrated epidemic in high-risk groups with greater presence of HIV-1 subtype.

“Over the past few years, however, it has been observed that several different HIV subtypes and recombinant forms are circulating [in] the country, also reporting cases with drug resistance in patients receiving medications,” he explained, adding that drug resistance might also be due to treatment failure.

Larkana outbreak

He also spoke about the HIV outbreak in Larkana and referred to the Sindh AIDS Control Programme statistics according to which 26,041 people had been screened for HIV since the start of the outbreak and 751 people were tested positive for the disease.

“The root cause or transmission factors behind this epidemic are still a mystery and the data on the molecular characterisation, drug resistance and its origin of spread is not available.”

Talking about HIV prevention and effective treatment and rehabilitation, Dr Khan said it was important to address the social stigma, fear of social disapproval and denial of accepting the reality in response to this disease.

“In our culture, topics related to sexual encounters and safe sex are considered as a taboo so they are not openly discussed, increasing vulnerability of population especially of the youth to the infection.”

He emphasised that society must take steps to reduce the stigma related to HIV/AIDS so that people could speak up and talk about the disease and its modes of transmission.

“This will also increase social acceptance of people living with HIV and help them attain their fundamental rights to quality education, health and better employment. In this respect, we all need to play a positive role since we know that government resources are limited,” he said, adding that no one was safe unless everyone was safe.

Thalassaemia management

Dr Saqib Hussain Ansari, a consultant haematologist and bone marrow transplant physician at Children’s Hospital Karachi, talked about thalassaemia management without blood transfusion and said it had a great prospect especially in the middle- and low-income countries where the burden of transfusion transmissible infections and iron overload were increasing.

According to him, stem cell transplantation (in Pakistan) is not a practical option due to multiple factors, for instance financial costs, donor unavailability and scarcity of transplantation facilities.

Referring to some data, he said the children’s hospital registered 1,135 patients with beta thalassaemia between January 2004 and December 2017. Of them, 221 left treatment for different reasons.

Focusing on the challenges posed by diabetes, Prof Mohammad Kamran Azim, dean of the faculty of life sciences at Mohammad Ali Jinnah University, said Type-2 diabetes had emerged as a growing health issue affecting more than 170 million individuals worldwide.

Citing WHO statistics, he said the number of Type-2 diabetes’ patients in Pakistan was expected to rise from 4.3m in 1995 to 14.5m in 2025, making Pakistan the fourth most diabetes-affected country in the world.

Scientists, he pointed out, had not yet fully understood this disease. “Though it’s well known that diabetes is associated with inflammation and altered immune response, the specific cellular and molecular mechanisms involved in the disease are yet to be fully understood,” he said.

Dr Syed Aqeel Ahmed, chief operating officer at the Tabba Kidney Institute, also spoke.

A large number of students and researchers participated in the conference, including those from the Bahauddin Zakaria University (Multan), Islamia University (Bahawalpur), University of Health Sciences (Lahore) and University of Sindh (Jamshoro).

Partnered with the Pakistan Physiological Society and the South Asian Association of Physiologists, the event was supported by the Higher Education Commission Pakistan, the Pakistan Science Foundation, the Office of Research, Innovation and Comm­ercialisation and the World Poultry Science Association.

Published in Dawn, January 10th, 2020