Proactive HIV Diagnosis & Advancing Treatment: Insights from Dr.Manuel Castaño
Dr.Manuel Castaño, a Specialist in Infectious Diseases at the Regional Hospital of Malaga, highlights a growing initiative in Andalusia to proactively identify undiagnosed HIV infections. Hospitals like Carlos Haya and the Malaga Clinic are implementing diagnostic protocols in emergency rooms, requesting HIV serology tests – with patient consent – for individuals presenting with conditions that raise suspicion of potential infection. This “hunt” for diagnoses is coupled with efforts to educate primary care physicians and residents to consider HIV as a potential diagnosis.
According to Dr. Castaño, approximately 8-10% of individuals currently infected with HIV remain undiagnosed. He emphasizes the importance of routine testing, stating, “If the population goes to their doctor to measure their cholesterol, they should also get an HIV check.” He underscores that early diagnosis and treatment dramatically improve prognosis, offering individuals with HIV the same life expectancy as those uninfected, while untreated HIV remains universally fatal.
Treatment for HIV has undergone a significant transformation in recent years. Current regimens are far more manageable and less toxic than those of the past. Approximately 80% of patients now control the virus with a single daily pill - often less medication than required for conditions like hypertension. Innovative approaches, including injections every two months, are already available, and clinical trials are underway exploring a combined drug pill administered just once a week, showing promising results. The future of treatment, Dr. Castaño suggests, lies in “long-acting” strategies involving subcutaneous or intravenous administration every six months. Though, he acknowledges the potential cost barrier associated with these newer therapies, requiring consideration by health authorities.
He also points to the effectiveness of pre-exposure prophylaxis (PrEP), utilizing tenofovir and emtricitabine, for individuals in high-risk relationships, noting its cost-effectiveness in preventing infection.
Despite advancements,Dr. Castaño expresses concern over a decline in preventative behaviors, especially among younger generations. He observes a significant decrease in condom use, with PrEP sometimes being treated as a substitute for barrier protection, leading to a rise in other sexually transmitted infections.He notes a stark contrast between the current attitude and the experiences of older patients, many of whom witnessed the devastating impact of AIDS in the 80s and 90s and are dismayed by the diminished fear surrounding HIV.
Dr. Castaño also shared that he currently follows HIV patients who are 84 years old, demonstrating the success of long-term treatment and care.
