Proactive HIV Diagnosis & Advancing Treatment: Insights from Dr.Manuel Castaรฑo
Dr.Manuel Castaรฑo, โขa Specialist in Infectiousโข Diseases at theโฃ Regional Hospital of Malaga, highlights a growing initiative in Andalusia to proactively โidentify undiagnosed HIV infections. Hospitalsโฃ like Carlos Haya and theโค Malaga Clinic are โimplementing diagnostic protocols โin emergency rooms, requesting HIV serology tests – withโ patient consent – for individuals presenting with conditions that raise suspicion ofโฃ potential infection. This “hunt” forโ diagnoses is coupled withโค effortsโ to educate primary care physicians and โขresidents to consider HIV โas a potential diagnosis.
According to Dr. โขCastaรฑo, approximately 8-10% ofโ individuals currently infectedโ withโ HIV remain undiagnosed. He emphasizes the importance of routine testing, stating, “If the population goes to their doctor to measureโ their cholesterol, they should also get โขan HIV check.” He underscores โthat early diagnosis and treatment โdramatically improve prognosis, offering individuals withโ HIV theโค same lifeโฃ expectancy as those uninfected, while untreated HIV remains universally fatal.
Treatment for HIV has undergoneโฃ a significant transformation in recent years. Current regimens are โฃfarโข more manageable and less toxicโ than those of the โฃpast. Approximatelyโค 80% ofโค patients now control the virus with aโ single daily pill -โข often less medication than required โfor 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. Theโข future of treatment, Dr. Castaรฑo suggests, lies in “long-acting” โฃstrategies 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, โคnoting its cost-effectiveness in preventing infection.
Despite advancements,Dr. Castaรฑo expresses concern over a decline inโ preventative behaviors, especially โคamong younger generations. He observes a significantโฃ 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 โthe experiences of olderโ patients, many of whom witnessed the devastating impact of AIDS in โthe 80s and 90s and are โdismayed by theโข diminished โคfear surrounding HIV.
Dr. Castaรฑo alsoโ shared that he currently follows HIV patients who are 84 years old, demonstrating the success of long-term treatment โand care.