Infektolog omubomír Soják.
In Europe and Slovakia, there are more and more people with HIV infection. Infektolog omubomír Soják from the University Hospital in Bratislava says that even sometimes general doctors underestimate the virus. When you are in danger, you must go to the test as soon as possible.
What did you read in the interview?
Why the infection is growing
How HIV is spreading
What is the difference between HIV and AIDS?
What is the treatment of HIV today?
Healthy HIV transplantation of the bone marrow
How many HIV positive people do we have in Slovakia?
We know less than a thousand people. Some parts are abroad, for example in the Czech Republic and the United Kingdom. There is still a group of people that we do not know and want to address. But we do not know how many of them are.
How to Treat HIV Positive?
Approximately eight hundred people. A great majority, of course.
Lately, the number of HIV positive people has increased. Why?
One of the causes is more risky behavior. This virus appeared in the 1980s and at that time the situation was such that when it got it, it was immediately clear that it would die. People are scared. Now they know that there is effective treatment, so they are less afraid. This can lead to more risky behavior and thus a greater likelihood of getting HIV.
So, because of the progress of medicine, are people less afraid of some diseases?
Yes, we can say so.
Has prevention been lost in Slovakia?
I do not think the state has failed. Prevention must be at the level of each person. In Europe, Slovakia is a country with a low HIV virus, so we feel good. Our endeavor as an expert is to influence other doctors before to think about when a patient with certain symptoms comes in.
Some groups are strictly against sex education in schools. Is this the right attitude?
HIV is only one of the sexually transmitted infections. There are still many other diseases, such as hepatitis, syphilis, gonorrhea, HPV. So this question is broad. Of course, we should not miss the education of young people in schools. Promoting healthy sex life is in place.
When the patient does not heal, he goes to death
Is it possible to generalize what people are positive about HIV in Slovakia?
In Slovakia, homosexual men are the most common. In anal contact, the risk of transmission of the infection is greater, therefore they are more risky. Of course, there is a risk of classical sexual intercourse. But in this group there are different people from different social groups who can not be completely simplified.
What threatens those who are not treated?
This is absolutely clear. If the patient does not heal, he may have a good time for some years and will not notice anything. But his immunity is gradually exhausted. This can cause severe infection or cancer. It's inevitably going to death. The question is only the time at which death occurs and depends on the patient. It depends on genetics or type of virus. The fact is that when a person is not dealt with, he is threatened with a serious illness and thus death. But even at a later stage, the patient has a hope for rescue.
What is the difference between HIV and AIDS?
AIDS is the final stage of HIV infection. If he is being treated with an HIV positive hospital, he is unlikely to come to AIDS. So, HIV is not the same as AIDS.
Our goal is for people living with HIV to live a normal life
What does the treatment of HIV look like today?
Significant progress has been made in the treatment of HIV in the past twenty years, and now it looks different. The patient takes a lot of medicines, usually with a combination of three medicines. Today, we can hide all three drugs in one tablet. The majority of patients we already have on one tablet, which are regularly taken, efficacy and tolerance are excellent. The profile of side effects is significantly lower than in the 1990s.
What does the normal life of a person with HIV mean?
Theoretically, they can do everything that healthy people do. In fact, our goal is to get involved in the company and perform the work that was done before. Naturally, patients with HIV are under the strictest control of doctors, they regularly go on blood tests and examinations. We strive for normal social and family life without restrictions. Of course, certain restrictions in sexual life must be more careful when they are damaged. Otherwise they have a completely normal life.
Do doctors have a duty to inform? Do all doctors have to say that HIV is positive?
Yes. All doctors should notify. For example, dentists come into contact with blood and body fluids, so they need to be notified. Similarly, all sex partners should know that they have been or are in contact with an HIV positive person.
Can doctors refuse an HIV positive patient?
Yes, and that's the problem. Most reject them when they need surgery to get their doctors into contact with blood. We already have a certain infrastructure of doctors with whom we work, and sometimes there are problems. This makes it difficult for us, but stigmatization is getting worse and gradually acting on it.
Did you see that the patient has long been looking for an expert?
Yes. But we are already a big center and here we have our doctors and we know the latest insight into the disease. They know that they do not have to worry when the patient is on treatment. In some reviews there is a problem, and then improvised. But this also applies to patients abroad.
Viruses do not tolerate hug, handshake, or saliva
How is HIV transmitted?
It's a blood-borne disease. Transmission can happen sexually. Under our conditions, transfusion virus can no longer be transmitted. Furthermore, injection syringes, which are used repeatedly, are mainly drug-taking people. Theoretically, from mother to child after blood. Within Slovakia and Europe, each pregnant woman is regularly tested for HIV. When he is found to be positive, he immediately comes to us and heals.
With a special approach during labor and postpartum, the risk of transmission of the virus to the child is significantly reduced. Theoretically, an HIV-positive woman can usually become pregnant and earn a healthy child. In Slovakia there are several such children.
People often do not know how to treat an HIV positive person. He is afraid of the virus or is afraid that the virus will be spreading in saliva. So, how is physical contact with an HIV positive person?
The saliva virus is present, but it has not been proven that it is spreading. So blood must come into contact with blood only when the virus is transmitted. With saliva, embrace manually, the virus is not transmitted. It has been proven that our patients who live in a healthy household with healthy people never infect their relatives. Of course they teach them what to do when they get hurt and bleed. But this is a situation that does not happen regularly and often.
Should HIV-positive people be more cautious?
Yes, but it depends on the patient and the rate at which the treatment begins. They are asymptomatic patients, that is what comes with HIV before they begin to manifest themselves. Such people usually have good immunity and can live as ordinary people.
Then there are people who come in the advanced stage. We vaccinate them because of some diseases, because the disease would have a worse disease. In the last stage, people have immunity in cancer patients. Similarly, a person knows what to look after chemotherapy. It is similar in people with AIDS. They must pay attention to food, to the surroundings in which they are located, to avoiding sick people or certain animals, and the like.
How old are your patients on average?
We also have those who have been here for 30 years. They're retired. In most cases, the virus is detected in a timely manner, in youth. When it comes to treatment immediately, its prognosis is essentially the same as the prognosis of the HIV negative person, which means that he is likely to live up to the age without serious HIV-related illnesses. Of course, this infection is associated with an increased risk of certain diseases, such as the heart or kidneys. We know about this and try to prevent them from preventing a true lifestyle or vitamins.
At what age do those who do not cure HIV live?
Once HIV positive people were treated as soon as they detected the virus, but waited for their immunity to be reduced to a certain level. Such treatment did not have good results and people have already died. So this also means how unharmed patients live. An unhealthy HIV positive person needs about five years to develop AIDS.
Then you can easily get cancer or other serious infections and die. However, there are cases in which such a patient can also be resolved. It depends on a particular person. It is also linked to the way of life. When a patient drinks alcohol, smokes or takes drugs, his chances of survival are lower. Current medicines for HIV have been on the market for ten years, so we do not have the exact evidence. I'll show up in a few years.
Even if the number of HIV patients is increased, the quality of treatment is not aggravated.
The problem is getting bigger. Europe is trying to stop this growth. Our goal is therefore to discover new cases and prevent further spread of viruses using treatment. But I can say that I do not currently have a patient who could not cure him.
Under what circumstances is HIV most commonly diagnosed? Do people come on their own initiative or are they more likely to happen in another?
Most patients come. They are aware that they live in danger and are being tested. Testing in Bratislava is free, anonymous, no problem. There are also options for self-testing. This group is the most common. Then there is a group of people that must be taken into account by doctors – people before surgery or pregnant women. They will be tested for HIV, and in some cases HIV may occur.
Then there are symptoms that every doctor should think. When a patient appears to be a patient, it should be tested for HIV. The latest diagnosis is already in the final stage of the worst diseases.
You can test the anonyms for free
What are the main symptoms of HIV?
Two to four weeks after infection, the patient may have flu, rash, mouth ulcers. The most ideal thing is that at this stage we get a patient. But only those who know that they are in danger will come to this. Those who do not think about HIV with these symptoms. Gradual impairment of immunity begins at a higher level. The patient receives several infections, such as pneumonia, shingles, fever, slender, swollen nodules. The last phase of AIDS is reflected in blood cancer or an infection that does not threaten common people, but it can kill people with HIV.
Not many people think about HIV for the first time. In some people, mouth ulcers are common.
Yes, but atypical apps, for example, last longer. Or, the patient gets a flu from the flu. When a person knows that he has a risky behavior, he must consider it. However, it is clear to me that we can not cover all people. We are also trying to influence experts to think about it.
When a person chooses to go for HIV tests, what is the option?
In Bratislava we have AIDS Center at the Slovak Medical University, where they are tested free of charge and anonymously. They are also called. Checkpoints where you can also test anonymously, mostly from a drop of blood. You can also buy tests in the pharmacy that detect the presence of HIV in saliva. These methods are sufficiently sensitive that they are highly likely to catch the virus. Once this is confirmed, you should consult your doctor for a detailed blood test to confirm or opt out.
Is it recommended that a person try risky behavior?
Yes. The antibodies start to form within a few weeks, until the virus is seen in the blood. Ideally, about a month after risky behavior, testing would take place. If the results are negative, testing is repeated for three months or half a year to confirm this. refuted.
Abroad, patients with bone marrow transplantation can completely reject HIV. Can HIV be treated in this way?
This will not be the method with which we go. Bone marrow transplantation itself is a risk interventions in which the patient can die. This patient was bone marrow transplanted due to other oncological diagnosis. It followed more or less coincidence. The bone marrow donor had a mutant type of receptor, which caused HIV to become "able to hold" in the cell and become resistant to HIV.
Such people are present in a small percentage of the population. We even have a small group of people who get HIV, but without medicines they can stay safe because of their genetic equipment. They are called elite controllers. I can control the virus myself. Research on the complete cure of HIV is still ongoing. The right way to treat is quite long, but I do not think bone marrow transplantation will be the case. Gene therapy is more likely.