Chemotherapy Of Sexually Transmitted Diseases(AIDS)

All most any communicable disease can be sexually transmitted during sexual contact.In modern times,the Sexually Transmitted Diseases (STD) have reached epidemic proportions in the Western societies and in india also,though we do not have stastistical data available.STD are on the increase.The devastating disease,Acquired Immune Deficiency Syndrome (AIDS) has drawn international attention.The risk of contacting STD andAIDS depends on the number and nature of sexual partners and the type of sexual contact.Sexually active young and unmarried individuals,homosexuals (gay-man) with multiple partners and those in the lower educational and socio-economic stastus are at high risk in acquring such diseases.
Acquired Immune Deficiency Syndrome(AIDS)
AIDS is a complex viral diseases due to a defect in the immune system.Because of the immune deficiency the patient becomes susceptible to serious infection caused by bacteria,fungi,viruses and other parasites.AIDS is caused by human immunodeficiency retrovirus (HIV) or lymph-adenopathy-associated virus (LAV). The virus can be transmitted both heterosexually or homosexually. Although the virus dose not invariably cause AIDS, in patients who develop the disease,it takes 6 months to 6 years or more for the development of AIDS symptoms.In india the firstHIV seropositive individuals was detected in 1986 and since then the HIV prevalence in our country has increased from 0.2% in 1986 to approximately 0.7% in 1994.It is estimated that about 0.61 million persons are infected in india and by turn of the 20th century nearly 10 million or more people would infected with this virus.
The diseases has attained alarming proportions,mainly because of free sex and increased mobility of the society.The young adults in cities like Mumbai and Delhi are at higher risk of contacting the disease.The disease is commonly seen in homosexually and bisexually actives males,intravenous drug abusers, hetrosexual partners of the above groups, haemophilics and other recipients of blood or blood components and infants of infected mother.The HIV virus is a transmitted during the intimate contact with infected body fluids such as blood,semen,saliva,urine and faeces or by exposure to infected blood as in the use of infected drug injection needles by addicts or by receiving an unscreened blood transfusion.

SYMPTOMS
Most of HIV infected individuals are asymptomatic and are capable of carrying out their usual daily activities.In active disease,there is occurrence of the symptoms such as feeling of fatigue,fever,loss of appetite,weight loss,diarrhoea.night sweets and lymph gland enlargement.About 85% of AIDS patientsdevelop either pneumonia(a parasitic infection of lungs) or a cancer (Kaposi’s sarcoma).The mortality rate in AIDS is very high (33% to 100%) depending up on the infection and length of exposure to the diseases.

TREATMENT
Zidovudine(ATZ,Retrovir) is an inhibitor of the reverse trancriptase enzymes of HIV virus. The recommended oral dose is 200mg every 4hr around the clock. The side effects associated with ATZ treatment are mainly haematologic toxicity including granulocytopenia and severe anaemia requiring blood transfusion.Blood picture should be periodically monitored. Use of other drugs which effects blood picture, nephotoxic and cytotoxic drug along with ATZ may increase the risk of toxicity.The quality as well as survial rate in AIDS patients who are on Zidovudine has increased,it is not a cure for AIDS and AIDS patients continue to be susceptible to infections although it prolongs life and reduced morbidity.Side effects of Zidovudine are headache, agitation, insomnia, diarrhoea, rashes and fevers.Morrow serious side effects are bone marrow depression , server anaemia, granulocytopenia and even thrombocytopenia.Other dtugs used for this disease are didanosine, Zalcitabine and stavudine.
Didanosine has efficacy against zidovudine-resistant strains in vitro.Thus, switching to didanosine after a period of zidovudine threapy has been shown to be beneficial. It is administered in a dose of 125-200 mg twice daily. The adverse effects includes peripherl neuropathy and fatal pancreatities. Zalcitabine is used in combination with zidovudine. The recommened dosage is 0.75 mg zalcitabine with 200 mg zidovudine ecery 8 hours.Zalcitabine causes painful sensory and motor peripheral neuropathy.Patient is advised to seek expert medical care for this before treatment is started.

SAFETY PRECAUTIONS
1. Know the sexual background and habbits of partners, and to stop sexual relationship if the partner is high risk patient.
2. Use of condoms which prevent the entry of the virus into the blood stream and the use of spermicide such as foams, creams or tablets.
3. Avoid sexual practices that may injure bodily tissues,example – anal intercourse.
4. Avoid the use of unprescribed intravenous drugs and do not share needles of syrunges as they are likely sources of infection.