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In reference to your editorial (Ref BMJ 2009; 338:b1460, published
15/June/2009),I am writing to you to let you know that the subject you
have raised in this article is critical especially in the low resource
countries like one I come from. Indeed, as you rightly put it forward in
this article, HIV infection among this group (older individuals) is on
increase and something has to be done in order to arrest the situation.
Questionably, is the choice of treatment the best one in this group? The
unfortunate bit is the efficacy and potency of the HAART in the older
patients that needs to be explored.
It is quite evident that older people are a neglected group in
developing countries because of the picture of the population pyramid,
where older population is at the tip of the pyramid. Geriatrics as a
subject and specialty in developing countries has not been embraced and
not a priority. One reader may wonder “what’s all the fuss about older
people and HIV treatment?”
Well, the “fuss” is already well explicated in this editorial.
Already there is evidence of HIV rates increasing in more married couples
than the youths in many African countries.
Iam entirely in support with most of your recommendations but the
issue of viral load criteria for commencement of HAART is an issue that
really needs reconsideration. This is simply because of its existence in
many policy and protocol documents of different countries and
additionally, training in use of viral load for HAART has already reached
at community level. Changes in protocols will lead to confusion
consequently compromising health provision.
This is why it will be beneficial to go through the process of
awareness training and the benefits as well as setting standards to be
followed in terms of age. I join your efforts to make this possible for
the improvement of therapies in this group.
HAART and Older group
Dear Editor,
In reference to your editorial (Ref BMJ 2009; 338:b1460, published
15/June/2009),I am writing to you to let you know that the subject you
have raised in this article is critical especially in the low resource
countries like one I come from. Indeed, as you rightly put it forward in
this article, HIV infection among this group (older individuals) is on
increase and something has to be done in order to arrest the situation.
Questionably, is the choice of treatment the best one in this group? The
unfortunate bit is the efficacy and potency of the HAART in the older
patients that needs to be explored.
It is quite evident that older people are a neglected group in
developing countries because of the picture of the population pyramid,
where older population is at the tip of the pyramid. Geriatrics as a
subject and specialty in developing countries has not been embraced and
not a priority. One reader may wonder “what’s all the fuss about older
people and HIV treatment?”
Well, the “fuss” is already well explicated in this editorial.
Already there is evidence of HIV rates increasing in more married couples
than the youths in many African countries.
Iam entirely in support with most of your recommendations but the
issue of viral load criteria for commencement of HAART is an issue that
really needs reconsideration. This is simply because of its existence in
many policy and protocol documents of different countries and
additionally, training in use of viral load for HAART has already reached
at community level. Changes in protocols will lead to confusion
consequently compromising health provision.
This is why it will be beneficial to go through the process of
awareness training and the benefits as well as setting standards to be
followed in terms of age. I join your efforts to make this possible for
the improvement of therapies in this group.
Sincerely,
Godfrey Katende
Dept of Nursing, Kampala, Uganda
Katendeg@yahoo.com
Competing interests:
None declared
Competing interests: No competing interests