Hello,the history is inadequate . This is something we usually don't get --in a discordant situation-the husband is negative and the wife is positive. The probability of transmission of
HIV from infected mothers to children is almost 30 % .It is a matter of great satisfaction that her husband and two babies are negative ,but you have not mentioned , when all these three people were tested negative. If the children are above the age of 18 months and subjected to HIV testing which has come negative , they are for sure --negative children. Husband problem is a different one --how this couple are engaging in sex -protected or unprotected, as the woman in question is indulging in some serious high risk activities including
drug abuse and multiple partners.
It is not clear what is her CD4 count and
Viral load -- to judge her status of immuno-suppression (which is evident from repeated oral thrushes (a stage 3 illness she is having and still not on ART ). It is again not clear --how long she is positive.
All these variables do have a bearing in deciding the advent of 'full blown AIDS' to her and it will be very difficult to predict to when will she become a case of 'Full blown AIDS', though she is already suffering from stage 3 illness(
Oral Candidiasis ) and all stage 4 illnesses are full blown AIDS illnesses
It is your duty to persuade her to go to an ICTC , where ,after testing they can refer her to ART centre so that her anti AIDS medicines could be started as soon as possible . Initiation of ART is paramount to the patient as this will keep her less infectious for her husband too.
Keep me posted.
Dr Matin .A. Khan
MBBS, MPH, MMSc (HIV Med) PhD
M.A (Sociology) , M.Sc(Psychology), M.Sc(
Counselling &
Psychotherapy)
Fellowship in HIV Medicine (School of Tropical Medicine Kolkata, India)
AAHIVS ( American Academy of HIV Medicine USA)
Galen Exam for Certificate of Clinical Competence in HIV Medicine from IAPAC USA
MGM Medical College , Jamshedpur , India