Current Status of Research on HIV Epidemic, Pathogenesis, Management and Prevention in India

The Indian HIV epidemic has not reached the predicted proportions even after more than 25 years since the first case of HIV infection was detected in Chennai. An estimated 2.4 million adults were living with HIV in 2009 and an adult prevalence of HIV was 0.3%. The disease burden is geographically diverse and has spread to rural areas also. HIV viruses circulating in India predominantly belong to HIV-1 subtype C although recombinant strains and HIV-2 infections have been identified. Tuberculosis is the commonest opportunistic infection reported from various parts of the country and HIV-TB co-infection is a public health challenge. Government of India launched free antiretroviral treatment (ART) programme 6 years back which has shown good clinical and immunological response in HIV infected individuals. Though the drug resistance monitoring survey has reported effectiveness of regimen in the programme, adherence remains the key issue for minimizing the drug resistance. In addition to the ongoing prevention efforts, India should be poised to accept and scale up newer preventive tools in a manner acceptable and feasible in our socio-cultural context in order to sustain and consolidate the gains that we have achieved so far.