NUH offers early treatment for newly diagnosed HIV patients

It is first hospital to cut wait time to up to 4 days from up to 8 weeks

The National University Hospital started the same-day antiretroviral therapy programme for HIV patients on Sept 1.
The National University Hospital started the same-day antiretroviral therapy programme for HIV patients on Sept 1.ST PHOTO: MARK CHEONG

Patients who are newly diagnosed with the human immunodeficiency virus (HIV) will no longer have to wait up to eight weeks before starting treatment.

Instead, waiting time for treatment with life-saving antiretroviral medication has been cut to up to four days.

The National University Hospital (NUH) is the first hospital to start the same-day antiretroviral therapy (ART) programme, which began on Sept 1 at the hospital's Multidisciplinary Infectious Diseases Clinic.

Dr Dariusz Piotr Olszyna, HIV programme director at NUH, explained that obtaining early treatment will help to reduce the anxiety of newly diagnosed patients and also lower the risk of HIV transmission in the community.

This programme will bring NUH closer to its goal of ending the HIV epidemic in Singapore by 2030, he added.

The first patient was enrolled last Tuesday.

Speaking to The Straits Times on condition of anonymity, the patient relayed feeling positive and less anxious after taking the medication, and hoped to achieve the target result of an undetectable viral load as soon as possible.

Dr Olszyna, who is also head and senior consultant at the division of advanced internal medicine in NUH, advised those who are sexually active to go for regular HIV tests as testing is the only way to determine if they have been infected.

"People who should be offered regular testing are those who have multiple sexual partners, men who have sex with men, people who pay or are paid for sex, people who inject drugs and sexual partners of all these individuals," said Dr Olszyna.

The frequency for HIV tests depends on the number of sexual partners.

Some may need to be tested every three months, Dr Olszyna said. It takes on average about two to four weeks for symptoms of an acute HIV infection to develop, but for some patients it may be months before signs of an infection show up.

  • 96 Number of hours within which patients will be offered an appointment at the HIV clinic in NUH after receiving a positive screening test.

  • 323 Number of new cases of HIV infections reported among Singapore residents last year.

Currently, individuals who suspect that they might have contracted HIV can get tested at anonymous testing clinics, polyclinics or the hospital.

A screening test is first taken, and if the result is reactive - suggesting a positive diagnosis - the blood sample undergoes confirmation testing.

Screening test results are generally available on the same day, but the confirmation test can take up to two weeks to produce a result. This wait time often leads to much anxiety.

Patients who have a positive diagnosis from the screening test can request to be enrolled under the new programme. They will be referred to the HIV clinic in NUH and offered an appointment within 96 hours of the positive screening test.

While waiting for the confirmation test results, they will receive a comprehensive assessment and also counselling.

These patients will also be given the option to start ART before their confirmation test results are out.

ART helps HIV-positive patients suppress their viral load till it reaches a stage where it becomes "undetectable" - a level so low that current testing methods are unable to detect the virus in the blood.

Those with undetectable viral loads are said to be unable to transmit the virus to their sexual partners.

The therapy allows people living with HIV to have virtually the same life expectancy as those without HIV, Dr Olszyna stressed.

"It is great news for the general population especially if they have family, friends, or a spouse who is HIV positive and experiences anxiety while waiting for treatment.

"They can be assured that their loved ones are taken care of by our doctors and continue to live normally once the treatment is initiated."

Most people infected with the virus will have significant symptoms only after they reach the more advanced stages as the symptoms of acute HIV are often missed, because they resemble other common viral infections.

These symptoms include headaches, fatigue, sore throats, night sweats and a loss of appetite.

According to the Ministry of Health, there were 323 new cases of HIV infections reported among Singapore residents last year. This brings the total number of HIV-infected Singapore residents to 8,618 as at end-2019, of whom 2,097 have died.

The number of new HIV cases among Singapore residents has been between 400 and 500 per year from 2007 to 2017 and about 310 to 330 in 2018 and last year.

The public can find out more information on the programme by contacting the team at nuh_midc @nuhs.edu.sg or dialling 9186-2310.

A version of this article appeared in the print edition of The Straits Times on November 09, 2020, with the headline 'NUH offers early treatment for newly diagnosed HIV patients'. Print Edition | Subscribe