Phuket has biggest list of HIV/Aids patients

Meanwhile, the Public Health Ministry is considering changing the formula of the anti-retroviral drugs after the World Health Organisation (WHO) warned countries of the bad side-effects from Stavudine (d4t).

Dr Pongsawat Rattanasaeng, public health chief in Phuket, reported that from 1989 until October 31, the province had 6,648 people living with HIV/Aids mostly aged between 25 and 39, and that 1,767 of them had died.

On a per-100,000 basis, Phuket ranked the highest in the number of HIV/Aids patients because it was a tourist destination with more than 7,000 sex workers, he said, adding that authorities need to beef up prevention campaigns.

WHO yesterday recommended not to use Stavudine (d4t) after a study discovered that the drug caused adverse side-effects and affected the neurological system.

Paijit Warachit, permanent secretary of the Public Health Ministry, said WHO has suggested that medical authorities use Zidovuine (AZT) or Tenofovir instead.

WHO also recommended that HIV patients, especially pregnant women, start taking the anti-retrovirals when CD4 cell count dropped below 350 cells per cubic centimetre. Earlier, WHO had been advising that HIV patients be put on the anti-retrovirals once their CD4 cell count fell below 200, but studies show that most of these people already had full-blown Aids.

Meanwhile, pregnant women with HIV were recommended to start taking their anti-retroviral drugs when they are 14 weeks into the pregnancy and should only breastfeed their babies for one year. Both mother and baby should be medicated to lower the risk of virus transmission.

At present, Thailand uses two anti-HIV drug cocktails - the GPO-VIR, which comprises Stavudine, Lamivudine and Nevirapine; and the GPO-VIR Z comprised of Zido-vudine, Lamivudine and Nevirapine.

Both formulas are available at hospitals nationwide.

Paijit said the Public Health Ministry would next year change prescription guidelines for the anti-retroviral drugs, and ensure that people living with HIV are given the medication when their CD4 cell count goes below 350.

Dr Somyot Deerasme, director-general of the Health Department, said his department had also called for a change in the anti-retroviral drug formula to prevent transmission from mother to child. This new formula will be tried out in 11 provinces before it is made available nationwide, he said.

Mothers with CD4 cell counts that are lower than 350 will be given AZT, Lamiduvine and Nevirapine, while those with cell counts above 350 would get AZT and Nevirapine. Their babies will be given formula milk 18 months as well as an anti-retroviral to prevent mother-to-child transmission.