30. When the treatment for HIV is initiated in a patient presented with tuberculosis? Anti-retroviral Therapy (ART) is usually started as soon as the patient starts tolerating treatment for tuberculosis. 31. What do we mean by “window period” in HIV infection? The period from the time the virus enters the human body until detectable levels of HIV speci ic antibodies appear is called the 'window period' or 'acute infection phase.' During this period, an individual is infected and is also infectious to other individuals. Antibody levels are not detectable during this phase of the infection, rendering the person sero - negative, i.e., tests for detecting HIV antibodies are negative. The time frame of this period ranges on average from 3 weeks to 3 months. During the window period for detection, the p24 (Gag) protein is used as a diagnostic test for HIV infection. However, PCR is the test of choice since the p24 antigen detection test is relatively less sensitive. The use of 4th generation screening kit in which both HIV antigen (p24) and both antibodies, IgG and IgM are detected have the advantage of further reducing the window period. 32. Whether thalassaemia patients are prone to HIV infection? Children with thalassemia are at risk to HIV infection because they receive multiple blood transfusions. Prevalence of HIV infection in thalassemia varies greatly worldwide, from less than 1% to more than 20%. The risk of transmission of HIV due to blood transfusion may be alarming due to high seroprevalence of anti HIV–1 viz; 0.5% in blood donors. Patients with a HIV Positive report must be referred to the nearest ART centre for care, support and treatment. MEDICAL DIMENSION OF FREQUENTLY ENCOUNTERED CASES | 38

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