Julia Granchi from the BBC News Brazil in Sao Paulo
Published on 08/28/2022 10:21
In 2015, Vitor Ramos, at the time a student in management, began experiencing flu-like symptoms. “It was just a sore throat and mild discomfort. Who can relate that to HIV?” , asks him, who received the diagnosis only three years later.
The hypothesis took a long time to come up with, Vitor says. “I thought I had never had a sexual relationship with someone who had the virus, because in my opinion that person would be bedridden and very weak,” he says.
Two years after the more general signs appeared, in 2017, Vitor developed severe diarrhea that made him lose about 20 kilograms and went to eight hospitals in search of a diagnosis in the city of Aracarigoma, where he lived in the interior of São Paulo. and in neighboring municipalities.
“The gastroenterologist ordered a colonoscopy, which came inconclusive for Crohn’s disease [uma doença inflamatória do trato gastrointestinal], the main doctor’s suspicion. However, he decided to treat me as if I had the painting,” he recalls.
“At that time, my mother even asked: ‘Doctor, right? Because HIV is still very much associated with homosexuals.”
In fact, infection with the virus can happen to anyone, regardless of their sexual orientation. HIV is found in secretions (fluids) such as blood, semen, vaginal secretions, and breast milk. This is why it is always recommended to use condoms during sex, and for HIV-positive mothers to feed their babies with infant formula.
In addition to the misdiagnosis, the doctor who attended Vetor prescribed an immunosuppressive drug, effective in treating Crohn’s disease, but extremely harmful for those living with HIV.
“Immunosuppressive drugs can work by weakening different parts of the immune system depending on the drug being prescribed. Considering a patient who already has impaired cellular immunity, if they use a drug that worsens immunity, there is a risk that they will become very susceptible to opportunistic infections, which in Sometimes HIV alone will not be enough to cause,” notes Acre infectious disease specialist Dyemison Pinheiro, who has not followed up on Vitor’s case.
“Since the day I started taking the medication, the deterioration has been very fast. I say I went down a steep, steep slope. I started walking slowly, the diarrhea didn’t stop, and I only stayed home because I might need a bathroom anytime. I had to quit college,” he recalls. Vitor.
As the condition became increasingly serious, his family insisted that they seek an emergency room. “I tried to hide it by saying I’m fine. But one day, my sister arrived determined to pick me up. I walked into the car, and when we got to the hospital, I couldn’t feel my leg anymore. A security guard pulled me out and I stayed in the chair. On wheels. There, I felt something was wrong. Extremely “.
On this day, April 8, 2018, Vitor was diagnosed with HIV.
The number of CD4 immune cells in her body was very low. For comparison, the indicator in a healthy person should be higher than 500. When it is less than 350, this indicates that the person has AIDS. Vettor’s CD4 cell count at the time of diagnosis was 2.
“With treatment, it is possible to improve the number, but the indicator does not take into account the immune recovery. Some people have important qualitative defects in the defense cells, and therefore, there are researchers who advocate that, as soon as the number is less than 350, a person will always have AIDS ” Pinero explains.
In the first week of hospitalization, Vitor remembers only flashes. The thing that distinguished him was a conversation he overheard from the doctors, who said that they would not cure HIV at first, as there were other opportunistic diseases that made his body weak.
In addition to HIV, tests have found neurotoxoplasmosis (an infection of the central nervous system), Kaposi’s sarcoma (cancer that affects the inner layers of blood vessels), the sexually transmitted infection syphilis and HPV.
“Although HIV is dangerous, it may not be the main condition responsible for death. Because of the increase in medication, in the case of various opportunistic infections, it is best to focus on what presents more risks,” Pinheiro points out.
In all, Vitor spent four months in the hospital, including two periods in the intensive care unit (ICU).
“I lost movement in my legs and arms and was dependent on others for everything. My body was hurting so much, and one night I started seeing everything red. That was when they took me to the ICU for the second time. There, I had no visitors, look at the ceiling and no I move. I just heard voices of people dying or the whistling of machines. These were very difficult days,” he recalls.
The first discharge occurred about three months later, but after a week of taking the drug at home for the supposed treatment of conjunctivitis, Vitor lost sight in one eye.
Back in the hospital, an ophthalmologist specializing in AIDS diagnosed the presence of CMV in the eye (an infection caused by a virus in the herpes family) and recommended urgent hospitalization.
“I didn’t want to go back at all, I cried a lot, but I was admitted to the hospital. I also continued physiotherapy, and to help me get my movements back, my mother put a towel under my plate and asked me to try to make the meal on my own. I looked like a kid who soiled everything, but little by little, I managed than doing so,” he says.
“In my months in the hospital, I’ve lost independence, freedom, and privacy. My father asked me, ‘What’s the first thing you want to do when you leave here?'” Travel, go to the mall… “And I answered that I wanted to take a shower. Standing alone. He was surprised.”
Vitor says his whole family was very affectionate and necessary during the treatment. “If today I spoke openly about living with HIV on social media and encouraged others to get tested, it was only because I had a very strong support network.”
Physiotherapy sessions to restore movement were excruciating. “When the nurses came, I pretended I was asleep so I wouldn’t have to go through the exercises, which I didn’t think helped me at all. More excited.”
From a wheelchair, Vitor began using a walker, then a pair of crutches, and finally, he walked with the help of a cane—a development that took a year.
When he was discharged, his CD4 count was 40, a number that is still considered very low. Therefore, the condition of his return home was that he return to the hospital every day for intravenous treatment.
“They said I wouldn’t go over 200, and my condition was very serious. Those were very difficult days. The drugs took away my strength.” In the last two tests, his CD4 was over 470.
Although the rate does not indicate that he has been cured, it shows a good response to treatment, which Vitor says he follows literally to this day, with the medications he gets at SUS.
In addition, shortly after the start of treatment, Vitor reached the stage of undetectable HIV, that is, he does not transmit the virus sexually (even without protection).
According to infectious disease specialist Dyemison Pinheiro, it is entirely possible that, even in severe cases such as Vitor, where people have irreversibly partial immunity, it is still possible to reach an undetectable level of HIV as treatment progresses – there Unrelated factor.
He plays sports regularly, in the gym or plays volleyball with his family, he finished university and recently got a job.
“Because of a late diagnosis that took almost three years, AIDS made me lose vision in my right eye, part of my hearing, and it caused me to suffer with the consequences of a certain delay in the movement of my left leg. But I feel much better, I think my recovery has been very good, and today I live Well “.
On social media, Vitor encourages other men and women to seek a test before the virus spreads in the body. “If I could go back in time, that would be the advice I would give myself. I will also talk about looking for the virus and not be influenced by what anyone says. There is life after diagnosis,” he says.
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