HIV Virus - Acquired Immunodeficiency Syndrome AIDS

The immunodeficiency virus or HIV is the virus that causes Acquired Immunodeficiency Syndrome (AIDS), a disease in which the immune system begins to fail, leading to life-threatening possible infections. AIDS was first recognized in 1981 in Los Angeles when 5 cases of Pneumocystis carinii pneumonia in homosexual men were reported to the Centers for Disease Control and Prevention (CDC). HIV is believed to have originated in Central Africa in the 1950s and subsequently spread via the Caribbean to the United States, Europe, and the rest of the world. HIV is a Lentivirus (or slow viruses), a subgroup of retroviruses. This family of viruses is known for latency, persistent viremia, infection of the nervous system, and weak host immune responses. An infection with a lentiviruse presupposes an interval -- sometimes years -- between the initial infection and the onset of symptoms. Upon entering the bloodstream -- through mucous membranes or blood-to-blood contact -- HIV infects the CD4+T cells and begins to replicate rapidly. Two types of virus are known to affect humans; HIV-1 causes AIDS and is found worldwide, and HIV-2 has been isolated from some African cases of AIDS.

The HIV virus is transmitted primarily by exposure to contaminated fluids, especially semen and vaginal secretions (70% of all HIV infections). It has also been isolated in blood, cerebrospinal fluid, breast milk, amniotic fluid, cervical cells, and bronchioalveolar lavage fluid. HIV has been found at low concentrations in the saliva, tears and urine of infected individuals, but the risk of transmission by these secretions is negligible. HIV is spread by sexual contact with an infected person, by sharing needles and/or syringes (primarily for drug injection) with someone who is infected, or, less commonly (and now very rarely in countries where blood is screened for HIV antibodies), through transfusions of infected blood or blood clotting factors. Babies born to HIV-infected women may become infected before or during birth or through breast-feeding after birth.

It has been scientifically demonstrated that HIV is NOT transmitted through casual contact like touching or sharing towels, bedding, utensils, telephones, swimming pools, or toilet seats. Scientists have also found no evidence of transmission through kissing, sweat, tears, urine or feces.

Persons already infected with a sexually transmitted disease are more susceptible to acquire HIV during unprotected sexual contact with an infected person.

As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics (a global epidemic) in recorded history. In 2005 alone, AIDS claimed an estimated 2.4-3.3 million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries. 

SIGNS AND SYMPTOMS 

The symptoms of an HIV infection diverse, ranging from an acute syndrome associated with primary infection to a prolonged asymptomatic state to advanced disease. HIV disease can be divided empirically based on the degree of immunodeficiency into (1) early stage (CD4 T-cell count >500/L), (2) intermediate stage (CD4 cell count 200-500/L), and (3) advanced stage (CD4 cell count <200/L). The third stage of HIV infection has been given a variety of names, including pre–acquired immune deficiency syndrome (AIDS) and AIDS-related complex.

The time from initial infection to clinical disease is highly variable, with a median time of approximately 10 years.

During the first two to four weeks of infection the virus migrates to various organs in the body, particularly the lymphoid organs, which may cause flu-like symptoms and enlarged lymph nodes. During this period people are highly infectious and HIV is present in large quantities in genital secretions.

Acute HIV infection affects the lymphatic system, skin, gastrointestinal system, genitourinary system, bone marrow, and neurologic system. Symptoms of acute HIV infection include persistent generalized lymphadenopathy (disease or swelling of the lymph nodes), thrush, pharyngitis, herpes simplex virus, rash, anaemia, thrombocytopenia (a low platelet count), primary neurological manifestations due to HIV infection, and secondary due to opportunistic infections, neoplasms (new abnormal growth of tissue) or other.

A strong immune defense reduces the number of viral particles in the blood stream, marking the start of the infection's clinical latency stage. This clinical latency can last from two weeks up to 20 years. During this early stage of infection HIV is active within lymphoid organs.

According to the Centers for Disease Control and Prevention, the following are symptoms that may be warning signs of HIV infections:

• Rapid weight loss

• Dry cough

• Recurring fever or profuse night sweats

• Profound and unexplained fatigue

• Swollen lymph glands in the armpits, groin or neck

• Diarrhea that lasts for more than a week

• White spots or unusual blemishes on the tongue, in the mouth or in the throat

• Pneumonia

• Red, brown, pink or purplish blotches on or under the skin or inside the mouth, nose or eyelids

• Memory loss, depression and other neurological disorders

The most severe manifestation of HIV infection is AIDS. Left untreated HIV progresses to AIDS in nine to ten years, and the median survival time after developing AIDS is 9.2 months. Nevertheless, the range of clinical disease progression varies widely between individuals from two weeks up to twenty years. The rate of progression can also be influenced by certain factors that influence the body's ability to defend against HIV like age, poor access to health care, coexistent infections such as tuberculosis, the genetic inheritance, etc.

The symptoms of AIDS are mostly the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages. They are known as opportunistic infections. This means that an infection takes the “opportunity” provided by the weakened immune system to cause an illness that is usually controlled by a healthy immune system. These infections are sometimes life-threatening and require medical intervention to prevent or treat serious illnesses. Persons living with advanced HIV infection suffer opportunistic infections of the lungs, brain, eyes and other organs.

People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas. They often have systemic symptoms of infection like fever, sweat (particularly at night), swollen glands, chills, weakness, and weight loss.

The major opportunity diseases are Pneumocystis jiroveci pneumonia, tuberculosis (TB), esophagitis, unexplained chronic diarrhea, toxoplasmosis, AIDS dementia complex, cryptococcal meningitis, cytomegalovirus (CMV), infections with Mycobacterium avium-intracellulare, penicilliosis, etc.

Because HIV symptoms are often not present upon infection with the HIV virus, it is important you go for HIV testing if you think you have been exposed to the virus. 

TREATMENT 

Currently there is no vaccine or cure for HIV or AIDS. The only known methods of prevention are based on avoiding exposure to the virus or, failing that, an antiretroviral treatment directly after a highly significant exposure, called post-exposure prophylaxis (PEP). PEP has a very demanding four week schedule of dosage. It also has very unpleasant side effects including diarrhea, malaise, nausea and fatigue.

The treatment for HIV consists of highly active antiretroviral therapy or HAART. The optimal HAART options consist of combinations of at least three drugs belonging to at least two types: two nucleoside analogue reverse transcriptase inhibitors (NARTIs or NRTIs) plus either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI). Still, there are cases when, for some patients HAART achieves far less than optimal results due to medication intolerance/side effects, prior ineffective antiretroviral therapy and infection with a drug-resistant strain of HIV. Measures to prevent opportunistic infection are beneficial to patients infected with HIV or AIDS. 

PREVENTION 

The male and female condoms are the only ones which can reduce the risk of HIV infection during sexual intercourse. The effective use of condoms and screening of blood transfusion in North America, Western and Central Europe is credited with contributing to the low rates of AIDS in these regions.

The male latex condom, if used correctly without oil-based lubricants, is the single most effective available technology to reduce the sexual transmission of HIV and other sexually transmitted infections. Petroleum jelly, butter, and lard are not be used with latex condoms as they weaken the latex, making the condoms porous. If necessary, use water-based lubricants.

The female condom is an alternative to the male condom and is made from polyurethane, which allows it to be used in the presence of oil-based lubricants. They are larger than male condoms and have a stiffened ring-shaped opening, and are designed to be inserted into the vagina. The female condom contains an inner ring, which keeps the condom in place inside the vagina – inserting the female condom requires squeezing this ring.

The United States government and health organizations both endorse the ABC Approach to lower the risk of acquiring AIDS during sexual intercourse: 

• Abstinence or delay of sexual activity, especially for youth

• Being faithful, especially for those in committed relationships

• Condom use, for those who engage in risky behavior

Condom use is an integral part of the CNN Approach: 

• Condom use, for those who engage in risky behavior

• Needles, use clean ones

• Negotiating skills; negotiating safer sex with a partner and empowering women to make smart choices

Drug users are advised not to share needles and other material required to prepare and take drugs (including syringes, cotton balls, the spoons, water for diluting the drug, straws, crack pipes, etc).

In order to prevent mother-to-child transmission scientists recommend antiretroviral drugs, caesarean delivery and formula feeding.

Sexually Transmitted Disease STD       HPV HPV and HPV Vaccine HIV AIDS HIV AIDS Epidemic Among Men Who Have Sex With Men Among Women Who Have Sex With Women Mother To Child Transmission