^ Jump up to: a b Kurth, AE; Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN (March 2011). “Combination HIV prevention: significance, challenges, and opportunities”. Current HIV/AIDS reports. 8 (1): 62–72. doi:10.1007/s11904-010-0063-3. PMC 3036787 . PMID 20941553.
Scientists suspect the simian immunodeficiency virus (SIV) jumped from chimps to humans when people consumed infected chimpanzee meat. Once inside the human population, the virus mutated into what we now know as HIV.
Several classes of antiretroviral drugs are used together to treat HIV infection. These drugs block HIV from entering human cells or block the activity of one of the enzymes HIV needs to replicate inside human cells and/or integrate its genetic material into human DNA.
Testing and diagnosis of HIV-exposed infants has been a challenge. For infants and children less than 18 months of age, serological testing is not sufficient to identify HIV infection – virological testing must be provided (at 6 weeks of age, or as early as birth) to detect the presence of the virus in infants born to mothers living with HIV. However, new technologies are now becoming available to perform the test at the point of care and enable return of the result on the same day to accelerate appropriate linkage and treatment initiation.
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Guadalupe M, Reay E, Sankaran S, et al. Severe CD4+ T-cell depletion in gut lymphoid tissue during primary human immunodeficiency virus type 1 infection and substantial delay in restoration following highly active antiretroviral therapy. J Virol. 2003 Nov. 77(21):11708-17. [Medline]. [Full Text].
Modern HIV testing is extremely accurate. A single screening test is correct more than 99% of the time.[needs update] The chance of a false-positive result in standard two-step testing protocol is estimated to be about 1 in 250,000 in a low risk population. Testing post-exposure is recommended immediately and then at six weeks, three months, and six months.
The disease usually spreads through the inhalation of infectious drops from coughs and can be transmitted easily to immune- compromised patients, including patients with acquired immune deficiency syndrome (AIDS) and human immuno-deficiency virus (HIV) infection.
Ohl ME, Perencevich E. Frequency of human immunodeficiency virus (HIV) testing in urban vs. rural areas of the United States: results from a nationally representative sample. BMC Public Health 2011;11:681. CrossRef PubMed
Consider the drug Truvada. The drug emtricitabine-tenofovir (Truvada) can reduce the risk of sexually transmitted HIV infection in people at very high risk. need to take it every day. It doesn’t prevent other STIs, so you’ll still need to practice safe sex. If you have hepatitis B you should be evaluated by an infectious disease or liver specialist before beginning therapy. You will need a blood test to check your kidney function before taking this drug.
New technologies to help people test themselves are being introduced, with many countries implementing self-testing as an additional option to encourage HIV diagnosis. HIV self-testing is a process whereby a person who wants to know his or her HIV status collects a specimen, performs a test and interprets the test results in private or with someone they trust. HIV self-testing does not provide a definitive HIV-positive diagnosis – instead, it is an initial test which requires further testing by a health worker.
Popper SJ, Sarr AD, Gueye-Ndiaye A, Mboup S, Essex ME, Kanki PJ. Low plasma human immunodeficiency virus type 2 viral load is independent of proviral load: low virus production in vivo. J Virol. 2000 Feb. 74(3):1554-7. [Medline]. [Full Text].
In 2011, HPTN 052, a study of 1,763 couples in 13 cities on four continents funded by the National Institute of Allergy and Infectious Diseases, found that people infected with H.I.V. are far less likely to infect their sexual partners when put on treatment immediately instead of waiting until their immune systems begin to fall apart. This “test and treat” strategy also significantly reduces the risk of illness and death. The data was so persuasive that the federal government began pushing new H.I.V./AIDS treatment guidelines to health care providers the following year. And in 2012, the Food and Drug Administration approved the preventive use of Truvada, in the form of a daily pill to be taken as pre-exposure prophylaxis (commonly called PrEP). It has been found to be up to 99 percent effective in preventing people who have not been infected with H.I.V. from contracting the virus, based on the results of two large clinical trials; an estimated 80,000 patients have filled prescriptions over the past four years.
Use a new condom every time you have sex. Use a new condom every time you have anal or vaginal sex. Women can use a female condom. If using lubricant, make sure it’s water-based. Oil-based lubricants can weaken condoms and cause them to break. During oral sex use a nonlubricated, cut-open condom or a dental dam — a piece of medical-grade latex.
Jump up ^ Yarchoan R, Tosato G, Little RF (2005). “Therapy insight: AIDS-related malignancies – the influence of antiviral therapy on pathogenesis and management”. Nat. Clin. Pract. Oncol. 2 (8): 406–415. doi:10.1038/ncponc0253. PMID 16130937.
HIV-1 originated in Central Africa in the first half of the 20th century, when a closely related chimpanzee virus first infected humans. Epidemic global spread began in the late 1970s, and AIDS was recognized in 1981.
Cells infected with HIV must be activated for the virus to replicate. Activation of CD4 T cells induces the expression of the transcription factor NFκB, which binds to the proviral LTR and initiates the transcription of the HIV genome into RNA. (more…)
However, viruses are highly antigenic. Mechanisms of pathologic injury to cells include cell lysis; induction of cell proliferation (as in certain warts and molluscum contagiosum); formation of giant cells, syncytia, or intracellular inclusion bodies caused by the virus; and perhaps most importantly, symptoms caused by the host’s immune response, such as inflammation or the deposition of antigen-antibody complexes in tissues.
Jump up ^ Keele BF, Van Heuverswyn F, Li Y, Bailes E, Takehisa J, Santiago ML, Bibollet-Ruche F, Chen Y, Wain LV, Liegeois F, Loul S, Ngole EM, Bienvenue Y, Delaporte E, Brookfield JF, Sharp PM, Shaw GM, Peeters M, Hahn BH (Jul 28, 2006). “Chimpanzee reservoirs of pandemic and nonpandemic HIV-1”. Science. 313 (5786): 523–6. Bibcode:2006Sci…313..523K. doi:10.1126/science.1126531. PMC 2442710 . PMID 16728595.
HIV needs the integrase enzyme to infect T cells. This drug prevents that step. Integrase inhibitors are often used in the first line of treatment because they are effective for many people, and cause minimal side effects. Integrase inhibitors include elvitegravir (Vitekta), dolutegravir (Tivicay), and raltegravir (Isentress)
Early advances in preventing HIV transmission resulted from educational programs describing how transmission occurs and providing barrier protection for those exposed to genital secretions and new needles or bleach to those exposed to blood by sharing needles. Despite these efforts, new infection in both the developed and developing worlds has continued at high rates.
Macrophages. Tissue macrophages are one of the target cells for HIV. These macrophages harbour the virus and are known to be the source of viral proteins. However, the infected macrophages are shown to lose their ability to ingest and kill foreign microbes and present antigen to T cells. This could have a major contribution in overall immune dysfunction caused by HIV infection.
Protease inhibitors (PIs) interrupt virus replication at a later step in the HIV life cycle, preventing cells from producing new viruses. Currently, these include ritonavir (Norvir), darunavir (Prezista), and atazanavir (Reyataz). Using PIs with NRTIs reduces the chances that the virus will become resistant to medications. Atazanavir and darunavir are available in combination with cobicistat as atazanavir/cobicistat (Evotaz) and darunavir/cobicistat (Prezcobix). Cobicistat and ritonavir inhibit the breakdown of other drugs, so they are used as boosters to reduce the number of pills needed.
HIV progressively destroys some types of white blood cells called CD4+ lymphocytes. Lymphocytes help defend the body against foreign cells, infectious organisms, and cancer. Thus, when HIV destroys CD4+ lymphocytes, people become susceptible to attack by many other infectious organisms. Many of the complications of HIV infection, including death, usually result from these other infections and not from HIV infection directly.
^ Jump up to: a b Centers for Disease Control (1982). “Opportunistic infections and Kaposi’s sarcoma among Haitians in the United States”. Morbidity and Mortality Weekly Report. 31 (26): 353–354; 360–361. PMID 6811853.
The HIV enzyme reverse transcriptase converts the viral RNA into DNA, which is compatible to human genetic material, when the virus is inside the cell. This DNA is transported to the cell’s nucleus, where it is spliced into human DNA by the HIV enzyme integrase. The HIV DNA is known as provirus after it is integrated.
The AIDS Taskforce of Greater Cleveland provides a compassionate and collaborative response to the needs of people infected, affected and at risk of HIV/AIDS. This is accomplished through leadership in prevention, education, supportive services and advocacy.
You don’t actually “get” AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who’s infected, even if they don’t look sick and even if they haven’t tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:
Patients with AIDS have had their immune system depleted by HIV and are very susceptible to such opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.
The O (“Outlier”) group is not usually seen outside of West-central Africa. It is reportedly most common in Cameroon, where a 1997 survey found that about 2% of HIV-positive samples were from Group O. The group caused some concern because it could not be detected by early versions of the HIV-1 test kits. More advanced HIV tests have now been developed to detect both Group O and Group N.
Jump up ^ Vasudevan AA, Smits SH, Höppner A, Häussinger D, Koenig BW, Münk C (Nov 2013). “Structural features of antiviral DNA cytidine deaminases”. Biological Chemistry. 394 (11): 1357–70. doi:10.1515/hsz-2013-0165. PMID 23787464.
Once HIV has entered the cell, it can replicate intracellularly and kill the cell in ways that are still not completely understood. In addition to killing some lymphocytes directly, the AIDS virus disrupts the functioning of the remaining immune system cells. Because the immune system cells are destroyed, a wide variety of infections and cancers can take advantage of a person’s weakened immune system (opportunistic infections/diseases).
However, with effective treatment, the HIV RNA level decreases to undetectable levels, CD4 counts increase dramatically, and people can continue to lead productive, active lives. The risk of illness and death decreases but remains higher than that of people who are of similar age and who are not infected with HIV. However, if people cannot tolerate or take drugs consistently, HIV infection and immune deficiency progresses, causing serious symptoms and complications.
Jump up ^ Eaton LA, Kalichman S (December 2007). “Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies”. Curr HIV/AIDS Rep. 4 (4): 165–72. doi:10.1007/s11904-007-0024-7. PMC 2937204 . PMID 18366947. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]