2Centers for Disease Control and Prevention. CDC Fact Sheet HIV Incidence: Estimated Annual Infections in the U.S., 2008-2014, Overall and by Transmission Route. February 2017. Available from: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-incidence-fact-sheet_508.pdf
Burgard M, Jasseron C, Matheron S, et al. Mother-to-child transmission of HIV-2 infection from 1986 to 2007 in the ANRS French Perinatal Cohort EPF-CO1. Clin Infect Dis. 2010 Oct 1. 51(7):833-43. [Medline].
Jump up ^ Osmanov S, Pattou C, Walker N, Schwardländer B, Esparza J (2002). “Estimated global distribution and regional spread of HIV-1 genetic subtypes in the year 2000”. Acquired Immune Deficiency Syndrome. 29 (2): 184–190. doi:10.1097/00042560-200202010-00013. PMID 11832690.
Analysis of reported AIDS cases shows that 51% had Pneumocystis carinii pneumonia (PCP) without Kaposi’s sarcoma (KS) (with or without other “opportunistic” infections (OOI) predictive of cellular immunodeficiency); 30% had KS without PCP (with or without OOI); 7% had both PCP and KS (with or without OOI); and 12% had OOI with neither PCP nor KS. The overall mortality rate for cases of PCP without KS (47%) was more than twice that for cases of KS without PCP (21%), while the rate for cases of both PCP and KS (68%) was more than three times as great. The mortality rate for OOI with neither KS nor PCP was 48%.
Most AIDS patients require complex long-term treatment with medications for infectious diseases. This treatment is often complicated by the development of resistance in the disease organisms. AIDS-related malignancies in the central nervous system are usually treated with radiation therapy. Cancers elsewhere in the body are treated with chemotherapy.
There is less evidence that treatment of HIV-2 infection slows progression, and certain antiretroviral medications (specifically the non-nucleoside–analogue reverse-transcriptase inhibitors) are not effective against HIV-2. The HIV-1 viral-load assays are much less reliable at quantifying HIV-2, if they work at all. HIV-2 viral load assays have been developed, but none has been approved by the US Food and Drug Administration except as blood donor–screening tools.
HIV is a member of the genus Lentivirus, part of the family Retroviridae. Lentiviruses share many morphological and biological characteristics. Many species of mammals are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period. Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. Upon entry into the target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded integrase and host co-factors. Once integrated, the virus may become latent, allowing the virus and its host cell to avoid detection by the immune system. Alternatively, the virus may be transcribed, producing new RNA genomes and viral proteins that are packaged and released from the cell as new virus particles that begin the replication cycle anew.
The size of the proviral reservoir correlates to the steady-state viral load and is inversely correlated to the anti-HIV CD8+ T-cell responses. Aggressive early treatment of acute infection may lower the proviral load, but generally, treatment in newly infected (but postseroconversion) patients yields no long-term benefit.
Despite significant efforts, there is no effective vaccine against HIV. The only way to prevent infection by the virus is to avoid behaviors that put one at risk, such as sharing needles or having unprotected sex. Unprotected sex means sex without a barrier such as a condom. Because condoms break, even they are not perfect protection. Many people infected with HIV don’t have any symptoms and appear healthy. There is no way to know with certainty whether a sexual partner is infected. Here are some prevention strategies:
Jump up ^ Schwartz O, Maréchal V, Le Gall S, Lemonnier F, Heard JM (March 1996). “Endocytosis of major histocompatibility complex class I molecules is induced by the HIV-1 Nef protein”. Nature Medicine. 2 (3): 338–42. doi:10.1038/nm0396-338. PMID 8612235.
HIV infection is not spread by casual contact (such as hugging and touching), by touching dishes, doorknobs, or toilet seats previously touched by a person infected with the virus, during participation in sports, or by mosquitoes.
During the latent period, the virus continues to multiply actively. It infects and kills critical infection fighting cells, a type of white blood cell called CD4 cells or T helper cells (T cells). Even though the person has no symptoms, he or she is contagious and can pass HIV to others through the routes described above. At the end of this phase, as the virus overwhelms the CD4 cells, the HIV viral load starts to rise, and the CD4 cell count begins to drop. this happens, the person may begin to have symptoms as the virus levels increase in the body. This is stage 3.
Hungarian Szerzett immunhiány syndromák, AIDS, szerzett immunhiány szindróma k.m.n., Szerzett immunhiány szindróma, Szerzett immunhiány szindróma, nem meghatározott, Autoimmun hiány-syndroma, szerzett immunhiányos szindróma
The most important way to stop HIV/AIDS is education. People can get HIV from the exchange of bodily fluids and from sharing needles. Children can also get HIV from their mothers (when they grow inside pregnant mothers and when they drink breast milk.) Sex is one way to get HIV. If people use condoms when they have sex, there is a much smaller chance of catching HIV.
Because of the great efficacy of the protease inhibitors, it is possible to learn much about the kinetics of HIV replication in vivo by measuring the decline in viremia after the initiation of protease inhibitor therapy. For the first 2 weeks after starting treatment there is an exponential fall in plasma virus levels with a half-life of viral decay of about 2 days (Fig. 11.26). This phase reflects the decay in virus production from cells that were actively infected at the start of drug treatment, and indicates that the half-life of productively infected cells is similarly about 2 days. The results also show that free virus is cleared from the circulation very rapidly, with a half-life of about 6 hours. After 2 weeks, levels of virus in plasma have dropped by more than 95%, representing an almost total loss of productively infected CD4 lymphocytes. After this time, the rate of decline of plasma virus levels is much slower, reflecting the very slow decay of virus production from cells that provide a longer-lived reservoir of infection, such as dendritic cells and tissue macrophages, and from latently infected memory CD4 T cells that have been activated. Very long-term sources of infection might be CD4 memory T cells that continue to carry integrated provirus, and virus stored as immune complexes on follicular dendritic cells. These very long-lasting reservoirs of infection might prove to be resistant to drug therapy for HIV.
The basis of management is described in the separate article Human Immunideficiency Virus (HIV). There may be defining conditions such as Pneumocystis jirovecii pneumonia that will need treatment. Highly active antiretroviral therapy (HAART) has improved the prognosis enormously in terms of duration of survival but premature death is to be expected.
OTCBB:AMUN), announced that it has filed a patent application to protect the company’s intellectual property for an investigational monoclonal antibody to treat patients suffering from human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).
The World Health Organization and United States recommends antiretrovirals in people of all ages including pregnant women as soon as the diagnosis is made regardless of CD4 count. Once treatment is begun it is recommended that it is continued without breaks or “holidays”. Many people are diagnosed only after treatment ideally should have begun. The desired outcome of treatment is a long term plasma HIV-RNA count below 50 copies/mL. Levels to determine if treatment is effective are initially recommended after four weeks and once levels fall below 50 copies/mL checks every three to six months are typically adequate. Inadequate control is deemed to be greater than 400 copies/mL. Based on these criteria treatment is effective in more than 95% of people during the first year.
Most HIV-infected individuals progress to AIDS over a period of years. The incidence of AIDS increases progressively with time after infection. Homosexuals and hemophiliacs are two of the groups at highest risk in the West—homosexuals from sexually (more…)
Antiviral treatment options have primarily included combinations of two NRTIs, often referred to as “nucs,” and a third drug, typically being a boosted PI, a NNRTI, often called “non-nucs, and InSTIs such as RAL, EVG or dolutegravir (Tivicay, DTG). Many of these drugs are available in fixed-dose combinations as well as increasing numbers of drugs as single-tablet regimens.
Weis KE, Liese AD, Hussey J, Gibson JJ, Duffus WA. Associations of rural residence with timing of HIV diagnosis and stage of disease at diagnosis, South Carolina 2001–2005. J Rural Health 2010;26:105–12. CrossRef PubMed
In mid-2017, 20.9 million people living with HIV were receiving ART globally. In 2016, a global ART coverage of 53% of adults and children living with HIV was reached. However, more efforts are needed to scale up treatment, particularly for children and adolescents. Only 43% of them were receiving ARVs at the end of 2016 and WHO is supporting countries to accelerate their efforts to timely diagnose and treat these vulnerable populations.
A small but vocal minority of people, including some scientists, continue to argue that HIV does not exist, or does not cause AIDS, and that the HIV tests are unreliable or that the therapies are toxic. Such misinformation is usually based on a lack of understanding of the scientific literature, deliberate misrepresentation, or logical fallacies based on pseudoscientific arguments.
Fungi. The most common fungal disease associated with AIDS is Pneumocystis carinii pneumonia (PCP). PCP is the immediate cause of death in 15-20% of AIDS patients. It is an important measure of a patient’s prognosis. Other fungal infections include a yeast infection of the mouth (candidiasis or thrush) and cryptococcal meningitis.
The weakening of the immune system associated with HIV infection can lead to unusual cancers like Kaposi’s sarcoma. Kaposi’s sarcoma develops as raised patches on the skin which are red, brown, or purple. Kaposi’s sarcoma can spread to the mouth, intestine, or respiratory tract. AIDS also may be associated with lymphoma (a type of cancer involving white blood cells).
Data reported to CDC’s National HIV Surveillance System from 50 states and the District of Columbia through June 2017 were used to estimate the total number of persons living with HIV infection (diagnosed and undiagnosed infection, or prevalence) at year-end 2015 and the median number of years and interquartile range between infection and diagnosis (diagnosis delay) of persons with HIV diagnosed in 2015 (8,9). The first CD4 test after HIV diagnosis and a CD4 depletion model indicating disease progression were used to estimate year of infection and the distribution of time from HIV infection to diagnosis among persons with diagnosed infection (9). The distribution of diagnosis delay was used to estimate the annual number of HIV infections, which includes persons with diagnosed infection and persons with undiagnosed infection. HIV prevalence (persons with diagnosed or undiagnosed HIV infection) was estimated by subtracting reported cumulative deaths among persons with HIV infection from cumulative HIV infections.
Masiá M, Padilla S, Alvarez D, et al. Risk, predictors, and mortality associated with non-AIDS events in newly diagnosed HIV-infected patients: role of antiretroviral therapy. AIDS. 2013 Jan 14. 27(2):181-9. [Medline].
Italian Sindromi da immunodeficienza acquisita, Sindrome da immunodeficienza acquisita, NAS, Sindrome da deficienza autoimmunitaria, Sindrome da immunodeficienza acquisita, non specificata, AIDS, Sindrome da deficienza immunologica acquisita, Sindrome da immunodeficienza acquisita
Jump up ^ Eaton, L; Kalichman, SC (November 2009). “Behavioral aspects of male circumcision for the prevention of HIV infection”. Current HIV/AIDS reports. 6 (4): 187–93. doi:10.1007/s11904-009-0025-9. PMC 3557929 . PMID 19849961.(subscription required)
Rarely, HIV has been transmitted via transplantation of organs from HIV-seropositive donors. Infection has developed in recipients of kidney, liver, heart, pancreas, bone, and skin—all of which contain blood—but screening for HIV greatly reduces risk of transmission. HIV transmission is even more unlikely from transplantation of cornea, ethanol-treated and lyophilized bone, fresh-frozen bone without marrow, lyophilized tendon or fascia, or lyophilized and irradiated dura mater.
Even with anti-retroviral treatment, over the long term HIV-infected people may experience neurocognitive disorders, osteoporosis, neuropathy, cancers, nephropathy, and cardiovascular disease. Some conditions like lipodystrophy may be caused both by HIV and its treatment.
Side effects associated with EFV are mostly dizziness, confusion, fatigue, and vivid dreams. These tend to be most prominent during the first weeks of therapy and then often decrease in severity. It is generally recommended that EFV be taken at bedtime so that the patient is asleep during the time dizziness and confusion may be most severe. It is also noteworthy that there may be an increased risk of depression associated with the use of this drug, and it should be used with caution in those with poorly managed depression. Rash and liver inflammation can occur with both EFV and DLV, and these drugs may also be linked to abnormalities of lipids in the blood.
Acute retroviral syndrome describes a group of symptoms that can resemble mononucleosis and that may be the first sign of HIV infection in 50-70% of all patients and 45-90% of women. Most patients are not recognized as HIV positive during this phase and may not seek medical attention. The symptoms are similar to those of many other diseases and may include fever, fatigue, muscle aches, loss of appetite, digestive disturbances, weight loss, skin rashes, headache, and chronically swollen lymph nodes (lymphadenopathy). Some patients will experience a form of meningitis during this phase in which the membranes that cover the brain and spinal cord become inflamed. Acute retroviral syndrome develops between one and six weeks after infection and lasts for two to three weeks. Blood tests during this period will indicate the presence of HIV virus (viremia) and the appearance of the viral p24 antigen in the blood.
There are currently six major classes of antiretroviral medications: (1) nucleoside reverse transcriptase inhibitors (NRTIs), (2) non-nucleoside reverse transcriptase inhibitors (NNRTIs), (3) protease inhibitors (PIs), (4) fusion (entry) inhibitors, (5) integrase inhibitors, and (6) CCR5 antagonists. These drugs are used in different combinations according to the needs of the patient and depending on whether the virus has become resistant to a specific drug or class of drugs. Treatment regimens usually consist of three to four medications at the same time. Combination treatment is essential because using only one class of medication by itself allows the virus to become resistant to the medication. There are now available pills that contain multiple drugs in a single pill, making it possible for many people to be treated with a single pill per day.
More than one million people in the United States are living with HIV. It’s different for everybody, but many enjoy a good quality of life and can expect a longer lifespan than those diagnosed before today’s treatments were available. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]