HIV-1 appears to have originated in southern Cameroon through the evolution of SIV(cpz), a simian immunodeficiency virus (SIV) that infects wild chimpanzees (HIV-1 descends from the SIV(cpz) endemic in the chimpanzee subspecies Pan troglodytes troglodytes). The closest relative of HIV-2 is SIV (smm), a virus of the sooty mangabey (Cercocebus atys atys), an Old World monkey living in littoral West Africa (from southern Senegal to western Côte d’Ivoire). New World monkeys such as the owl monkey are resistant to HIV-1 infection, possibly because of a genomic fusion of two viral resistance genes. HIV-1 is thought to have jumped the species barrier on at least three separate occasions, giving rise to the three groups of the virus, M, N, and O.
The goal is to start PEP as soon after exposure as possible if prophylaxis is warranted. CDC recommends providing PEP within 24 to 36 h after exposure; a longer interval after exposure requires the advice of an expert.
HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome or AIDS if not treated. Unlike some other viruses, the human body can’t get rid of HIV completely, even with treatment. So once you get HIV, you have it for life.
stage 2 dystrophic phase/Sudek’s atrophy; lasting for several months; characterized by constant unrelenting pain, exacerbated by any stimulus, and tissue cyanosis, coolness and induration, and diffuse osteoporosis
American Medical Association. Universal, routine screening of pregnant women for HIV infection. CSA Report I–01. Council on Scientific Affairs. Chicago (IL): AMA; 2001. Available at: http://www.ama-assn.org/ama/pub/category/13548.html. Retrieved July 10, 2007.
Once infection has progressed to AIDS, the survival period is usually less than 2 years in untreated patients. Persons in whom the infection does not progress long-term may not develop AIDS for 15 years or longer, although many still exhibit laboratory evidence of CD4 T-cell decline or dysfunction. [79, 80, 81, 82]
Jump up ^ Attia, Suzanna; Egger, Matthias; Müller, Monika; Zwahlen, Marcel; Low, Nicola (2009). “Sexual transmission of HIV according to viral load and antiretroviral therapy: Systematic review and meta-analysis”. AIDS. 23 (11): 1397–404. doi:10.1097/QAD.0b013e32832b7dca. PMID 19381076.
Jump up ^ Michod RE, Bernstein H, Nedelcu AM (May 2008). “Adaptive value of sex in microbial pathogens” (PDF). Infection, Genetics and Evolution. 8 (3): 267–85. doi:10.1016/j.meegid.2008.01.002. PMID 18295550.
“He was immediately put on treatment, strong antiviral drugs, which has suppressed the virus, to the point that he is absolutely healthy from that vantage,” Huizenga said. “Individuals who are optimally treated with undetectable viral loads, (the risk is) incredibly low to transmit the virus. We can’t say it’s zero, but it’s an incredibly low number.”
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
§ Social-structural variables were used to identify a representative sample for NHBS of heterosexual persons at increased risk of HIV infection. Heterosexual persons at increased risk were defined as male or female (not transgender) in a metropolitan statistical area with high AIDS prevalence, who had sex with a member of the opposite sex in the past 12 months, never injected drugs, and met low income or low education criteria. Low income was defined as not exceeding U.S. Department of and Human Services poverty guidelines and low education as having a high school education or less.
Other measures can help. For men, circumcision, an inexpensive, safe procedure, reduces the risk of becoming infected during vaginal intercourse with an infected woman by about half. Whether circumcision reduces the risk of HIV infection in other circumstances is unclear. Because circumcision provides only partial protection against HIV infection, people should also use other measures to prevent HIV infection . For example, if either partner has a sexually transmitted disease or HIV infection, it should be treated, and condoms should be used correctly and consistently.
The most common side effect associated with NNRTIs is a rash, typically occurring during the first weeks of therapy. This is most common in individuals treated with NVP. In this case, the overall risk of rash is reduced if therapy is started as a single 200 mg NVP pill once per day during the first two weeks before increasing to the full dose of 200 mg twice per day. If the rash is mild, therapy usually can be continued if antihistamines are given, and if the rash resolves, treatment with the NNRTI can be continued. If the rash is severe, associated with liver inflammation or blisters, changes in the mouth or around the eyes, or with high fevers, therapy with the NNRTI usually needs to be discontinued. Decisions regarding continuing or stopping treatment need to be made with the primary care professional. In some patients, NVP can cause a severe allergic reaction characterized by fever, rash, and severe liver inflammation. Recent data suggests that the groups at the greatest risk for the severe reaction are those with stronger immune systems, such as HIV-uninfected people given this treatment after an exposure to HIV, women with CD4+ T cells >250 cells per mm3, and men with CD4+ T cells >400 cells per mm3. There is also likely to be increased risk in pregnant women and individuals with other underlying liver diseases. Consequently, NVP probably should not be used in any of these groups, or if used, used with caution. In addition, whenever NVP is started, liver tests that are markers for liver inflammation should be monitored at regular intervals during the first several months of treatment.
We will return to discuss in more detail the interactions of HIV with the immune system and the prospects for manipulating them later in this chapter, but before doing so we must describe the viral life cycle and the genes and proteins on which it depends. Some of these proteins are the targets of the most successful drugs in use at present for the treatment of AIDS.
Getting the right screening test at the right time is one of the most important things a man can do for his health. Learn at what age men should be screened for prostate cancer, high blood pressure, cholesterol and other health risks.
^ Jump up to: a b c d e f g h i Markowitz, edited by William N. Rom ; associate editor, Steven B. (2007). Environmental and occupational medicine (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 745. ISBN 978-0-7817-6299-1. Archived from the original on September 11, 2015.
Confidential testing for HIV infection: Testing should be offered routinely to adolescents and adults in virtually all health care settings. To facilitate routine testing, some states no longer require written consent or extensive pre-test counseling. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]