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The impact of AIDS in southern Africa has been devastating. Some communities have been very hard hit with many deaths and economic hardship related to loss of the workforce of young adults. However, significant progress has been made in the last decade. South Africa has the largest antiviral roll-out programme in the world. Campaigns to reduce homophobia are encouraging MSM to declare their sexuality and come forward for testing and treatment. Innovative work with sex workers and injectable drug users, antiretroviral treatment of children, condom distribution programmes and mother-to-child transmission prevention services are all beginning to bear fruit. Life expectancy has increased by five years since the height of the epidemic.[21]With a prevalence of 17.9% and a population of 6.1 million, South Africa has the largest HIV epidemic of any country. In neighbouring countries in southern Africa, the prevalance ranges from 10-15%.[2]

Entry of HIV into the host cell also requires the participation of a set of cell-surface proteins that normally serve as receptors for chemokines (hormonelike mediators that attract immune system cells to particular sites in the body). Those receptors, which occur on T cells, are often described as coreceptors, since they work in tandem with CD4 to permit HIV entry into the cells. Chemokine receptors that are known to act as HIV coreceptors include CCR5 (chemokine [C-C motif] receptor 5) and CXCR4 (chemokine [C-X-C motif] receptor 4), both of which are classified as G protein-coupled receptors. The binding of gp120 to CD4 exposes a region of gp120 that interacts with the chemokine receptors. That interaction triggers a conformational change that exposes a region of the viral envelope protein gp41, which inserts itself into the membrane of the host cell so that it bridges the viral envelope and the cell membrane. An additional conformational change in gp41 pulls those two membranes together, allowing fusion to occur. After fusion the viral genetic information can enter the host cell. Both CCR5 and CXCR4 have generated significant interest as targets for drug development; agents that bind to and block those receptors could inhibit HIV entry into cells.

A transmissible retrovirus that causes AIDS in humans. Two forms of HIV are now recognized: HIV-1, which causes most cases of AIDS in Europe, North and South America, and most parts of Africa; and HIV-2, which is chiefly found in West African patients. HIV-2, discovered in 1986, appears to be less virulent than HIV-1, but also may have a longer latency period.

AIDS in the Workplace The workplace is a common battleground. Many people with AIDS have lost their jobs, been denied promotions, or been reassigned to work duties that remove them from public contact. During the 1980s, this discrimination was fought through lawsuits based on older laws designed to protect the disabled. Plaintiffs primarily used the Rehabilitation Act of 1973 (29 U.S.C.A. § 701 et seq.), the earliest law of this type. But the Rehabilitation Act has a limited scope: it applies only to federally funded workplaces and institutions; it says nothing about those that do not receive government money. Thus, for example, the law was helpful to a California public school teacher with AIDS who sued for the right to resume teaching classes (Chalk v. United States District Court, 840 F.2d 701 [9th Cir. 1988]), but it would be of no use to a worker in a private business.

Jump up ^ Hellmund, Chris; Lever, Andrew M. L. (2016-07-14). “Coordination of Genomic RNA Packaging with Viral Assembly in HIV-1”. Viruses. 8 (7): 192. doi:10.3390/v8070192. ISSN 1999-4915. PMC 4974527 . PMID 27428992.

^ Jump up to: a b Kellerman, S; Essajee, S (Jul 20, 2010). “HIV testing for children in resource-limited settings: what are we waiting for?”. PLOS Medicine. 7 (7): e1000285. doi:10.1371/journal.pmed.1000285. PMC 2907270 . PMID 20652012.

Some viruses do not produce rapid lysis of host cells, but rather remain latent for long periods in the host before the appearance of clinical symptoms. This carrier state can take any of several different forms. The term latency is used to denote the interval from infection to clinical manifestations. In the lentiviruses, it was formerly mistakenly believed that virus was inactive during this period. The true situation is that lentiviruses are rapidly replicating and spawning dozens of quasi-species until a particularly effective one overruns the ability of the host’s immune system to defeat it. Other viruses, however, such as the herpesviruses, actually enter a time known as “viral latency,” when little or no replication is taking place until further replication is initiated by a specific trigger. For many years all forms of latency were thought to be identical, but now it has been discovered that there are different types with basic and important distinctions.

Jump up ^ Underhill K, Operario D, Montgomery P (2008). Operario, Don, ed. “Abstinence-only programs for HIV infection prevention in high-income countries”. Cochrane Database of Systematic Reviews (4): CD005421. doi:10.1002/14651858.CD005421.pub2. PMID 17943855. Archived from the original on November 25, 2010.

Jump up ^ Cunningham AL, Donaghy H, Harman AN, Kim M, Turville SG (2010). “Manipulation of dendritic cell function by viruses”. Current Opinion in Microbiology. 13 (4): 524–529. doi:10.1016/j.mib.2010.06.002. PMID 20598938.

human T-cell lymphotropic virus type III; a cytopathic retrovirus (genus Lentvirus, family Retroviridae) that is 100-120 nm in diameter, has a lipid envelope, and has a characteristic dense cylindric nucleoid containing core proteins and genomic RNA. There are currently two types: HIV-1 infects only humans and chimpanzees and is more virulent than HIV-2, which is more closely related to Simian or monkey viruses. HIV-2 is found primarily in West Africa and is not as widespread as HIV-1. In addition to the usual gene associated with retroviruses, this virus has at least six genes that regulate its replication. It is the etiologic agent of acquired immunodeficiency syndrome (AIDS). Formerly or also known as the lymphadenopathy virus (LAV) or the human T-cell lymphotropic virus type III (HTLV-III). Identified in 1984 by Luc Montagnier and colleagues.

Seroconversion may take a few weeks, up to several months. Symptoms during this time may include fever, flulike illness, lymphadenopathy, and rash. These manifestations develop in approximately half of all people infected with HIV.

Primary prophylaxis with clindamycin and pyrimethamine or trimethoprim/ sulfamethoxazole (as for Pneumocystis pneumonia) indicated for patients with a CD4 count of < 100/μL and previous toxoplasmosis or positive antibodies; can be stopped if CD4 counts increase to > 200/μL for ≥ 3 mo in response to antiretroviral therapy

UNAIDS also launched the ambitious 90-90-90 targets which aim for 90% of people living with HIV to be diagnosed, 90% of those diagnosed to be accessing antiretroviral treatment and 90% of those accessing treatment to achieve viral suppression by 2020.94

With therapy, viral loads can often be suppressed to an undetectable level (< 20-75 copies/mL; optimal viral suppression); complete inhibition of viral replication appears impossible and may be unnecessary These are standard doses for average-sized adults, and dosing may vary depending upon the weight of a patient. Certain combinations of drugs in this class should generally be avoided, including d4T with ZDV or ddI, 3TC with FTC, and TDF with ddI. Mania Secondary Causes Dysthymic Disorder Pericarditis Causes Group A Streptococcal Cellulitis Seborrheic Dermatitis Lymphoma Hepatomegaly Salmonella Zidovudine Spontaneous Pneumothorax Marijuana Small Bowel Obstruction Charlson Comorbidity Index Bacillary Angiomatosis Peliosis Hepatitis Mycobacterium Avium Complex Isospora belli Non-Nucleoside Reverse Transcriptase Inhibitor Oral Health Primary Sclerosing Cholangitis Lymphocyte Count Didanosine Symmetric Peripheral Neuropathy Lymphoma in HIV Brain Tumor Against Medical Advice Pregnane Progestin Cachexia in Cancer Lipodystrophy Viral Encephalitis Impetigo Unintentional Weight Loss HIV and AIDS Links Efavirenz HIV and AIDS Books Journal Abbreviations Neuroimaging after First Seizure Alcohol Abuse Acute Bacterial Prostatitis Tuberculosis Related Chest XRay Changes Erythropoietin HIV in Pregnancy Testosterone Supplementation Diarrhea in HIV AIDS Dementia Complex Bartonella Yellow Nail Syndrome Rhinosinusitis Candida Vulvovaginitis Cryptococcal Meningitis Babesiosis Extrapulmonary Tuberculosis Spinal Infection Echinacea Ichthyosis Hepatitis in HIV Pneumonia Causes Dyspnea History Practice Management Links Headache in HIV Hairy Tongue Failure to Thrive in the Elderly Immune Thrombocytopenic Purpura Sexually Transmitted Disease in HIV HIV Test Pneumococcal Conjugate Vaccine Facial Nerve Paralysis Causes Asymmetric Peripheral Neuropathy Bacterial Endocarditis Acute Necrotizing Ulcerative Gingivitis Intertrigo Psoriatic Arthritis Unintentional Weight Loss Causes Night Sweats Erythema Multiforme Major Adverse Drug Reaction Human Bite Hepatitis B Cervical Cancer Cardiovascular Manifestations of HIV Pediatric HIV Urinary Tract Infection Heart Transplant Medication Compliance Family Practice Notebook Updates 2017 Erythroderma Orbital Cellulitis Genital Wart Granuloma Annulare Hypothyroidism Acute Diarrhea Neutropenic Colitis Generalized Lymphadenopathy Human Papilloma Virus Vaccine Neisseria gonorrhoeae Preconception Counseling Rhabdomyolysis Causes Aseptic Meningitis Gastrointestinal Manifestations of HIV Polyarteritis Nodosa Preventive Health Care of Women Who Have Sex With Women Erythralgia Pruritus Causes Splenomegaly Lymphadenopathy Thrombocytopenia CD4 Cell Count HIV Related Rheumatologic Conditions Fever of Unknown Origin History Herpes Zoster Pneumonia Tuberculin Skin Test Headache Red Flag Systemic Lupus Erythematosus Health Care of the Homeless Niacin Deficiency Skin Infection Nonspecific Management of Pruritus Taste Dysfunction Loss of Smell Asplenic Trichomonal Vaginitis Viral skin infection in HIV Gynecologic Manifestations of HIV HIV Exposure Primary Series Bacterial Meningitis Management St. John's Wort Major Depression Differential Diagnosis Rheumatica Septic Joint Pediatric Anemia Causes Vaccines in Immunocompromised Patients Family Practice Notebook Updates 2016 Onychomycosis Addison's Disease Neck Masses in Children Lymphadenopathy in HIV Thrombotic Thrombocytopenic Purpura HIV Related Neuropathy Typhoid Vaccine Yellow Fever Vaccine Bloodborne Pathogen Exposure Genital Herpes Opioid Abuse Psychosis Psychosis Differential Diagnosis Antinuclear Antibody Proteinuria Causes Postexposure Prophylaxis Toxic Shock Syndrome Tetanus Psoriasis Anal Fissure Cytomegalovirus Mononucleosis-Like Syndrome Tuberculous Peritonitis Cesarean Section Methadone for Opioid Dependence Testicular Failure Spontaneous Vaginal Delivery Sulfonamide Allergy Acute Nonsuppurative Sialoadenitis Direct Bilirubin Primary Immunodeficiency Malaria Viral Meningitis Exchange Transfusion in Newborns Breast Feeding Suppurative Tenosynovitis Nephrotic Syndrome Fatigue Causes Osteoporosis Secondary to Medication Proctitis Pulmonary Arterial Hypertension Preventive Health Care of Men Who Have Sex With Men Multidrug Resistance Score Systolic Dysfunction Pulmonary Hypertension Causes Necrotizing Otitis Externa Lymphadenopathy in the Febrile Returning Traveler Emerging Infection Atovaquone Parvovirus B19 Guillain Barre Syndrome Failure to Thrive Causes HIV Course Penicillin Resistant Pneumococcus Fever in the Returning Traveler Varicella Zoster Virus Vaccine Possibly Resistant Tuberculosis Treatment HIV Risk Factor Family Practice Notebook Updates 2014 Orthostatic Hypotension Hepatitis C Gluten Enteropathy Meningococcal Vaccine International Medical Concerns Isoniazid Herpes Ophthalmicus Multiple Sclerosis Substance Abuse Evaluation Methamphetamine Acute Glomerulonephritis AIDS-Defining Illness Pulmonary Hypertension Salivary Gland Enlargement HIV Risk Screening Questions Cholera Vaccine Influenza Vaccine Smallpox Vaccine Pentamidine Noisy Breathing Acute Kidney Injury Causes Wound Repair Chronic Paronychia Hypogonadotropic Hypogonadism Hives Thrush Dry Mouth Autoimmune Hemolytic Anemia Hodgkin Disease Brucellosis Candidiasis Viral Causes of Arthritis Lung Cancer Active Tuberculosis Treatment Paresthesia Causes Polymyositis Differential Diagnosis Reiter's Syndrome Pre-participation History Proteinuria in Children HIV Preexposure Prophylaxis Body Piercing Infectious Causes of Neutropenia Pneumococcal Vaccine Virus Tuberculosis Screening in Children Low Back Pain Red Flag Chronic Renal Failure Abdominal Pain Evaluation Transfusion Complication Sexually Transmitted Disease Latent Tuberculosis Treatment Dementia Increased Intracranial Pressure Causes Osteomyelitis Causes Zinc Osteoporosis Secondary Causes Exercising with Infection Epididymitis Menomune Cardiomyopathy HIV Complications Tuberculosis Risk Factors for progression from Latent to Active Disease Gynecomastia Erythema Multiforme Cryptosporidium parvum Pelvic Inflammatory Disease Aplastic Anemia HIV Presentation Anti-Retroviral Therapy Cutaneous Conditions in Febrile Returning Traveler Strongyloides Varicella Vaccine Tuberculosis Risk Factors Dementia Causes Refugee Health Exam Joint Pain Polyarticular Arthritis Abnormal Gait and Balance Causes in the Elderly Thrombocytopenia Causes Ataxia in Children This July, at the Twentieth International AIDS Conference, in Melbourne, Australia, Sharon Lewin, an infectious-disease expert at Monash University, said, “We probably are looking, at the moment, at trying to achieve long-term remission.” Most experts agree that remission is feasible, and that, to some degree, we will be able to wean patients off lifelong therapies. The main treatment for HIV is antiretroviral therapy (ART), a combination of daily medications that stop the virus from reproducing. This helps protect your CD4 cells, keeping your immune system strong enough to fight off disease. Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health 1999;89:1397–405. [PubMed] [Full Text] ⇦ Jump up ^ Douek DC, Roederer M, Koup RA (2009). "Emerging Concepts in the Immunopathogenesis of AIDS". Annual Review of Medicine. 60: 471–84. doi:10.1146/annurev.med.60.041807.123549. PMC 2716400 . PMID 18947296. [redirect url='http://penetratearticles.info/bump' sec='7']

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