^ Jump up to: a b c Knoll B, Lassmann B, Temesgen Z (2007). “Current status of HIV infection: a review for non-HIV-treating physicians”. Int J Dermatol. 46 (12): 1219–28. doi:10.1111/j.1365-4632.2007.03520.x. PMID 18173512.
With the numbers of those who acquired their infections heterosexually there has been an decrease in the number of women diagnosed. The male:female ratio for all new infections diagnosed in 2008 was about 1.6:1 whereas in 2012 it was 2.6:1.
These drugs, also referred to as “nukes,” interfere with HIV as it tries to replicate and make more copies of itself. NRTIs include abacavir (Ziagen), lamivudine/zidovudine (Combivir), and emtricitabine (Emtriva)
The transmission of HIV from an HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called vertical or mother-to-child transmission (MTCT). In the absence of any interventions during these stages, rates of HIV transmission from mother-to-child can be between 15–=45%. MTCT can be nearly fully prevented if both the mother and the baby are provided with ARV drugs as early as possible in pregnancy and during the period of breastfeeding.
These studies show that most of the HIV present in the circulation of an infected individual is the product of rounds of replication in newly infected cells, and that virus from these productively infected cells is released into, and rapidly cleared from, the circulation at the rate of 109 to 1010 virions every day. This raises the question of what is happening to these virus particles: how are they removed so rapidly from the circulation? It seems most likely that HIV particles are opsonized by specific antibody and complement and removed by phagocytic cells of the mononuclear phagocyte system. Opsonized HIV particles can also be trapped on the surface of follicular dendritic cells, which are known to capture antigen:antibody complexes and retain them for prolonged periods (see Chapters 9 and 10).
In the UK in 2012, 15 donors tested positive for HIV infection at screening. This represented 0.6 detected infections per 100,000 donations. These were mainly in men who probably acquired the infection via heterosexual transmission.
Even with treatment, some people seem to naturally experience a more rapid course towards AIDS. However, the majority of HIV patients who receive appropriate treatment do well and live healthy lives for years.
Human immunodeficiency virus (HIV) associated cholangiopathy has been described in children.95 As in adults, the biliary abnormalities include irregularities of contour and caliber of the intrahepatic and extrahepatic ducts and papillary stenosis. The changes may result from concomitant infection with opportunistic organisms such as cytomegalovirus and Cryptosporidium parvum.
It is now established that, given the right treatment, someone living with HIV can reduce his or her viral load to such a degree that it is no longer detectable. After assessing a number of large studies, the CDC concluded that individuals who have no detectable viral load “have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”
Ideally, prior to initiating treatment, the viral load and the CD4 cell count should be checked and the viral load test then repeated after approximately four weeks of treatment. If the patient is beginning a regimen that includes two to three drugs for which the patient’s virus does not appear to be resistant, it is expected that the amount of virus should decrease by at least a hundredfold during this interval. The ultimate goal is for the viral load to decrease to undetectable levels which should occur by approximately 12-24 weeks. There are some individuals that despite taking all of their medications correctly will suppress their viral load to less than 200 copies/mL but not consistently undetectable levels. It is not completely known how to optimally manage this situation but many experts would continue to monitor on therapy as long as viral load remains below 200 copies/mL. Those who are not having an appropriate response to therapy need to be questioned to make sure that they are taking their medications correctly, and if not, why. If the viral load is not going to undetectable levels and the patient is taking the medications correctly, then it is likely that there is a resistant virus to some of the medications. Drug-resistance testing then should be performed and the patient managed as described in the next section. Once the patient’s viral load is suppressed, they can often have viral load and CD4 cell counts performed less frequently (for example, every three to four months and in select cases every six months or possibly even less).
^ Jump up to: a b c Zheng YH, Lovsin N, Peterlin BM (2005). “Newly identified host factors modulate HIV replication”. Immunology Letters. 97 (2): 225–34. doi:10.1016/j.imlet.2004.11.026. PMID 15752562. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]