There are still tremendous hurdles. Thirty-five million people in the world are living with the virus. In sub-Saharan Africa, where most new cases are reported, sixty-three per cent of those eligible for the drug regimen do not receive it; those who do often fail to receive it in full. In the United States, a year’s worth of HAART costs many thousands of dollars per patient, and the long-term side effects can be debilitating.
Anti-LGBTQ bias further enables the spread of HIV by discouraging many in our community from getting tested or treated for HIV for fear of harassment. A 2014 Kaiser Family Foundation survey of gay and bisexual men in the U.S. found that 15% of them had received poor treatment from a medical professional as a result of their sexual orientation, and least 30% did not feel comfortable discussing their sexual behaviors with a healthcare provider. For gay and bisexual youth who are just beginning to explore their sexuality, homophobia and other forms of anti-LGBTQ bias help explain why so many young people in our community are unaware of their HIV status.
Russian SINDROM PRIOBRETENNOGO IMMUNODEFITSITA, SPID, CHELOVECHESKII T-LIMFOTSITARNYI VIRUS-III, INFEKTSIIA, IMMUNODEFITSITA SINDROM PRIOBRETENNYI, ИММУНОДЕФИЦИТА СИНДРОМ ПРИОБРЕТЕННЫЙ, СИНДРОМ ПРИОБРЕТЕННОГО ИММУНОДЕФИЦИТА, СПИД, ЧЕЛОВЕЧЕСКИЙ T-ЛИМФОЦИТАРНЫЙ ВИРУС-III, ИНФЕКЦИЯ
A type of protein molecule in human blood, sometimes called the T4 antigen, that is present on the surface of 65% of immune cells. The HIV virus infects cells with CD4 surface proteins, and as a result, depletes the number of immune system cells (T cells, B cells, natural killer cells, monocytes) in the individual’s blood. Most of the damage to an AIDS patient’s immune system is done by the virus’ destruction of CD4+ lymphocytes.
Two main clinical staging systems are used to classify HIV and HIV-related disease for surveillance purposes: the WHO disease staging system for HIV infection and disease, and the CDC classification system for HIV infection. The CDC’s classification system is more frequently adopted in developed countries. Since the WHO’s staging system does not require laboratory tests, is suited to the resource-restricted conditions encountered in developing countries, where it can also be used to help guide clinical management. Despite their differences, the two systems allow comparison for statistical purposes.
In the United States, guidelines for using antiviral therapy have been developed and are updated on a regular basis by an expert panel assembled by the DHHS, the IAS-USA panel, and others. The DHHS guidelines are available at https://aidsinfo.nih.gov/. The most recent IAS-USA guidelines were published in the Journal of the American Medical Association (JAMA) in the summer of 2016.
Abnormal elevation of immune activation may be caused in part by absorption of components of bowel bacteria. Immune activation contributes to CD4+ depletion and immunosuppression by mechanisms that remain unclear.