There is a specific decline in the CD4+ helper T cells, resulting in inversion of the normal CD4/CD8 T-cell ratio and dysregulation of B-cell antibody production. [26, 27] Immune responses to certain antigens begin to decline, and the host fails to adequately respond to opportunistic infections and normally harmless commensal organisms. Because the defect preferentially affects cellular immunity, the infections tend to be nonbacterial (fungal, viral).
As opposed to treating infected people to protect their uninfected partners, another approach is to provide antiviral treatment to uninfected individuals, so-called pre-exposure prophylaxis (PrEP). The first success in this research arena came from the CAPRISA 004 study, which showed that vaginal administration before and after intercourse of a gel containing the antiretroviral agent tenofovir reduced the risk of transmission of both HIV and herpes simplex virus to heterosexual women. Other studies are under way to confirm the results of this study as well as to determine whether the results are any different if the agent is administered daily rather than simply around the time of intercourse. One such study was not be able to show that once-daily tenofovir vaginal gel demonstrated protection from infection compared to placebo gel. The reasons for this finding are not completely known, but it does appear that adherence with the therapy was very poor.
Jump up ^ Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vézinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L (1983). “Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS)”. Science. 220 (4599): 868–871. Bibcode:1983Sci…220..868B. doi:10.1126/science.6189183. PMID 6189183.
In 2003, President george w. bush proposed spending $15 billion over five years to support international AIDS prevention and the purchase of anti-viral drugs. The largest share of the money would be contributed directly by the United States to other countries, such as through programs sponsored by the U.S. Agency for International Development. The proposal would account for almost half the money in a global fund committed to fight HIV and AIDS.
The World Health Organization (WHO) has issued recommendations regarding nutrient requirements in HIV/AIDS. A generally healthy diet is promoted. Dietary intake of micronutrients at RDA levels by HIV-infected adults is recommended by the WHO; higher intake of vitamin A, zinc, and iron can produce adverse effects in HIV positive adults, and is not recommended unless there is documented deficiency. Dietary supplementation for people who are infected with HIV and who have inadequate nutrition or dietary deficiencies may strengthen their immune systems or help them recover from infections, however evidence indicating an overall benefit in morbidity or reduction in mortality is not consistent.
^ Jump up to: a b c d e f g h i j k l m n o p q r Vogel, M; Schwarze-Zander, C; Wasmuth, JC; Spengler, U; Sauerbruch, T; Rockstroh, JK (July 2010). “The treatment of patients with HIV”. Deutsches Ärzteblatt International. 107 (28–29): 507–15; quiz 516. doi:10.3238/arztebl.2010.0507. PMC 2915483 . PMID 20703338.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.
Jump up ^ Hymes KB, Cheung T, Greene JB, et al. (September 1981). “Kaposi’s sarcoma in homosexual men-a report of eight cases”. Lancet. 2 (8247): 598–600. doi:10.1016/S0140-6736(81)92740-9. PMID 6116083.
The Ethics Committee of the American Society for Reproductive Medicine has said, “Health care workers who are willing to provide reproductive assistance to couples whose offspring are irreducibly at risk for a serious genetic disease should find it ethically acceptable to treat HIV-positive individuals or couples who are willing to take reasonable steps to minimize the risks of transmission.” (20).
Regular blood tests are needed to make sure the virus level in the blood (viral load) is kept low, or suppressed. The goal of treatment is to lower the HIV virus in the blood to a level that is so low that the test can’t detect it. This is called an undetectable viral load.
One way to measure the damage to your immune system is to count your CD4 cells you have. These cells, also called “T-helper” cells, are an important part of the immune system. Healthy people have between 500 and 1,500 CD4 cells in a milliliter of blood. Fact Sheet 124 has has more information on CD4 cells.
Sexual abstinence is completely effective in eliminating sexual transmission, but educational campaigns have not been successful in promoting abstinence in at-risk populations. Monogamous sexual intercourse between two uninfected partners also eliminates sexual transmission of the virus. Using barrier methods, such as condoms, during sexual intercourse markedly reduces the risk of HIV transmission. These measures have had some success in blunting the rate of new cases, especially in high-risk areas such as sub-Saharan Africa or Haiti. As discussed above, medications may be used to reduce the risk of HIV infection if used within hours of an exposure. There also is data that if uninfected people can take antiretroviral medications, in particular tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC or Truvada) once daily, that it markedly reduces the risk of sexual transmission. Perhaps the most effective way to reduce HIV transmission is for the HIV-infected partner to be on ART with undetectable levels of virus in their blood. As noted above, a pregnant woman with HIV can reduce the risk of passing the infection to her baby by taking medications during pregnancy and labor and avoiding breastfeeding.
Healthcare visits in the preceding year were associated with a lower rate of unawareness (37% vs 81%) but a higher rate of HIV-positivity (21% vs 12%). Because this study targeted a high-risk group and may involve participation bias, the overall rate of HIV infection (19%) cannot be easily extrapolated to the overall population. 
The history of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) dates back to 1981, when gay men with symptoms and signs of a disease that now are considered typical of AIDS were first described in Los Angeles and New York. The men had an unusual type of lung infection (pneumonia) called Pneumocystis carinii (now known as Pneumocystis jiroveci) pneumonia (PCP) and rare skin tumors called Kaposi’s sarcomas. The patients were noted to have a severe reduction in a type of cell in the blood (CD4 cells) that is an important part of the immune system. These cells, often referred to as T cells, help the body fight infections. Shortly thereafter, this disease was recognized throughout the United States, Western Europe, and Africa. In 1983, researchers in the United States and France described the virus that causes AIDS, now known as HIV, belonging to the group of viruses called retroviruses. While HIV infection is required to develop AIDS, the actual definition of AIDS is the development of a low CD4 cell count (<200 cells/mm3) or any one of a long list of complications of HIV infection ranging from a variety of so-called "opportunistic infections," cancers, neurologic symptoms, and wasting syndromes. Acquired immunodeficiency syndrome A condition defined by CDC criteria, which is intimately linked to infection by a retrovirus, human immunodeficiency virus–HIV-1; long-term survival after HIV infection is possible; once clinical AIDS develops, it is fatal, despite temporary response to various therapies. See ARC, 'Dominant dozen. ', gp120, gp160, Hairy leukoplakia, HIV-1, HIV-2, Isospora belli, Nonprogressive HIV infection Patient zero, Pneumocystis carinii, VLIA–virus-like infectious agent, Walter Reed classification. The second phase of HIV infection, the asymptomatic period, lasts an average of 10 years. During that period the virus continues to replicate, and there is a slow decrease in the CD4 count (the number of helper T cells). When the CD4 count falls to about 200 cells per microlitre of blood (in an uninfected adult it is typically about 1,000 cells per microlitre), patients begin to experience opportunistic infections—i.e., infections that arise only in individuals with a defective immune system. That is AIDS, the final stage of HIV infection. The most-common opportunistic infections are Pneumocystis carinii pneumonia, tuberculosis, Mycobacterium avium infection, herpes simplex infection, bacterial pneumonia, toxoplasmosis, and cytomegalovirus infection. In addition, patients can develop dementia and certain cancers, including Kaposi sarcoma and lymphomas. Death ultimately results from the relentless attack of opportunistic pathogens or from the body’s inability to fight off malignancies. After HIV infection is confirmed, your doctor will start you on a drug regimen consisting of several drugs; combinations of different types of anti-HIV drugs sometimes are called HAART, for highly-active antiretroviral therapy (HIV is a kind of virus called a retrovirus). Kaposi's sarcoma – a type of cancer that usually affects the skin (often causing red or purple lesions, or wounds, on the skin). Sometimes KS only affects the skin; sometimes it also affects other systems in the body. It is possible for HIV to become resistant to some antiretroviral medications. The best way to prevent resistance is for the patient to take their ART as directed. If the patient wants to stop a drug because of side effects, he or she should call the physician immediately. In August 2013, the FDA approved Alere Determine HIV-1/2 Ag/Ab Combo test (Orgenics, Ltd) as the first rapid HIV test for the simultaneous detection of HIV-1 p24 antigen as well as antibodies to both HIV-1 and HIV-2 in human serum, plasma, and venous or fingerstick whole blood specimens. [6, 7] The test does not distinguish between antibodies to HIV-1 and HIV-2, and is not intended to be used for screening of blood donors. [6, 7] Jump up ^ Hallenberger S, Bosch V, Angliker H, Shaw E, Klenk HD, Garten W (November 26, 1992). "Inhibition of furin-mediated cleavage activation of HIV-1 glycoprotein gp160". Nature. 360 (6402): 358–61. Bibcode:1992Natur.360..358H. doi:10.1038/360358a0. PMID 1360148. Restricting sexual activity to a single partner and practicing safer sex (i.e., always using a condom). Besides avoiding the risk of HIV infection, condoms are successful in reducing other sexually transmitted diseases and unwanted pregnancies. Before engaging in a sexual relationship with someone, getting tested for HIV infection is recommended. There is no cure for HIV infection. Before there were treatments for the virus, people with AIDS lived only for a couple of years. Fortunately, medications have substantially improved the outlook and survival rates. Prevention efforts have reduced HIV infection in young children and have the potential to limit new infections in other populations. At any time during the course of HIV infection, patients may develop a yeast infection in the mouth called thrush, open sores or ulcers, or other infections of the mouth; diarrhea and other gastrointestinal symptoms that cause malnutrition and weight loss; diseases of the lungs and kidneys; and degeneration of the nerve fibers in the arms and legs. HIV infection of the nervous system leads to general loss of strength, loss of reflexes, and feelings of numbness or burning sensations in the feet or lower legs. Because HIV infection often is detected through prenatal and STD screening, it is not uncommon for an obstetrician–gynecologist to be the first health professional to provide care for an infected woman. This Committee Opinion is designed to provide guidance to obstetrician–gynecologists regarding ethical issues associated with HIV testing, including the use of newly developed rapid HIV tests and disclosure of positive test results. It also outlines responsibilities related to patient care for women who are infected with HIV, access for affected couples to assisted reproductive technology, and the health care professional who is infected with HIV. HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS. Learn more about the stages of HIV and how to know whether you’re infected. HIV strains in several compartments, such as the nervous system (brain and CSF) and genital tract (semen), can be genetically distinct from those in plasma, suggesting that they have been selected by or have adapted to these anatomic compartments. Thus, HIV levels and resistance patterns in these compartments may vary independently from those in plasma. or recurrent pyogenic bacterial infections Coccidioidomycosis, disseminated Histoplasmosis, disseminated Isoporaspp infection, > 1 month duration Kaposi sarcoma, any age Mycobacterium (not M tuberculosis), disseminated Mycobacterium tuberculosis–extrapulmonary Non-Hodgkin’s lymphoma (small noncleaved cell, Burkitt or non-Burkitt, immunoblastic sarcoma) Primary CNS lymphoma, any age Salmonella septicemia, an infective disease caused by parasites that are transmitted through the bite of an infected female Anopheles mosquito. It is caused by four different pathogens Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale , and is present in over 100 countries.
Palella FJ Jr, Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006 Sep. 43(1):27-34. [Medline].
Jump up ^ Levy JA, Kaminsky LS, Morrow WJW, Steimer K, Luciw P, Dina D, Hoxie J, Oshiro L (1985). “Infection by the retrovirus associated with the acquired immunodeficiency syndrome”. Annals of Internal Medicine. 103: 694–699. doi:10.7326/0003-4819-103-5-694.
Although many effective medications are on the market, the virus can become resistant to any drug. This can be a serious complication if it means that a less effective medicine must be used. To reduce the risk of resistance, patients should take their medications as prescribed and call their physician immediately if they feel they need to stop one or more drugs. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]