Ndembi N, Goodall RL, Dunn DT, et al. Viral rebound and emergence of drug resistance in the absence of viral load testing: a randomized comparison between zidovudine-lamivudine plus Nevirapine and zidovudine-lamivudine plus Abacavir. J Infect Dis. 2010 Jan 1. 201(1):106-13. [Medline].
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.
Most HIV-infected individuals progress to AIDS over a period of years. The incidence of AIDS increases progressively with time after infection. Homosexuals and hemophiliacs are two of the groups at highest risk in the West—homosexuals from sexually (more…)
Jump up ^ Carr JK, Foley BT, Leitner T, Salminen M, Korber B, McCutchan F (1998). “Reference sequences representing the principal genetic diversity of HIV-1 in the pandemic” (PDF). In Los Alamos National Laboratory. HIV sequence compendium. Los Alamos, New Mexico: Los Alamos National Laboratory. pp. 10–19.
Plasma HIV virion levels, expressed as number of HIV RNA copies/mL, stabilize after about 6 mo at a level (set point) that varies widely among patients but averages 30,000 to 100,000/mL (4.2 to 5 log10/mL). The higher this set point, the more quickly the CD4 count decreases to a level that seriously impairs immunity (< 200/μL) and results in the opportunistic infections and cancers that define AIDS. In 2016 about 36.7 million people were living with HIV and it resulted in 1 million deaths. There were 300,000 fewer new HIV cases in 2016 than in 2015. Most of those infected live in sub-Saharan Africa. Between its discovery and 2014 AIDS has caused an estimated 39 million deaths worldwide. HIV/AIDS is considered a pandemic—a disease outbreak which is present over a large area and is actively spreading. HIV is believed to have originated in west-central Africa during the late 19th or early 20th century. AIDS was first recognized by the United States Centers for Disease Control and Prevention (CDC) in 1981 and its cause—HIV infection—was identified in the early part of the decade. Once a person has been infected with HIV he or she remains infected for life and is able to transmit the virus to others. The risk of transmitting the infection to another person is dependent on the level of virus in body fluids of the infected person. Women exposed to HIV infection through heterosexual contact are the most rapidly growing risk group in the United States. The percentage of AIDS cases diagnosed in American women has risen from 7% in 1985 to about 25% in 2006. According to the CDC, in 2006 approximately 278,400 women in the United States were living with HIV/AIDS. The rate was highest among black women and lowest among white women. About 75% of these women contracted HIV through high-risk heterosexual activity; almost all of the remainder acquired the infection through needle sharing. ^ Jump up to: a b Pope M, Haase AT (2003). "Transmission, acute HIV-1 infection and the quest for strategies to prevent infection". Nature Medicine. 9 (7): 847–52. doi:10.1038/nm0703-847. PMID 12835704. The earliest unambiguously identified HIV-antibody positive serum stems from Kinhasa, Zaire dating back to 1959. HIV infection spread unrecognized in the 1960s and 1970s before it was finally recognized in 1981. The spread of the virus has been phenomenal thereafter, and close to 40 million people are estimated to be infected with the virus. There are two main ways HIV is spread in the United States -- by sex and by sharing needles, syringes or any of the equipment used to prepare and inject drugs. Anal sex carries the highest risk, followed by vaginal sex and having multiple partners. We've come a long way from the days when diagnosis with HIV equaled a death sentence. Today, there are a variety of treatments that, when used in combination can significantly slow down and in some cases stop altogether, the progression of HIV infection. Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr. 2010 Mar 1. 53(3):311-22. [Medline]. Drug-resistance testing also has become a key tool in the management of HIV-infected individuals. Details of these tests will be discussed later. Clearly, resistance testing is now routinely used in individuals experiencing poor responses to HIV therapy or treatment failure. In general, a poor response to initial treatment would include individuals who fail to experience a decline in viral load of approximately hundredfold in the first weeks, have a viral load of greater than 500 copies per mL by week 12, or have levels greater than 50 copies per mL by week 24. Treatment failure would generally be defined as an increase in viral load after an initial decline in a person who is believed to be consistently taking his or her medications. Since drug-resistant virus can be transmitted, guidelines from the U.S. Department of Health and Human Services (DHHS) (https://aidsinfo.nih.gov/) and International Antiviral Society-USA (IAS-USA) have suggested that resistance testing be performed in individuals who have never been on therapy to determine if they might have acquired HIV that is resistant to drugs. Some people may develop a flu-like illness within a month or two after exposure to the HIV virus, although many people do not develop any symptoms at all when they first become infected. Many people mistake this flu-like illness as being caused by something else. Persistent or severe symptoms may not surface for 10 years or more, after HIV first enters the body in adults, or within two years in children born with an HIV infection. Side effects of combinations of antiretroviral drugs may be unpleasant and serious. However, doctors can prevent many serious problems (such as anemia, hepatitis, kidney problems, and pancreatitis) by regularly examining the person and blood tests. The blood tests can detect side effects before they become serious and enable doctors to change antiretroviral drugs when needed. For most people, doctors can find a combination of drugs with minimal side effects. If screening test results are positive, they are confirmed by a more accurate, specific tests such as the Western blot. The Western blot test is more difficult to do than screening tests but is more accurate. PrEP is short for pre-exposure prophylaxis. People who do not have HIV can take a daily pill to reduce their risk of becoming infected. PrEP is not right for everyone and must still be used in combination with safer sex and injection practices. It requires commitment to treatment and does not replace other prevention measures like condom use. It also requires very regular medical visits and frequent blood tests for STDs and HIV, because unknowingly continuing PrEP medication while HIV-infected can lead to resistance and limit HIV treatment options. Resistance has already been reported in a person who became infected while taking PrEP. Human immunodeficiency virus (HIV) is a blood-borne, sexually transmissible virus (see the image below.) The virus is typically transmitted via sexual intercourse, shared intravenous drug paraphernalia, and mother-to-child transmission (MTCT), which can occur during the birth process or during breastfeeding. Nowhere are the two sides more split than on the issue of condoms. Schools in at least 23 cities sought to distribute condoms during the mid-to late-1990s. The assumption was that since students will have sex anyway—despite warnings not to—they had better be protected. Conservatives see this position as a cop-out in two ways: it sells values short and it undermines parental authority. In 1992, in Washington, D.C., critics erupted over a decision by the Public Health Commission to hand out condoms in junior and senior high schools without parental consent. William Brown, president of the D.C. Congress of Parents and Teachers, complained: "We are looking to build and reinforce and establish family values where they have been lost, and here we have an agency of our government that totally ignores those things we are working for." Dr. Mary Ellen Bradshaw, the commission's chief, replied: "Our whole focus is to save the lives of these children, stressing abstinence as the only sure way to avoid [AIDS] and making condoms available only after intensive education." In other cities, upset parents simply sued. By 1992, Class Action lawsuits had been brought against school districts in New York City, Seattle, and Falmouth, Massachusetts, arguing that condom distribution violated parents' right to privacy. [redirect url='http://penetratearticles.info/bump' sec='7']