^ Jump up to: a b c Herek GM, Capitanio JP (1999). “AIDS Stigma and sexual prejudice” (PDF). American Behavioral Scientist. 42 (7): 1130–1147. doi:10.1177/0002764299042007006. Archived from the original (PDF) on April 9, 2006. Retrieved March 27, 2006.
The most powerful known cause of innate human immunodeficiency virus resistance is CCR5Δ32, a mutant allele, coding for a truncated inactive form of CCR5 (Dean et al., 1996; Dragic et al., 1996; Huang et al., 1996; Liu et al., 1996; Michael et al., 1997; Samson et al., 1996; Zimmerman et al., 1997). CX3CR1 that recognizes ABCD-3 is a recently identified human immunodeficiency virus coreceptor too (Combadiere et al., 1998; Reeves et al., 1997; Rucker et al., 1997). CX3CR1 interacts only with a limited number of human immunodeficiency virus envelopes, and ABCD-3 can efficiently block human immunodeficiency virus coreceptor activity of CX3CR1 (Combadiere et al., 1998). That CX3CR1 functions as a human immunodeficiency virus coreceptor suggests that nucleotide polymorphic variations of it may slow or accelerate disease progression. Indeed, rapid progression to acquired immunodeficiency syndrome was observed in human immunodeficiency virus individuals with a structural variant of CX3CR1 (Faure et al., 2000).
“PrEP is feasible and effective for African women in discordant relationships with high adherence and has a significant impact on reducing new HIV infections..”–Dr. William Blattner, JAIDS Co-Editor-in-Chief
a retrovirus that causes acquired immunodeficiency syndrome (AIDS). Retroviruses produce the enzyme reverse transcriptase, which allows the viral RNA genome to be transcribed into DNA inside the host cell. HIV is transmitted through contact with an infected individual’s blood, semen, breast milk, cervical secretions, cerebrospinal fluid, or synovial fluid. It infects CD4-positive helper T cells of the immune system and causes infection with an incubation period that averages 10 years. With the immune system destroyed, AIDS develops as opportunistic infections such as candidiasis, Kaposi’s sarcoma, Pneumocystis pneumonia, and tuberculosis attack organ systems throughout the body. Aside from the initial antibody tests (enzyme-linked immunosorbent assay and Western blot) that establish the diagnosis for HIV infection, the most important laboratory test for monitoring the level of infection is the CD4 lymphocyte test, which determines the percentage of T lymphocytes that are CD4 positive. Patients with CD4 cell counts greater than 500/mm3 are considered most likely to respond to treatment with alpha-interferon and/or zidovudine. A significant drop in the CD4 cell count is a signal for therapeutic intervention with antiretroviral therapy. Vaccines based on the HIV envelope glycoproteins gp120 and gp160, intended to boost the immune system of people already infected with HIV, are being investigated. Formerly called human T-cell leukemia virus type III, human T-cell lymphotropic virus type III. See also acquired immunodeficiency syndrome.
The earliest, well-documented case of HIV in a human dates back to 1959 in the Belgian Congo. The virus may have been present in the United States as as the mid-to-late 1950s, as a sixteen-year-old male presented with symptoms in 1966 died in 1969.
The viral load of an infected person is an important risk factor in both sexual and mother-to-child transmission. During the first 2.5 months of an HIV infection a person’s infectiousness is twelve times higher due to this high viral load. If the person is in the late stages of infection, rates of transmission are approximately eightfold greater. An HIV-positive person who has an undetectable viral load as a result of long-term treatment has effectively no risk of transmitting HIV sexually.
A person gets HIV when an infected person’s body fluids (blood, semen, fluids from the vagina or breast milk) enter his or her bloodstream. The virus can enter the blood through linings in the mouth, anus, or sex organs (the penis and vagina), or through broken skin.
The basis of management is described in the separate article Human Immunideficiency Virus (HIV). There may be defining conditions such as Pneumocystis jirovecii pneumonia that will need treatment. Highly active antiretroviral therapy (HAART) has improved the prognosis enormously in terms of duration of survival but premature death is to be expected.
It appears that macrophage-tropic isolates of HIV are preferentially transmitted by sexual contact as they are the dominant viral phenotype found in newly infected individuals. Virus is disseminated from an initial reservoir of infected dendritic cells and macrophages and there is evidence for an important role for mucosal lymphoid tissue in this process. Mucosal epithelia, which are constantly exposed to foreign antigens, provide a milieu of immune system activity in which HIV replication occurs readily. Infection of CD4 T cells via CCR5 occurs early in the course of infection and continues to occur, with activated CD4 T cells accounting for the major production of HIV throughout infection. Late in infection, in approximately 50% of cases, the viral phenotype switches to a T-lymphocyte-tropic type that utilizes CXCR4 co-receptors, and this is followed by a rapid decline in CD4 T-cell count and progression to AIDS.
There are complete copies of HIV genetic material among the strands of mRNAs produced by the cell. These gather together with newly made HIV proteins and enzymes to form new viral particles, which are then released from the cell. The enzyme protease plays a vitla role at this stage of HIV’s life cycle by cutting down long strands of protein into smaller pieces, which are used to construct mature viral cores.
HIV is one of a group of viruses known as retroviruses. After getting into the body, the virus enters many different cells, incorporates its genes into the human DNA, and hijacks the cell to produce HIV virus. Most importantly, HIV attacks cells of the body’s immune system called CD4 or T-helper cells (T cells). These cells are destroyed by the infection. The body tries to keep up by making new T cells or trying to contain the virus, but eventually the HIV wins out and progressively destroys the body’s ability to fight infections and certain cancers. The virus structure has been studied extensively, and this ongoing research has helped scientists develop new treatments for HIV/AIDS. Although all HIV viruses are similar, small variations or mutations in the genetic material of the virus create drug-resistant viruses. Larger variations in the viral genes are found in different viral subtypes. Currently, HIV-1 is the predominant subtype that causes HIV/AIDS. HIV-2, another form of HIV, occurs almost exclusively in West Africa.
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 attaches to and penetrates host T cells via CD4+ molecules and chemokine receptors (see Figure: Simplified HIV life cycle.). After attachment, HIV RNA and several HIV-encoded enzymes are released into the host cell.
As soon as you’re infected with HIV, it starts to reproduce in your body. Your immune system reacts to the antigens by producing antibodies. The time between exposure to HIV and when it becomes detectable in your blood is called the HIV window period.
Cryptosporidiosis. This infection is caused by an intestinal parasite that’s commonly found in animals. You get it when you eat or drink contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS.
Where you live matters. People in the United States and other developed countries are more likely to have access to antiretroviral therapy. Consistent use of these drugs helps prevent HIV from progressing to AIDS.
Oral PrEP of HIV is the daily use of ARV drugs by HIV-negative people to block the acquisition of HIV. More than 10 randomized controlled studies have demonstrated the effectiveness of PrEP in reducing HIV transmission among a range of populations including serodiscordant heterosexual couples (where one partner is infected and the other is not), men who have sex with men, transgender women, high-risk heterosexual couples, and people who inject drugs.
AIDS education in schools is not merely a local issue. While most decisions are made by states and school boards the federal government plays two important roles. First, it funds AIDS prevention programs: abstinence-based programs receive funding under the Adolescent Family Life Act of 1981, and programs that promote contraceptive use among teenagers are supported through the Family Planning Act of 1970. How these funds are spent is a matter of local control, but conservatives have sought to put limits on program content. During the early 1990s, Senator jesse helms (R-NC) twice tried to ban funding for programs that were perceived to promote homosexuality or that did not continuously teach abstinence as the only effective protection against AIDS. In response, one federal agency, the Center for Disease Control, adopted regulations that prohibited the use of funds on any materials that are found offensive by some members of communities.
Few viruses produce toxins, although viral infections of bacteria can cause previously innocuous bacteria to become much more pathogenic and toxic. Other viral proteins, such as some of the human immunodeficiency virus, appear to be actively toxic, but those are the exception, not the rule.
CDC recommends routine testing for HIV infection for persons aged 13–64 years in health care settings and testing at least annually for persons at high risk for HIV infection (7). Yet, according to National HIV Behavioral Surveillance (NHBS), one third of gay, bisexual, and other men who have sex with men (MSM) have not been tested in the past year, with even lower percentages of recent testing reported among other population segments at high risk for HIV infection.
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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.
A count below about 50 cells per microliter of blood is particularly dangerous because additional opportunistic infections that can rapidly cause severe weight loss, blindness, or death commonly occur. These infections include
There are an estimated 42 million people in the world living with HIV/AIDS, of which 19.2 million are women, and 3.2 million are children below 15 years of age. In 2002, there were 5 million newly infected HIV individuals and 3.1 million deaths relating to AIDS. In the United States, HIV/AIDS is more prevalent in African American and Hispanic communities than Caucasians.
“There are many different opportunistic infections and each one can present differently,” Dr. Malvestutto says. In Ron’s case, it was Pneumocystis pneumonia (PCP), aka “AIDS pneumonia,” which eventually landed him in the hospital.
Jump up ^ Celum CL, Coombs RW, Lafferty W, Inui TS, Louie PH, Gates CA, McCreedy BJ, Egan R, Grove T, Alexander S (1991). “Indeterminate human immunodeficiency virus type 1 western blots: seroconversion risk, specificity of supplemental tests, and an algorithm for evaluation”. The Journal of Infectious Diseases. 164 (4): 656–664. doi:10.1093/infdis/164.4.656. PMID 1894929. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]