human T-cell lymphotropic virus type III; a cytopathic retrovirus (genus Lentvirus, family Retroviridae) that is 100-120 nm in diameter, has a lipid envelope, and has a characteristic dense cylindric nucleoid containing core proteins and genomic RNA. There are currently two types: HIV-1 infects only humans and chimpanzees and is more virulent than HIV-2, which is more closely related to Simian or monkey viruses. HIV-2 is found primarily in West Africa and is not as widespread as HIV-1. In addition to the usual gene associated with retroviruses, this virus has at least six genes that regulate its replication. It is the etiologic agent of acquired immunodeficiency syndrome (AIDS). Formerly or also known as the lymphadenopathy virus (LAV) or the human T-cell lymphotropic virus type III (HTLV-III). Identified in 1984 by Luc Montagnier and colleagues.
Nathan King wants to help fight the stigma associated with PrEP. “Unlike many medical breakthroughs and preventive strategies, PrEP, and its users, faced criticism from the beginning,” he said. “People who used the medication are stigmatized and stereotyped, rather than supported for taking steps to protect the health of themselves and their communities.”
A transmissible retrovirus that causes AIDS in humans. Two forms of HIV are now recognized: HIV-1, which causes most cases of AIDS in Europe, North and South America, and most parts of Africa; and HIV-2, which is chiefly found in West African patients. HIV-2, discovered in 1986, appears to be less virulent than HIV-1, but also may have a longer latency period.
Like his predecessors, President bill clinton called for fighting the disease, rather than the people afflicted with it. In 1993, he appointed the first federal AIDS policy coordinator. He fully funded the Ryan White Care Act, increasing government support by 83 percent, to $633 million, and also increased funding for AIDS research, prevention, and treatment by 30 percent. These measures met most of his campaign promises on AIDS. He reneged on one: despite vowing to lift the ban on HIV-positive Aliens, he signed legislation continuing it. In addition, he met a major obstacle on another proposal: Congress failed to pass his health care reform package, which would have provided health coverage to all U.S. citizens with HIV, delivered drug treatment against AIDS on demand to intravenous drug users, and prohibited health plans from providing lower coverage for AIDS than for other life-threatening diseases.
The best combination of drugs for HIV are those that effectively suppress viral replication in the blood and also are well tolerated and simple to take so that people can take the medications consistently without missing doses.
Parasitic Infections of the biliary tract are a common cause of biliary obstruction in endemic areas.96,97 Tropical and subtropical countries have the highest incidence and prevalence of these infections. Radiologic imaging may show intrahepatic ductal dilatation. ERCP can be used diagnostically and therapeutically.98 Endoscopic extraction of biliary ascariasis can be performed without sphincterotomy using wire guide baskets.99,100
These sub-epidemics each follow their own pattern, although there is some degree of interdependence. Early on, nearly all cases of HIV infection detected in the Western Hemisphere were in homosexual men, but the spread of the disease to female partners of bisexual men with HIV infection gave rise to an increased rate among heterosexual persons.
acronym for Acquired Immune Deficiency Syndrome, a serious disease caused by Human Immunodeficiency Virus (HIV) which debilitates the immune system. HIV 1 attaches to the CD4 receptor present on T LYMPHOCYTES and MACROPHAGES. The viral RNA enters the host cell and is transcribed by REVERSE TRANSCRIPTASE into DNA. This viral DNA becomes integrated into the chromosomal DNA of the host. There it may control the production of new HIV particles, which are budded off from the infected host cell. Alternatively, the integrated DNA may remain latent and not be detected by the immune system. HIV avoids the host’s IMMUNE RESPONSE by remaining in vacuoles within macrophages. HIV also shows high rates of ANTIGENIC VARIATION, since errors during replication of HIV RNA to DNA cause numerous changes in the nature of the ENVELOPE PROTEINS of the virus. Not everyone who carries HIV develops AIDS, but all infected individuals can pass it on. There are three major routes of transmission:
Antiretroviral therapy should be initiated regardless of CD4 count in pregnant patients, patients with HIV-associated nephropathy, and those with hepatitis B virus (HBV) coinfection when treatment of HBV infection is indicated
A small but vocal minority of people, including some scientists, continue to argue that HIV does not exist, or does not cause AIDS, and that the HIV tests are unreliable or that the therapies are toxic. Such misinformation is usually based on a lack of understanding of the scientific literature, deliberate misrepresentation, or logical fallacies based on pseudoscientific arguments.
The prognosis in patients with untreated HIV infection is poor, with an overall mortality rate of more than 90%. The average time from infection to death is 8-10 years, although individual variability ranges from less than 1 year to long-term nonprogression. Many variables have been implicated in HIV’s rate of progression, including CCR5-delta32 heterozygosity, mental health,  concomitant drug or alcohol abuse, superinfection with another HIV strain, nutrition, and age.
Jump up ^ Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS (1997). “The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia”. Proc Natl Acad Sci U S A. 94 (1): 254–258. Bibcode:1997PNAS…94..254P. doi:10.1073/pnas.94.1.254. PMC 19306 . PMID 8990195.
In 1983, two separate research groups led by American Robert Gallo and French investigators Françoise Barré-Sinoussi and Luc Montagnier independently declared that a novel retrovirus may have been infecting AIDS patients, and published their findings in the same issue of the journal Science. Gallo claimed that a virus his group had isolated from a person with AIDS was strikingly similar in shape to other human T-lymphotropic viruses (HTLVs) his group had been the first to isolate. Gallo’s group called their newly isolated virus HTLV-III. At the time, Montagnier’s group isolated a virus from a patient presenting with swelling of the lymph nodes of the neck and physical weakness, two classic symptoms of AIDS. Contradicting the report from Gallo’s group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier’s group named their isolated virus lymphadenopathy-associated virus (LAV). As these two viruses turned out to be the same, in 1986 LAV and HTLV-III were renamed HIV.
When HIV infection is diagnosed in a routine test, as for blood donation, in pregnancy, or after counselling a person with a lifestyle that puts him or her at risk, there is not usually full AIDS but just infection with HIV. When the disease is suspected, HIV counselling must precede testing. There is a characteristic presentation of the infection that is described in the separate article Primary HIV Infection. Once the diagnosis is made, the separate article Managing HIV-positive Individuals in Primary Care becomes relevant. The separate article HIV and Skin Disorders outlines the many dermatological manifestations of the disease.
State Legislation and the Courts To stem transmission of HIV, states have adopted several legal measures. Two states attempted to head off the virus at the pass: Illinois and Louisiana at one point required HIV blood testing as a prerequisite to getting a marriage license. Both states ultimately repealed these statutes because they were difficult to enforce; couples simply crossed state lines to be married in neighboring states. Several states have taken a less stringent approach, requiring only that applicants for a marriage license must be informed of the availability—and advisability—of HIV tests. More commonly, states criminalize sexual behavior that can spread AIDS. Michigan law makes it a felony for an HIV or AIDS-infected person to engage in sex without first informing a partner of the infection. Florida law provides for the prosecution of any HIV-positive person committing prostitution, and it permits rape victims to demand that their attackers undergo testing. Indiana imposes penalties on persons who recklessly or knowingly donate blood or semen with the knowledge that they are HIV-infected.
Jump up ^ “WHO HIV and Infant Feeding Technical Consultation Held on behalf of the Inter-agency Task Team (IATT) on Prevention of HIV – Infections in Pregnant Women, Mothers and their Infants – Consensus statement” (PDF). October 25–27, 2006. Archived (PDF) from the original on April 9, 2008. Retrieved March 12, 2008.
Currently, there is no licensed vaccine for HIV or AIDS. The most effective vaccine trial to date, RV 144, was published in 2009 and found a partial reduction in the risk of transmission of roughly 30%, stimulating some hope in the research community of developing a truly effective vaccine. Further trials of the RV 144 vaccine are ongoing.
Key populations are groups who are at increased risk of HIV irrespective of epidemic type or local context. They include: men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people.
Jump up ^ Beyrer, C; Baral, SD; van Griensven, F; Goodreau, SM; Chariyalertsak, S; Wirtz, AL; Brookmeyer, R (Jul 28, 2012). “Global epidemiology of HIV infection in men who have sex with men”. Lancet. 380 (9839): 367–77. doi:10.1016/S0140-6736(12)60821-6. PMID 22819660.
In a study of 6,036 HIV-infected patients who had achieved suppression of HIV with antiretroviral therapy, researchers found that the incidence of non-Hodgkin lymphoma (NHL) remained high (171 per 100,000 person-years [PY]), far exceeding the rate of approximately 10 to 20 per 100,000 person-years reported in HIV-uninfected populations. The high incidence of NHL was observed even in patients with nadir CD4 cell count > 200 cells/μl (140 per 100,000 PY). After adjustment for older age, white race, male sex, HCV coinfection, and time-varying CD4 cell count, the risk of NHL risk was higher when HIV viremia was above the limit of detection (50 copies/mL) in a dose-dependent manner. [86, 87]
Jump up ^ Nunnari G, Coco C, Pinzone MR, Pavone P, Berretta M, Di Rosa M, Schnell M, Calabrese G, Cacopardo B (2012). “The role of micronutrients in the diet of HIV-1-infected individuals”. Front Biosci. 4: 2442–56. PMID 22652651. Archived from the original on April 16, 2015.
People living with HIV/AIDS are required to achieve high levels of adherence to benefit from many antiretroviral regimens. This review identified 19 studies involving a total of 2,159 participants that evaluated an intervention intended to improve adherence. Ten of these studies demonstrated a beneficial effect of the intervention. We found that interventions targeting practical medication management skills, those administered to individuals vs groups, and those interventions delivered over 12 weeks or more were associated with improved adherence to antiretroviral therapy. We also found that interventions targeting marginalized populations such as women, Latinos, or patients with a past history of alcoholism were not successful at improving adherence. We did not find studies that evaluated the quality of the patient‐provider relationship or the clinical setting. Most studies had several methodological shortcomings.
Sexual practices such as fellatio and cunnilingus appear to be relatively low risk but not absolutely safe (see Table: HIV Transmission Risk for Several Sexual Activities). Risk does not increase significantly if semen or vaginal secretions are swallowed. However, open sores in the mouth may increase risk.
^ Jump up to: a b c d Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach (PDF). World Health Organization. 2010. pp. 19–20. ISBN 978-92-4-159976-4. Archived (PDF) from the original on July 9, 2012. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]