These subtypes are sometimes further split into sub-subtypes such as A1 and A2 or F1 and F2. In 2015, the strain CRF19, a recombinant of subtype A, subtype D and subtype G, with a subtype D protease, was found to be strongly associated with rapid progression to AIDS in Cuba. This is not thought to be a complete or final list, and further types are likely to be found.
Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was originally discovered (and initially referred to also as LAV or HTLV-III). It is more virulent, more infective, and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2 as compared with HIV-1 implies that fewer people exposed to HIV-2 will be infected per exposure. Because of its relatively poor capacity for transmission, HIV-2 is largely confined to West Africa.
“Safe sex” practices, such as latex condoms, are highly effective in preventing HIV transmission. HOWEVER, there remains a risk of acquiring the infection even with the use of condoms. Abstinence is the only sure way to prevent sexual transmission of HIV.
A blood test can tell if you have HIV infection. Your health care provider can do the test, or you can use a home testing kit. Or to find free testing sites, call the national referral hotline at 1-800-CDC-INFO (1-800-232-4636 in English and en español; 1-888-232-6348 – TTY).
tarsal tunnel syndrome; TTS pain, paraesthesia and numbness in sole of foot; due to tibial nerve compression within tarsal tunnel; associated with excess foot pronation or rearfoot rheumatoid arthritis; symptoms reproduced by tapping the skin overlying distal medial malleolar area (Tinel’s sign positive); conservative treatment includes valgus filler pads, cobra pads and medial heel wedges, or control of excessive rearfoot pronation with moulded cushioned orthoses worn with bespoke shoes, together with non-steroidal anti-inflammatory drugs and/or disease-modifying antirheumatic drugs; surgical treatment includes decompression procedures to free posterior tibial nerve and excise local fibrous structures (see tarsal tunnel)
The prevalence of women with HIV in the United States is low compared to the rate in many countries in the developing world. Worldwide about half the people living with HIV are women. According to the United Nations, in 2005 about 59% of women living in sub-Saharan Africa are infected with HIV. The vast majority of them were infected through sex with an infected male partner.
These symptoms can come and go or get progressively worse. If you’ve been exposed to HIV, you may also have been exposed to other sexually transmitted diseases (STDs). Men are more likely than women to notice symptoms like sores on their genitals. But men typically don’t seek medical care as often as women.
In the United States, guidelines for using antiviral therapy have been developed and are updated on a regular basis by an expert panel assembled by the DHHS, the IAS-USA panel, and others. The DHHS guidelines are available at https://aidsinfo.nih.gov/. The most recent IAS-USA guidelines were published in the Journal of the American Medical Association (JAMA) in the summer of 2016.
Universal precautions within the health care environment are believed to be effective in decreasing the risk of HIV. Intravenous drug use is an important risk factor and harm reduction strategies such as needle-exchange programs and opioid substitution therapy appear effective in decreasing this risk.
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.
Many people with HIV do not know they are infected. In the United States, it is likely that 14% of HIV-positive individuals are unaware of their infection. HIV infection progresses in three very general stages.
The second most frequent mode of HIV transmission is via blood and blood products. Blood-borne transmission can be through needle-sharing during intravenous drug use, needle stick injury, transfusion of contaminated blood or blood product, or medical injections with unsterilized equipment. The risk from sharing a needle during drug injection is between 0.63 and 2.4% per act, with an average of 0.8%. The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333) per act and the risk following mucous membrane exposure to infected blood as 0.09% (about 1 in 1000) per act. In the United States intravenous drug users made up 12% of all new cases of HIV in 2009, and in some areas more than 80% of people who inject drugs are HIV positive.
runner’s-knee syndrome mild lateral subluxation of patella in patellar groove; due to an increase in Q angle (i.e. >15°), often in association with excessive foot pronation, tibial varum, internal tibial torsion, weakened quadriceps group, malposition of vastus medialis, hard running surfaces or faulty sports shoes, leading to uneven pressure on anterolateral surface of femoral condyle and local pain; often affects female runners; treated by prescription orthoses to reduce torque, torsion and knee joint stress
No effective cure currently exists, but with proper medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.
Jump up ^ Zhu T, Wang N, Carr A, Nam DS, Moor-Jankowski R, Cooper DA, Ho DD (1996). “Genetic characterization of human immunodeficiency virus type 1 in blood and genital secretions: evidence for viral compartmentalization and selection during sexual transmission”. Journal of Virology. 70 (5): 3098–107. PMC 190172 . PMID 8627789.
HIV-2 diagnosis can be made when a patient has no symptoms but positive blood work indicating the individual has HIV. The Multispot HIV-1/HIV-2 Rapid Test is currently the only FDA approved method for such differentiation between the two viruses. Recommendations for the screening and diagnosis of HIV has always been to use enzyme immunoassays that detect HIV-1, HIV-1 group O, and HIV-2. When screening the combination, if the test is positive followed by an indeterminate HIV-1 western blot, a follow up test, such as amino acid testing, must be performed to distinguish which infection is present. According to the NIH, a differential diagnosis of HIV-2 should be considered when a person is of West African descent or has had sexual contact or shared needles with such a person. West Africa is at the highest risk as it is the origin of the virus.
The total number of cases of HIV in the UK includes 120 cases from injecting drug use (IDU). IDU has played a smaller part in the HIV epidemic in the UK than it has in many other European countries and the numbers of new diagnoses have been around 100 for the last few years. In 2013, the prevalence in England, Wales and Northern Ireland in recent initiates to injectable drugs was 1.0%. This was similar to previous years, suggesting that this source of infection remained at relatively low levels.
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.
45. Centers for Disease Control and Prevention (CDC) (1989) ‘Guidelines for Prophylaxis Against Pneumocystis carinii Pneumonia for Persons Infected with Human Immunodeficiency Virus’ MMWR Weekly 38(S-5):1-9
These drugs prevent HIV from replicating in cells and dramatically reduce the amount of HIV in the blood over a few days to weeks. If replication is sufficiently slowed, the destruction of lymphocytes by HIV is decreased and the CD4 count begins to increase. As a result, much of the damage to the immune system caused by HIV can be reversed. Doctors can detect this reversal by measuring the CD4 count, which begins to return toward normal levels over weeks to months. The CD4 count continues to increase for several years but at a slower rate.
Jump up ^ Miyauchi K, Kim Y, Latinovic O, Morozov V, Melikyan GB (2009). “HIV Enters Cells via Endocytosis and Dynamin-Dependent Fusion with Endosomes”. Cell. 137 (3): 433–444. doi:10.1016/j.cell.2009.02.046. PMC 2696170 . PMID 19410541.
Studies with powerful drugs that completely block the cycle of HIV replication indicate that the virus is replicating rapidly at all phases of infection, including the asymptomatic phase. Two viral proteins in particular have been the target of drugs aimed at arresting viral replication. These are the viral reverse transcriptase, which is required for synthesis of the provirus, and the viral protease, which cleaves the viral polyproteins to produce the virion proteins and viral enzymes. Inhibitors of these enzymes prevent the establishment of further infection in uninfected cells. Cells that are already infected can continue to produce virions because, once the provirus is established, reverse transcriptase is not needed to make new virus particles, while the viral protease acts at a very late maturation step of the virus, and inhibition of the protease does not prevent virus from being released. However, in both cases, the released virions are not infectious and further cycles of infection and replication are prevented.
^ Jump up to: a b Marx PA, Alcabes PG, Drucker E (2001). “Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa” (PDF). Philosophical Transactions of the Royal Society B. 356 (1410): 911–20. doi:10.1098/rstb.2001.0867. PMC 1088484 . PMID 11405938. Archived (PDF) from the original on September 17, 2013.
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].
In developing nations, co-infection with HIV and tuberculosis is very common. The immunosuppressed state induced by HIV infection contributes not only to a higher rate of tuberculosis reactivation but also to an increased disease severity, as with many other opportunistic infections.
Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, and Society forHealthcare Epidemiology of America
Diagnosis of HIV infection is made using blood tests. A positive blood test indicates the development of antibodies to HIV and therefore the presence of the virus. Antibodies to HIV usually develop within a few weeks to three months. Even though the blood test for antibodies may not be positive during the early stage of infection, the virus will be present in blood and body fluids, making the person infectious to other people. Polymerase chain reaction (PCR) tests in a pathology laboratory can be used for the early detection of HIV genetic material in the blood. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]