Kidney disease, which is a common complication of HIV infection and its treatment, may shorten the lifespan of affected patients. This review considers the breadth of conditions that may affect the kidneys in persons with HIV infection.
TDF is generally well tolerated although there may be rare kidney damage and may have a greater impact on reducing bone density than other agents. Both of these problems appear to be attenuated with the new formulation of tenofovir called TAF.
But even Sturdevant knows he can’t save everyone. A shadow passes over his face and his voice grows low when he talks about the one young man he couldn’t save. He remains haunted by him. A few years ago, a co-worker, Dot, suggested Sturdevant talk to a quiet fair-skinned man who was struggling with his H.I.V. diagnosis. “I told him my story and let him know, ‘You can do this, too,’ ” Sturdevant recalled. “He was in denial and very secretive, but still, he got into treatment and was doing good.”
Jump up ^ Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD (1998). “An African HIV-1 Sequence from 1959 and Implications for the Origin of the epidemic”. Nature. 391 (6667): 594–7. Bibcode:1998Natur.391..594Z. doi:10.1038/35400. PMID 9468138.
Rarely, HIV has been transmitted via transplantation of organs from HIV-seropositive donors. Infection has developed in recipients of kidney, liver, heart, pancreas, bone, and skin—all of which contain blood—but screening for HIV greatly reduces risk of transmission. HIV transmission is even more unlikely from transplantation of cornea, ethanol-treated and lyophilized bone, fresh-frozen bone without marrow, lyophilized tendon or fascia, or lyophilized and irradiated dura mater.
Ehlers-Danlos syndrome; Ehlers-Danlos diseases I-X hereditary connective tissue disorder characterized by collagen abnormality, marked generalized skin and blood vessel laxity, and joint hypermobility; skin is readily traumatized and heals slowly; see syndrome, hypermobility
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.
One morning in the winter of 1981, my wife came home after her on-call shift at the U.C.L.A. Medical Center and told me about a baffling new case. Queenie was an eighteen-year-old prostitute, his hair dyed the color of brass. He had arrived at the emergency room with a high fever and a cough, and appeared to have a routine kind of pneumonia, readily treated with antibiotics. But the medical team retrieved a microbe from his lungs called Pneumocystis carinii. The microbe was known for causing a rare fungal pneumonia that had been seen in severely malnourished children and in adults undergoing organ transplants or chemotherapy.
Jump up ^ RC Gallo; PS Sarin; EP Gelmann; M Robert-Guroff; E Richardson; VS Kalyanaraman; D Mann; GD Sidhu; RE Stahl; S Zolla-Pazner; J Leibowitch; M Popovic (1983). “Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS)”. Science. 220 (4599): 865–867. Bibcode:1983Sci…220..865G. doi:10.1126/science.6601823. PMID 6601823.
For HIV treatment to be effective in reducing HIV incidence, infections need to be diagnosed as quickly as possible. This requires increasing HIV testing coverage and frequency. CDC recommends testing all persons aged 13–64 years at least once as a routine part of medical care and more frequent testing (at least annually) for persons at high risk for HIV infection (7). A large proportion (84%) of HIV sexually transmitted from MSM and heterosexual persons is transmitted by MSM (1). Some sexually active MSM might benefit from more frequent testing (e.g., every 3 to 6 months) (18). Testing according to CDC guidelines is critical to diagnosing HIV infection, so that anyone who receives a diagnosis of HIV infection can start antiretroviral treatment. Overall, prior year testing increased among groups at high risk over time. However, 29% of MSM (in 2014), 42% of persons who inject drugs (in 2015), and 59% of heterosexual persons at increased risk (in 2016) did not report testing in the past 12 months. In addition, it is important to note that these data are from persons residing in large metropolitan statistical areas in the United States. Studies have found that persons residing in rural areas are less likely to report prior HIV testing, including in the past 12 months, compared with their urban counterparts, and that persons living in rural areas are more likely to have HIV infection diagnosed at a late stage (19,20). Barriers to implementing routine testing include lack of time, competing priorities, and concerns about reimbursement on the health care provider’s part and stigma and lack of perceived risk on the client’s part (21). Lack of perceived risk was also one of the main reasons cited by MSM in NHBS for not testing in the past 12 months.
People who inject drugs can take precautions against becoming infected with HIV by using sterile injecting equipment, including needles and syringes, for each injection and not sharing drug using equipment and drug solutions. Treatment of dependence, and in particular opioid substitution therapy for people dependent on opioids, also helps reduce the risk of HIV transmission and supports adherence to HIV treatment. A comprehensive package of interventions for HIV prevention and treatment includes:
Protease is an enzyme that HIV needs to replicate. As the name suggests, protease inhibitors bind to the enzyme and inhibit its action, preventing HIV from making copies of itself. These include atazanavir/cobicistat (Evotaz), lopinavir/ritonavir (Kaletra), and darunavir/cobicistat (Prezcobix).
Acute HIV infection may be associated with symptoms resembling mononucleosis or the flu within 2 to 4 weeks of exposure. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure.
HIV is a retrovirus, one of a unique family of viruses that consist of genetic material in the form of RNA (instead of DNA) surrounded by a lipoprotein envelope. HIV cannot replicate on its own and instead relies on the mechanisms of the host cell to produce new viral particles. HIV infects helper T cells by means of a protein embedded in its envelope called gp120. The gp120 protein binds to a molecule called CD4 on the surface of the helper T cell, an event that initiates a complex set of reactions that allow the HIV genetic information into the cell.
Jump up ^ Underhill K, Operario D, Montgomery P (2008). Operario, Don, ed. “Abstinence-only programs for HIV infection prevention in high-income countries”. Cochrane Database of Systematic Reviews (4): CD005421. doi:10.1002/14651858.CD005421.pub2. PMID 17943855. Archived from the original on November 25, 2010.
A subgroup of HIV-infected people (termed long-term nonprogressors) remains asymptomatic with high CD4 counts and low HIV levels in the blood without antiretroviral treatment. These people usually have vigorous cellular and humoral immune responses to their infecting HIV strain as measured by assays in vitro. The specificity of this effective response is shown by the following: When these people acquire a superinfection with a second strain of HIV to which their immune response is not as effective, they convert to a more typical pattern of progression. Thus, their unusually effective response to the first strain does not apply to the second strain. These cases provide a rationale for counseling HIV-infected people that they still need to avoid exposure to possible HIV superinfection through unsafe sex or needle sharing.
The main treatment for HIV is antiretroviral therapy (ART), a combination of daily medications that stop the virus from reproducing. This helps protect your CD4 cells, keeping your immune system strong enough to fight off disease.
At the same time, it is important to recognise that reaching an undetectable viral load is determined by many factors, including treatment adherence, HIV resistance to certain anti-retroviral drugs, stigma, and inadequate health systems.
The second phase of HIV infection, the asymptomatic period, lasts an average of 10 years. During that period the virus continues to replicate, and there is a slow decrease in the CD4 count (the number of helper T cells). When the CD4 count falls to about 200 cells per microlitre of blood (in an uninfected adult it is typically about 1,000 cells per microlitre), patients begin to experience opportunistic infections—i.e., infections that arise only in individuals with a defective immune system. That is AIDS, the final stage of HIV infection. The most-common opportunistic infections are Pneumocystis carinii pneumonia, tuberculosis, Mycobacterium avium infection, herpes simplex infection, bacterial pneumonia, toxoplasmosis, and cytomegalovirus infection. In addition, patients can develop dementia and certain cancers, including Kaposi sarcoma and lymphomas. Death ultimately results from the relentless attack of opportunistic pathogens or from the body’s inability to fight off malignancies.
Frightened and overwhelmed, he eventually landed on the doorstep of Grace House. “I couldn’t believe I was living in a shelter,” said Huff, who is now couch-surfing, applying for jobs at fast-food outlets and retail shops and attending Sturdevant’s support group, determined to stay healthy. “I felt like I had no one. Off and on, I got tired of living, because all I was doing was basically dying trying to stay alive.”
^ Jump up to: a b c Centers for Disease Control and Prevention, (CDC) (April 11, 2014). “Revised surveillance case definition for HIV infection—United States, 2014”. MMWR. Recommendations and reports : Morbidity and Mortality Weekly Report. Recommendations and reports / Centers for Disease Control. 63 (RR-03): 1–10. PMID 24717910.
Some conspiracy theories have been put about. Operation INFEKTION was a worldwide Soviet active measures operation to spread the claim that United States had created HIV/AIDS. Surveys show that a significant number of people believed – and continue to believe – in such claims. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]