Universal precautions: Medical and dental health care practitioners should wear gloves in situations that may involve contact with any patient’s mucous membranes or body fluids and should be taught how to avoid needlestick accidents. Home caregivers of patients with HIV infection should wear gloves if their hands may be exposed to body fluids. Surfaces or instruments contaminated by blood or other body fluids should be cleaned and disinfected. Effective disinfectants include heat, peroxide, alcohols, phenolics, and hypochlorite (bleach). Isolation of HIV-infected patients is unnecessary unless indicated by an opportunistic infection (eg, TB). Guidelines to prevent transmission from infected practitioners to patients have not been established. See also the CDC’s Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures.
In some individuals treatment may not be commenced as recommended and disease progression may occur. The length of time that people with untreated HIV infection may live without symptoms varies widely. Some people experience rapid development of symptoms or disease due to their HIV infection, whereas others may remain free of any symptoms for years.
HIV/AIDS affects the economics of both individuals and countries. The gross domestic product of the most affected countries has decreased due to the lack of human capital. Without proper nutrition, health care and medicine, large numbers of people die from AIDS-related complications. They will not only be unable to work, but will also require significant medical care. It is estimated that as of 2007 there were 12 million AIDS orphans. Many are cared for by elderly grandparents.
The genome of HIV-1 is dimeric, unsegmented and contains a single molecule of linear. The genome is -RT and is positive-sense, single-stranded RNA. The complete genome is fully sequenced and of one monomer 9200 nucleotides long. The genome has terminally redundant sequences that have long terminal repeats (LTR) of about 600 nt. The 5′-end of the genome has a methylated nucleotide cap with a sequence of type 1 m7G5ppp6’GmpNp. The 3′-terminus has a poly (A) tract and has a tRNA-like structure and accepts lysin. Two copies of the genome are present in the virion in a dimeric configuration with two copies per particle being held together by hydrogen bonds to form a dimer. (source: ICTV db Descriptions)
Guttmacher Institute. An overview of minors’ consent law. State Policies in Brief. New York (NY): GI; 2013. Available at: http://www.guttmacher.org/statecenter/spibs/spib_OMCL.pdf. Retrieved November 4, 2013.
HIV produces cellular immune deficiency characterized by the depletion of helper T lymphocytes (CD4+ cells). The loss of CD4+ cells results in the development of opportunistic infections and neoplastic processes.
DeJesus E, Rockstroh JK, Henry K, et al. Co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate versus ritonavir-boosted atazanavir plus co-formulated emtricitabine and tenofovir disoproxil fumarate for initial treatment of HIV-1 infection: a randomised, double-blind, phase 3, non-inferiority trial. Lancet. 2012 Jun 30. 379(9835):2429-38. [Medline].
[Guideline] CDC. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/hiv/pdf/HIVtestingAlgorithmRecommendation-Final.pdf. Accessed: Jul 7 2014.
CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2015. HIV Surveillance Supplemental Report, vol. 22, no. 2. Atlanta, GA: US Department of Health and Human Services, CDC; 2017. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-22-2.pdf
HIV/AIDS can be diagnosed via a blood test to see the presence of antibodies to the HIV virus. Blood given for donation in many places is screened for HIV before it is administered to patients, as blood transfusion can be one mode of transmission of the HIV virus. HIV/AIDS patients face many serious health conditions. For example, they are more prone to cancers which can be aggressive and devastating. Sometimes, individuals may not be able to carry out their normal lifestyles, while in other cases, individuals may experience bouts of illness and then a calm. There are two general classes of drugs used to treat HIV/AIDS: nucleoside reverse transcriptase inhibitors and protease inhibitors. The first class works during the replication of the virus while the second influences the virus life cycle later on.
Mandatory testing strategies are problematic because they abridge a woman’s autonomy. In addition, during pregnancy, the public health objective of this strategy, identification of women who are infected with HIV who will benefit from treatment, has been accomplished in certain populations by other ethically sound testing strategies noted previously (6). Some see mandatory testing as a more efficient way of achieving universal testing. Advocates support this strategy, believing it provides the greatest good for the greatest number and that the potential benefit to the woman and, if pregnant, her newborn justifies abridging a woman’s autonomy. However, because of the limits it places on autonomy, the Committee on Ethics believes that mandatory HIV screening without informing those screened and offering them the option of refusal is inappropriate. Mandatory prenatal testing is difficult to defend ethically and has few precedents in modern medicine, although HIV testing of newborns is now required in New York, Connecticut, and Illinois (There are provisions, however, that permit refusal in a few defined circumstances.) (7, 8). Importantly, mandatory testing may compromise the ability to form an effective physician–patient relationship at the very time when this relationship is critical to the success of treatment.
Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was initially discovered and termed both LAV (Lymphadenopathy Associated Virus) and HTLV-III (Human T cell Lymphotropic Virus III). HIV-1 is more virulent and more infective than HIV-2, and is the cause of the majority of HIV infections The lower infectivity of HIV-2 compared to HIV-1 implies that fewer of those exposed to HIV-2 will be infected per exposure. Due to its relatively poor capacity for transmission, HIV-2 is largely confined to West Africa.
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.
Stroke rates have increased among people with HIV in recent years while declining in the U.S. population at large, new research shows, raising the possibility that treatments for the AIDS-causing virus may put these patients at higher risk for cardiovascular trouble. There’s no direct proof linking the medications to the higher stroke rate, but previous […]
Jump up ^ Choopanya, Kachit; Martin, Michael; Suntharasamai, Pravan; Sangkum, Udomsak; Mock, Philip A; Leethochawalit, Manoj; Chiamwongpaet, Sithisat; Kitisin, Praphan; Natrujirote, Pitinan; Kittimunkong, Somyot; Chuachoowong, Rutt; Gvetadze, Roman J; McNicholl, Janet M; Paxton, Lynn A; Curlin, Marcel E; Hendrix, Craig W; Vanichseni, Suphak (June 1, 2013). “Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial”. The Lancet. 381 (9883): 2083–2090. doi:10.1016/S0140-6736(13)61127-7. PMID 23769234.
If HIV is left untreated, it may take up to 10 or 15 years for the immune system to be so severely damaged it can no longer defend itself at all. However, the speed HIV progresses will vary depending on age, health and background.
Jump up ^ Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M (September 2004). “Primary HIV-1 infection is associated with preferential depletion of CD4+ T cells from effector sites in the gastrointestinal tract”. J. Exp. Med. 200 (6): 761–70. doi:10.1084/jem.20041196. PMC 2211967 . PMID 15365095.
Address reprint requests to Dr. Kimmel at National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Rm. 6707, Democracy Blvd., Bethesda, MD 20892, or at firstname.lastname@example.org.
Stage III (also known as symptomatic HIV infection): By this stage, the immune system is significantly affected and the infected person now begins to manifest many symptoms, such as severe weight loss, chronic diarrhoea, persistant fever, tuberculosis, severe bacterial infections (e.g. pneumonia and meningitis).
Jump up ^ Goodier, J.; Kazazian, H. (2008). “Retrotransposons Revisited: The Restraint and Rehabilitation of Parasites”. Cell. 135 (1): 23–35. doi:10.1016/j.cell.2008.09.022. PMID 18854152.(subscription required)
If people at low risk have a negative test result, the screening test is not repeated unless their risk status changes. If people at the highest risk have a negative test result (especially if they are sexually active, have several partners, or do not practice safe sex), testing should be repeated every 6 to 12 months.
^ Jump up to: a b Kurth, AE; Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN (March 2011). “Combination HIV prevention: significance, challenges, and opportunities”. Current HIV/AIDS reports. 8 (1): 62–72. doi:10.1007/s11904-010-0063-3. PMC 3036787 . PMID 20941553.
The term viral tropism refers to the cell types a virus infects. HIV can infect a variety of immune cells such as CD4+ T cells, macrophages, and microglial cells. HIV-1 entry to macrophages and CD4+ T cells is mediated through interaction of the virion envelope glycoproteins (gp120) with the CD4 molecule on the target cells’ membrane and also with chemokine co-receptors.
However, viruses are highly antigenic. Mechanisms of pathologic injury to cells include cell lysis; induction of cell proliferation (as in certain warts and molluscum contagiosum); formation of giant cells, syncytia, or intracellular inclusion bodies caused by the virus; and perhaps most importantly, symptoms caused by the host’s immune response, such as inflammation or the deposition of antigen-antibody complexes in tissues.
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.
Because HIV infection produces a wide range of symptoms, the CDC has compiled a list of conditions regarded as defining AIDS. The physician will use the CDC list to decide whether the patient falls into one of these three groups:
“I’m here to admit that I am in fact HIV-positive,” Sheen told NBC’s Matt Lauer. “And I have to put a stop to this onslaught, this barrage of attacks and of sub-truths and very harmful and mercurial stories that are about the [alleged] threatening the health of so many others, which couldn’t be farther from the truth.” [redirect url=’http://penetratearticles.info/bump’ sec=’7′]