“Resistance occurs when the virus replicates in the presence of the drugs,” said Dr. Stephen Boswell, president and CEO of Boston’s Fenway Health, a healthcare organization that works with lesbian, gay, bisexual and transgender people. “Missed dosages lead to lower concentrations in the bloodstream and in the body, so the virus can become resistant and spread. So staying on your medications and not missing dosages is absolutely critical.”
simian immunodeficiency virus (SIV) a lentivirus closely related to human immunodeficiency virus that causes inapparent infection in African green monkeys and a disease resembling acquired immunodeficiency syndrome in macaques and chimpanzees.
Choopanya K, Martin M, Suntharasam P, Sangkum U, Mock P, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomized, double-blind, placebo-controlled phase 3 trial. Lancet. 2013. 2083-90.
In June, the 6th International AIDS Conference in San Francisco protested against the USA’s immigration policy which stopped people with HIV from entering the country. NGOs boycotted the conference.47
Side effects vary and may include headache and dizziness. Serious side effects include swelling of the mouth and tongue and liver damage. Some people eventually develop drug-resistant strains of HIV. If you have serious side effects, your medications can be adjusted.
Tuberculosis co-infection is one of the leading causes of sickness and death in those with HIV/AIDS being present in a third of all HIV-infected people and causing 25% of HIV-related deaths. HIV is also one of the most important risk factors for tuberculosis. Hepatitis C is another very common co-infection where each disease increases the progression of the other. The two most common cancers associated with HIV/AIDS are Kaposi’s sarcoma and AIDS-related non-Hodgkin’s lymphoma. Other cancers that are more frequent include anal cancer, Burkitt’s lymphoma, primary central nervous system lymphoma, and cervical cancer.
Re F, Braaten D, Franke EK, Luban J. Human immunodeficiency virus type 1 Vpr arrests the cell cycle in G2 by inhibiting the activation of p34cdc2-cyclin B. J Virol. 1995 Nov. 69(11):6859-64. [Medline]. [Full Text].
Condomless sex – having sex without a condom can put a person at risk of contracting HIV and other sexually transmitted infections (STIs). HIV can be transmitted by having sex without a condom (vaginal, oral, and/or anal sex). It can also be transmitted by sharing sex toys with someone infected with HIV. Condoms should be used with every sexual act.
Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Updated August 22, 2016. aidsinfo.nih.gov/guidelines. Accessed May 7, 2015.
The sexual partners and drug injecting partners of people diagnosed with HIV infection have an increased probability of also being HIV-positive. WHO recommends assisted HIV partner notification services as a simple and effective way to reach these partners, many of whom are undiagnosed and unaware of their HIV exposure, and may welcome support and an opportunity to test for HIV.
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.
The earliest, well-documented case of HIV in a human dates back to 1959 in the Belgian Congo. The virus may have been present in the United States as early as the mid-to-late 1950s, as a sixteen-year-old male presented with symptoms in 1966 died in 1969.
HIV influences both the epidemiology and the clinical features of many other infectious diseases, malignancies and other illnesses (e.g. renal disease) (see Chapter 10).47 In HIV-infected patients, immunodeficiency increases the risk that atypical (opportunistic) pathogens will result in clinical illness, and is associated with atypical presentations of some diseases. In addition, HIV-infected patients frequently present with multiple pathologic processes simultaneously, making decisions regarding empiric treatment very challenging. We describe the relationship between HIV and three common infectious diseases that have complex and important interactions.
Administration of HIV treatment to HIV-positive pregnant women during pregnancy and labour and after delivery, as well as to the newborn baby, dramatically reduces the risk of mother-to-baby transmission of HIV.
However, developing countries have not consistently used sensitive HIV screening tests and have not restricted donors. Consequently, transmission by these routes is still a problem in these countries.
The opinions in this article are those of the authors and do not necessarily reflect those of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Institutes of Health, the Department of Health and Human Services, or the U.S. Government.
Infected mothers should not breastfeed if they live in countries where formula feeding is safe and affordable. However, in countries where infectious diseases and undernutrition are common causes of infant death and where safe, affordable infant formula is not available, the World Health Organization recommends that mothers breastfeed. In such cases, the protection provided by breastfeeding from potentially fatal infections may counterbalance the risk of HIV transmission.
The infected person frequently gets infections and even some forms of cancer which a healthy immune system would have gotten rid of quite easily. These infections are known as opportunistic infections. HIV infection, once established, cannot be eliminated by the body or by drugs.
In 1983, two separate research groups led by Robert Gallo and Luc Montagnier declared that a novel retrovirus may have been infecting people with AIDS, 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 same time, Montagnier’s group isolated a virus from a person presenting with swelling of the lymph nodes of the neck and physical weakness, two characteristic 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.
One interesting issue is that the co-receptor usage of the virus strains tends to change over time. The initial infection nearly always involves a strain that uses the chemokine receptor 5 (CCR5), which is found on macrophages and dendritic cells, as a co-receptor with CD4. People who are homozygous for deletions in the CCR5 gene (ie, CCR5-delta32) tend to be resistant to infection, [46, 47] and those with heterozygosity for the polymorphism tend to show slower progression of disease. 
One of the proteins that enters the cell with the viral genome is the viral reverse transcriptase, which transcribes the viral RNA into a complementary DNA (cDNA) copy. The viral cDNA is then integrated into the host cell genome by the viral integrase, which also enters the cell with the viral RNA. The integrated cDNA copy is known as the provirus. The infectious cycle up to the integration of the provirus is shown in Fig. 11.23. In activated CD4 T cells, virus replication is initiated by transcription of the provirus, as we will see in the next section. However, HIV can, like other retroviruses, establish a latent infection in which the provirus remains quiescent. This seems to occur in memory CD4 T cells and in dormant macrophages, and these cells are thought to be an important reservoir of infection.
An alternative view holds that unsafe medical practices in Africa after World War II, such as unsterile reuse of single use syringes during mass vaccination, antibiotic and anti-malaria treatment campaigns, were the initial vector that allowed the virus to adapt to humans and spread.
Talal AH, Irwin CE, Dieterich DT, Yee H, Zhang L. Effect of HIV-1 infection on lymphocyte proliferation in gut-associated lymphoid tissue. J Acquir Immune Defic Syndr. 2001 Mar 1. 26(3):208-17. [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.
This past July, results came in on the third case. In 2010, a girl known as the Mississippi baby was born to an H.I.V.-positive mother who had taken no antiretrovirals, and the baby had the virus in her blood. Thirty hours after delivery, the newborn started on antiretroviral therapy. Within weeks, the viral count fell below the limit of detection. The baby was eighteen months old when the treatment was interrupted, against medical advice. For two years, the girl’s blood showed no trace of the virus, and researchers speculated that very early HAART might prevent the virus from forming a dormant reservoir. Twenty-seven months after going off the drugs, however, the child tested positive for the virus. Though researchers were impressed that early intervention had temporarily banished H.I.V., she was not cured.
Other tests can detect antibodies in body fluids other than blood, such as saliva, urine, and vaginal secretions. Some of these are designed to be rapid HIV tests that produce results in approximately 20 minutes. These tests have accuracy rates similar to traditional blood tests. OraQuick is an at-home test that uses an oral swab to detect HIV antibodies in oral fluid. Clearview is another rapid HIV test that can detect HIV antibodies in blood or plasma. HIV home-testing kits are available at many local drugstores. Blood is obtained by a finger prick and blotted on a filter strip. Other test kits use saliva or urine. The filter strip is mailed in a protective envelope to a laboratory to be tested. Results are returned by mail within one to two weeks.
Rodger AJ, Cambiano V, Bruun T, et al. ; PARTNER Study Group. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016;316:171–81. CrossRef PubMed [redirect url=’http://penetratearticles.info/bump’ sec=’7′]