For additional information and assistance about rare disorders, please contact the National Organization for Rare Disorders at P.O. Box 1968, Danbury, CT 06813-1968; phone (203) 744-0100; web site www.rarediseases.org or email [email protected]
Many people do not know that condoms and clean needles help stop HIV. They may not even know that sharing needles and sex with someone who has HIV can make them get HIV. Even if people know about condoms and clean needles, they may not have condoms and clean needles.
Treating infected women with HIV drugs can dramatically reduce the risk of transmission. Infected pregnant women should be treated during the 2nd and 3rd trimesters of pregnancy, during delivery, and during breastfeeding. Doing a cesarean delivery and treating the baby for several weeks after birth also reduce the risk.
After the virus enters the body there is a period of rapid viral replication, leading to an abundance of virus in the peripheral blood. During primary infection, the level of HIV may reach several million virus particles per milliliter of blood. This response is accompanied by a marked drop in the number of circulating CD4+ T cells. The acute viremia is almost invariably associated with activation of CD8+ T cells, which kill HIV-infected cells, and subsequently with antibody production, or seroconversion. The CD8+ T cell response is thought to be important in controlling virus levels, which peak and then decline, as the CD4+ T cell counts recover. A good CD8+ T cell response has been linked to slower disease progression and a better prognosis, though it does not eliminate the virus.
HIV disease becomes AIDS when your immune system is seriously damaged. If you have less than 200 CD4 cells or if your CD4 percentage is less than 14%, you have AIDS. See Fact Sheet 124 for more information on CD4 cells. If you get an opportunistic infection, you have AIDS. There is an “official” list of these opportunistic infections put out by the Centers for Disease Control (CDC). The most common ones are:
61. Centers for Disease Control and Prevention (CDC) (1993, 5 August) ‘Recommendations of the U.S. Public Health Service Task Force on the Use of Zidovudine to Reduce Perinatal Transmission of Human Immunodeficiency Virus’ MMWR Recommendations and Reports 43(11):1-20
OTCBB:AMUN), announced that it has filed a patent application to protect the company’s intellectual property for an investigational monoclonal antibody to treat patients suffering from human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).
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).
The development of rapid HIV tests is another mechanism to support HIV testing and management. Until recently, HIV testing was performed using the repeatedly reactive enzyme immunoassay followed by confirmatory Western blot or immunofluorescence assay. Although this test is very accurate, the results are not available for 24–48 hours after testing. In contrast, a rapid HIV test is a screening test with results that are available quickly, ideally within an hour. Rapid tests include point-of-care tests performed outside a laboratory (eg, an oral swab testing done in an outpatient setting) as well as testing performed in a laboratory. The tests currently approved by the U.S. Food and Drug Administration range in specificity from 93% to 100% with a sensitivity of 98.6–100% (11). The use of rapid HIV tests may provide test results to patients in a timelier manner and may reduce challenges related to loss to follow-up. Although a positive rapid test result is preliminary and must be confirmed with additional testing, a negative rapid test result does not require any additional testing. Therefore, rapid testing may be a feasible and acceptable approach for an HIV screening program in an obstetric–gynecologic practice (12).
This complex scenario leads to the generation of many variants of HIV in a single infected patient in the course of one day. This variability is compounded when a single cell is simultaneously infected by two or more different strains of HIV. When simultaneous infection occurs, the genome of progeny virions may be composed of RNA strands from two different strains. This hybrid virion then infects a new cell where it undergoes replication. As this happens, the reverse transcriptase, by jumping back and forth between the two different RNA templates, will generate a newly synthesized retroviral DNA sequence that is a recombinant between the two parental genomes. This recombination is most obvious when it occurs between subtypes.
Fungal and viral infections: Although prophylaxis for these infections is not routinely necessary, some recommend fluconazole in patients with CD4 + T-cell counts under 50/µL to prevent candidal or cryptococcal infections and to protect against endemic fungal infections; oral ganciclovir is indicated for CMV prophylaxis in patients with advanced AIDS
If treatment fails, drug susceptibility (resistance) assays can determine the susceptibility of the dominant HIV strain to all available drugs. Genotypic and phenotypic assays are available and can help clinicians select a new regimen that should contain at least 2 and preferably 3 drugs to which the HIV strain is more susceptible. The dominant HIV strain in the blood of patients who are taken off antiretroviral therapy may revert over months to years to the wild-type susceptible) strain because the resistant mutants replicate more slowly and are replaced by the wild type. Thus, if patients have not been treated recently, the full extent of resistance may not be apparent through resistance testing, but when treatment resumes, strains with resistance mutations often reemerge from latency and again replace the wild-type HIV strain.
There also appears to be an increased rate of anal cancer in high-risk groups (in particular, men who have sex with men). This is unsurprising considering the link between anal cancer and human papillomavirus (HPV), and the fact that cervical cancer, also caused by HPV, is considered an AIDS-defining condition. 
German Human-Immunodeficiency-Virus-Syndrom, HIV-Infektion NNB, Human Immunodeficiency Virus-Infektion, unspezifisch, HIV-Erkrankung, Nicht naeher bezeichnete HIV-Krankheit [Humane Immundefizienz-Viruskrankheit], LYMPHOTROPES VIRUS TYP III INFEKTIONEN HUMANE T, HTLV WIII INFEKTIONEN, HTLV WIII LAV INFEKTIONEN, HIV-Infektionen, HIV-Infektion, HTLV-III-Infektionen, HTLV-III-LAV-Infektionen, T-lymphotropes Virus Typ III-Infektionen, humane
Side effects of combinations of antiretroviral drugs may be unpleasant and serious. However, doctors can prevent many serious problems (such as anemia, hepatitis, kidney problems, and pancreatitis) by regularly examining the person and doing blood tests. The blood tests can detect side effects before they become serious and enable doctors to change antiretroviral drugs when needed. For most people, doctors can find a combination of drugs with minimal side effects.
Cahn P, Pozniak AL, Mingrone H, Shuldyakov A, Brites C, Andrade-Villanueva JF, et al. Dolutegravir versus raltegravir in antiretroviral-experienced, integrase-inhibitor-naive adults with HIV: week 48 results from the randomised, double-blind, non-inferiority SAILING study. Lancet. 2013 Jul 2. [Medline].
In areas where antiretroviral drugs are not readily available, doctors may have to decide who should be treated first. People who should be treated first include those who are pregnant, have hepatitis B, or have kidney problems due to HIV infection, regardless of their CD4 count.
[Guideline] American College of Obstetricians and Gynecologists. Committee opinion no: 635: prenatal and perinatal human immunodeficiency virus testing: expanded recommendations. Obstet Gynecol. 2015 Jun. 125 (6):1544-7. [Medline].
HIV-1 originated in Central Africa during the first half of the 20th century when a closely related chimpanzee virus first infected people. The global spread of HIV-1 began in the late 1970s, and AIDS was first recognized in 1981. In 2015, about 36.7 million people were living with HIV infection worldwide, there were 1.1 million AIDS-related deaths, and 2.1 million people were newly infected.
^ Jump up to: a b Smith DK, Grohskopf LA, Black RJ, Auerbach JD, Veronese F, Struble KA, Cheever L, Johnson M, Paxton LA, Onorato IM, Greenberg AE (21 January 2005). “Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services.”. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 54 (RR-2): 1–20. PMID 15660015.
Sometimes when HIV is resistant to one medicine, another medicine can be used. To make less resistance happen, people with AIDS take more than one medicine at the same time. They may take 2–4 medicines at once. This is sometimes called a cocktail or AIDS cocktail.
Jump up ^ Attia, Suzanna; Egger, Matthias; Müller, Monika; Zwahlen, Marcel; Low, Nicola (2009). “Sexual transmission of HIV according to viral load and antiretroviral therapy: Systematic review and meta-analysis”. AIDS. 23 (11): 1397–404. doi:10.1097/QAD.0b013e32832b7dca. PMID 19381076.
The most common route of infection varies from country to country and even among cities, reflecting the population in which HIV was introduced initially and local practices. Co-infection with other viruses that share similar routes of transmission, such as hepatitis B, hepatitis C, and human herpes virus 8 (HHV8; also known as Kaposi sarcoma herpes virus [KSHV]), is common.
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.
As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, severe bacterial infections and cancers such as lymphomas and Kaposi’s sarcoma, among others.
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]. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]