Prejean J, Song R, Hernandez A, Ziebell R, Green T, Walker F, et al. Estimated HIV incidence in the United States, 2006–2009. HIV Incidence Surveillance Group. PLoS One 2011;6:e17502. [PubMed] [Full Text] ⇦
* Past year testing was assessed during the interview by asking participants, “When did you have your most recent HIV test? Please tell me the month and year.” A missed opportunity was defined as a visit to a health care provider in the past 12 months for a person who did not report past year HIV testing or as not being offered an HIV test at any health care visits for a person who did not report past year HIV testing and had visited a health care provider in the past year.
The vast majority of infections remain in sub-Saharan Africa, where 5.2% of the population is thought to be infected. Between 2004 and 2006, the prevalence of HIV infection in central and eastern Asia and Eastern Europe increased by 21%. During this period, the number of new HIV infections in persons aged 15 to 64 years rose by 70% in Eastern Europe and central Asia.
A considerable amount of stigma has been attached to HIV infection, mostly because of the virus’s association with sexual acquisition and the inference of sexual promiscuity. Consequences of this stigma have included discrimination and reluctance to be tested for HIV infection. The stigma of HIV infection is also associated with a fear of acquiring a rapidly fatal infection from relatively casual contact.
Candidiasis of esophagus CMV retinitis Disseminated mycobacterial infection–culture not required HIV encephalopathy HIV wasting syndrome Kaposi sarcoma Lymphoid interstital pneumonitis and/or pulmonary lymphoid hyperplasia < age 13 Pneumocystis cariniipneumonia Toxoplasmosis of the brain in Pts > 1 month of age
Safe sex practices: Unless both partners are known to be free of HIV and remain monogamous, safe sex practices are essential. Safe sex practices are also advised when both partners are HIV-positive; unprotected sex between HIV-infected people may expose a person to resistant or more virulent strains of HIV and to other viruses (eg, cytomegalovirus, Epstein-Barr virus, herpes simplex virus, hepatitis B virus) that cause severe disease in AIDS patients, as well as to syphilis and other sexually transmitted diseases (STDs). Condoms offer the best protection. Oil-based lubricants should not be used because they may dissolve latex, increasing the risk of condom failure. (See also the recommendations of the CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America: Incorporating HIV Prevention into the Medical Care of Persons Living with HIV.)
Jump up ^ Worobey M, Gemmel M, Teuwen DE, Haselkorn T, Kunstman K, Bunce M, Muyembe Kabongo JM, Kalengayi RM, Van Marck E, Gilbert MT, Wolinsky SM (2008). “Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960”. Nature. 455 (7213): 661–4. Bibcode:2008Natur.455..661W. doi:10.1038/nature07390. PMC 3682493 . PMID 18833279.
The risk of transmitting the virus to others is higher when the viral load (the amount of HIV in the blood) is higher, in particular in early infection (when a person may not even be aware he or she has HIV) and late in untreated infection (when the immune system is failing). Research demonstrates that having a consistently low (undetectable) viral load dramatically reduces infectiousness and that together with consistent condom use and/or safe injecting practices, lowers the risk of transmission to almost zero. However certain factors, including poor treatment adherence or the presence of other STIs can increase the risk of transmission.
On June 5, 1981, the U.S. Centers for Disease Control and Prevention (CDC) published a report describing a rare lung infection known as Pneumocystis carinii pneumonia in five homosexual men in Los Angeles. Expert review of the cases suggested that the disease likely was acquired through sexual contact and that it appeared to be associated with immune dysfunction caused by exposure to some factor that predisposed the affected individuals to opportunistic infection. The following month the CDC published a report describing an outbreak of cases of a rare cancer called Kaposi sarcoma in homosexual men in New York City and San Francisco. The report noted that in many instances the cancers were accompanied by opportunistic infections, such as P. carinii pneumonia. Researchers subsequently determined that the infections and cancers were manifestations of an acquired immunodeficiency syndrome.
Returning to work after beginning treatment for HIV/AIDS is difficult, and affected people often work less than the average worker. Unemployment in people with HIV/AIDS also is associated with suicidal ideation, memory problems, and social isolation; employment increases self-esteem, sense of dignity, confidence, and quality of life. A 2015 Cochrane review found low-quality evidence that antiretroviral treatment helps people with HIV/AIDS work more, and increases the chance that a person with HIV/AIDS will be employed.
If a person gets an “AIDS-defining illness,” this is usually a sign that the person has AIDS. Healthy people do not get these illnesses, because a healthy immune system is strong enough to fight off these diseases. Because of this, getting an AIDS-defining illness is a sign that a person’s immune system is seriously damaged. In a person with HIV, getting an AIDS-defining illness signals that the HIV has damaged the immune system badly enough that the person now has AIDS.
Jump up ^ Zwahlen M, Egger M (2006). “Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis” (PDF). UNAIDS Obligation HQ/05/422204. Archived (PDF) from the original on April 9, 2008. Retrieved March 19, 2008.
Rockstroh JK, DeJesus E, Lennox JL, et al. Durable efficacy and safety of raltegravir versus efavirenz when combined with tenofovir/emtricitabine in treatment-naive HIV-1-infected patients: final 5-year results from STARTMRK. J Acquir Immune Defic Syndr. 2013 May 1. 63(1):77-85. [Medline].
Diagnosis of HIV infection is made using blood tests. A positive blood test indicates the development of antibodies to HIV and therefore the presence of the virus. Antibodies to HIV usually develop within a few weeks to three months. Even though the blood test for antibodies may not be positive during the early stage of infection, the virus will be present in blood and body fluids, making the person infectious to other people. Polymerase chain reaction (PCR) tests in a pathology laboratory can be used for the early detection of HIV genetic material in the blood.
Shacklett BL, Cox CA, Sandberg JK, Stollman NH, Jacobson MA, Nixon DF. Trafficking of human immunodeficiency virus type 1-specific CD8+ T cells to gut-associated lymphoid tissue during chronic infection. J Virol. 2003 May. 77(10):5621-31. [Medline]. [Full Text].
The human immunodeficiency virus (HIV) is a type of virus called a retrovirus, which can infect humans when it comes in contact with tissues that line the vagina, anal area, mouth, or eyes, or through a break in the skin.
Jump up ^ Beard, J; Feeley, F; Rosen, S (November 2009). “Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review”. AIDS Care. 21 (11): 1343–56. doi:10.1080/09540120902889926. PMID 20024710.
There are some people who do not want people to know about condoms or clean needles. They believe that if people know about condoms and have condoms they will have more sex. They believe that if people have clean needles they will use illegal drugs more. Many of these people think this because of their religion. For example, the Catholic church does not want people to have or use condoms. They do not want people to have condoms because they do not think people should have sex unless they are married. They also think that married people should not use condoms, because they believe that if people have sex, they should be prepared to accept a possible pregnancy.
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.
TB, or tuberculosis, is a disease caused by bacteria called Mycobacterium tuberculosis that can affect anyone at any age. The bacteria usually attacks the lungs. Particular groups of individuals, however, are shown to be at a higher risk of acquiring the disease than others. These include HIV/AIDS patients, individuals in close contact with TB patients, diabetics, individuals with suppressed immune systems, foreign-born individuals in countries with high TB incidences, healthcare workers, alcoholics, and others. Symptoms of the disease include a persistent cough, fatigue, weight loss, fever, coughing blood, and sweating at night. When an infected individual coughs or sneezes, others nearby are at risk for breathing in the bacteria.
Jump up ^ Mills E, Wu P, Ernst E (June 2005). “Complementary therapies for the treatment of HIV: in search of the evidence”. Int J STD AIDS. 16 (6): 395–403. doi:10.1258/0956462054093962. PMID 15969772.
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.
In other respects, health care is a distinct area of concern for AIDS patients and health professionals alike. Discrimination has often taken place. State and federal statutes, including the Rehabilitation Act, guarantee access to health care for AIDS patients, and courts have upheld that right. In the 1988 case of Doe v. Centinela Hospital, 57 U.S.L.W. 2034 (C.D. Cal.), for example, an HIV-infected person with no symptoms was excluded from a federally funded hospital residential program for drug and alcohol treatment because health care providers feared exposure to the virus. The case itself exposed the irrationality of such discrimination. Although its employees had feared HIV, the hospital argued in court that the lack of symptoms meant that the patient was not disabled and thus not protected by the Rehabilitation Act. A federal trial court in California rejected this argument, ruling that a refusal to grant services based solely on fear of contagion is discrimination under the Rehabilitation Act.
In IRIS, symptoms of various infections worsen or appear for the first time because immune responses improve (are reconstituted), increasing inflammation at sites of infection. Symptoms sometimes worsen because parts of dead viruses persist, triggering immune responses.
People giving or receiving tattoos, piercings, and scarification are theoretically at risk of infection but no confirmed cases have been documented. It is not possible for mosquitoes or other insects to transmit HIV.
Macrophages and dendritic cells seem to be able to harbor replicating virus without necessarily being killed by it, and are therefore believed to be an important reservoir of infection, as well as a means of spreading virus to other tissues such as the brain. Although the function of macrophages as antigen-presenting cells does not seem to be compromised by HIV infection, it is thought that the virus causes abnormal patterns of cytokine secretion that could account for the wasting that commonly occurs in AIDS patients late in their disease.
Jump up ^ Israël N, Gougerot-Pocidalo MA (1997). “Oxidative stress in human immunodeficiency virus infection”. Cellular and Molecular Life Sciences. 53 (11–12): 864–70. doi:10.1007/s000180050106. PMID 9447238.
By the mid-’90s, Sheen was as famous for being a ladies’ man as he was for being a leading man. Known as “the Machine,” he dated porn stars, and though Hollywood madam Heidi Fleiss kept the names of her clients secret, Sheen testified during her tax-evasion trial that he’d used her services. He also spent time in rehab and was hospitalized for a drug overdose. “Pray for my boy,” said his father. “He has appetites that get him into trouble.”
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
The most common side effect associated with NNRTIs is a rash, typically occurring during the first weeks of therapy. This is most common in individuals treated with NVP. In this case, the overall risk of rash is reduced if therapy is started as a single 200 mg NVP pill once per day during the first two weeks before increasing to the full dose of 200 mg twice per day. If the rash is mild, therapy usually can be continued if antihistamines are given, and if the rash resolves, treatment with the NNRTI can be continued. If the rash is severe, associated with liver inflammation or blisters, changes in the mouth or around the eyes, or with high fevers, therapy with the NNRTI usually needs to be discontinued. Decisions regarding continuing or stopping treatment need to be made with the primary care professional. In some patients, NVP can cause a severe allergic reaction characterized by fever, rash, and severe liver inflammation. Recent data suggests that the groups at the greatest risk for the severe reaction are those with stronger immune systems, such as HIV-uninfected people given this treatment after an exposure to HIV, women with CD4+ T cells >250 cells per mm3, and men with CD4+ T cells >400 cells per mm3. There is also likely to be increased risk in pregnant women and individuals with other underlying liver diseases. Consequently, NVP probably should not be used in any of these groups, or if used, used with caution. In addition, whenever NVP is started, liver tests that are markers for liver inflammation should be monitored at regular intervals during the first several months of treatment.
Subunit vaccines, which induce immunity to only some proteins in the virus, have also been made. One such vaccine has been made from the envelope protein gp120 and has been tested on chimpanzees. This vaccine proved to be specific to the precise strain of virus used to make it, and was therefore useless in protection against natural infection. Subunit vaccines are also less efficient at inducing prolonged cytotoxic T-cell responses. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]