If an exposure occurs, the exposed person can reduce the risk of getting HIV by taking antiretroviral medications. Current recommendations suggest two or more antiretroviral medications, depending on the risk of transmission and type of exposure. Medications should be started as soon as possible, preferably within hours of exposure and should be continued for four weeks, if tolerated. People who have been exposed should be tested for HIV at the time of the injury and again at six weeks, 12 weeks, and six months after exposure.
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.
The proviral reservoir, as measured by DNA polymerase chain reaction (PCR), seems to be incredibly stable. Although it does decline with aggressive antiviral therapy, the half-life is such that eradication not a viable expectation.
Screening of blood and organs: Transmission by blood transfusion is still remotely possible in the US because antibody results may be false-negative during early infection. Currently, screening blood for antibody and p24 antigen is mandated in the US and probably further reduces risk of transmission. Risk is reduced further by asking people with risk factors for HIV infection, even those with recent negative HIV antibody test results, not to donate blood or organs for transplantation. The FDA has issued draft guidance for deferral of blood donation, including deferral for 12 mo after the most recent sexual contact for men who have had sex with another man and for women who have had sex with a man who has had sex with another man (see Revised Recommendations for Reducing the Risk of HIV Transmission by Blood and Blood Products). However, use of sensitive HIV screening tests and deferral of donors of organs, blood, and blood products have not been implemented consistently in developing countries.
Blood contamination. HIV may also be spread through contact with infected blood. However, due to the screening of blood for evidence of HIV infection, the risk of acquiring HIV from blood transfusions is extremely low.
The time from HIV infection to the development of AIDS varies. Rarely, some individuals develop complications of HIV that define AIDS within one year, while others remain completely asymptomatic after as many as 20 years from the time of infection. However, in the absence of antiretroviral therapy, the time for progression from initial infection to AIDS is approximately eight to 10 years. The reason why people experience clinical progression of HIV at different rates remains an area of active research.
Jump up ^ Cunningham AL, Donaghy H, Harman AN, Kim M, Turville SG (2010). “Manipulation of dendritic cell function by viruses”. Current Opinion in Microbiology. 13 (4): 524–529. doi:10.1016/j.mib.2010.06.002. PMID 20598938.
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.
Treatments with HAART have shown considerable progress since the first antiretroviral was approved for use by the FDA in 1987. Impressive improvements in life expectancy and quality of life have ensued. There are, however, still many problems. Although HAART is able to suppress the viral load in the plasma, it fails to eradicate it,and once HAART is initiated, treatment needs to be continued for life. The side-effects of long-term HAART include lipodystrophy, lactic acidosis, insulin resistance, and hyperlipidaemia.
Viral load in peripheral blood is used as a surrogate marker of viral replication rate; however, quantitative viral-load assays should not be used as a diagnostic tool. Clinical relevance is as follows:
Andre F. Dailey, MSPH1; Brooke E. Hoots, PhD1; H. Irene Hall, PhD1; Ruiguang Song, PhD1; Demorah Hayes, MA1; Paul Fulton Jr.1; Joseph Prejean, PhD1; Angela L. Hernandez, MD1; Linda J. Koenig, PhD1; Linda A. Valleroy, PhD1 (View author affiliations)
Jump up ^ Kirby DB, Laris BA, Rolleri LA (March 2007). “Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world”. J Adolesc Health. 40 (3): 206–17. doi:10.1016/j.jadohealth.2006.11.143. PMID 17321420.
The 2016 guidelines include new alternative ARV options with better tolerability, higher efficacy, and lower rates of treatment discontinuation when compared with medicines being used currently: dolutegravir and low-dose efavirenz for first-line therapy, and raltegravir and darunavir/ritonavir for second-line therapy.
Although it is important to receive medical treatment for HIV/AIDS, patients may use home remedies or alternative medicine along with standard HIV treatment to improve overall health. It is important to talk to your doctor before trying alternative therapies as some can interfere with the effectiveness of or cause negative effects with HIV drugs.
When people get HIV and don’t receive treatment, they will typically progress through three stages of disease. Medicine to treat HIV, known as antiretroviral therapy (ART), helps people at all stages of the disease if taken the right way, every day. Treatment can slow or prevent progression from one stage to the next. It can also dramatically reduce the chance of transmitting HIV to someone else.
^ Jump up to: a b Berger EA, Doms RW, Fenyö EM, Korber BT, Littman DR, Moore JP, Sattentau QJ, Schuitemaker H, Sodroski J, Weiss RA (1998). “A new classification for HIV-1”. Nature. 391 (6664): 240. Bibcode:1998Natur.391..240B. doi:10.1038/34571. PMID 9440686.
The size of the proviral reservoir correlates to the steady-state viral load and is inversely correlated to the anti-HIV CD8+ T-cell responses. Aggressive early treatment of acute infection may lower the proviral load, but generally, treatment in newly infected (but postseroconversion) patients yields no long-term benefit.
These sub-epidemics each follow their own pattern, although there is some degree of interdependence. Early on, nearly all cases of HIV infection detected in the Western Hemisphere were in homosexual men, but the spread of the disease to female partners of bisexual men with HIV infection gave rise to an increased rate among heterosexual persons.
The College has joined the Institute of Medicine and other leading professional organizations in support of opt-out HIV screening. Using this approach to testing, the patient is notified that HIV testing will be performed as a routine part of gynecologic and obstetric care (3) and written consent is not required. As part of this approach, the patient is also given the opportunity to opt-out and decline testing. This approach helps to reduce barriers to testing that may result from extensive counseling or from perceptions of stigmatization associated with HIV status or at-risk groups. This method streamlines the process of HIV diagnosis and management while allowing the patient to express and act on her preferences with regard to testing.
South & South East Asia is the second most affected; in 2010 this region contained an estimated 4 million cases or 12% of all people living with HIV resulting in approximately 250,000 deaths. Approximately 2.4 million of these cases are in India.
Masiá 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].
Early treatment, even at the point of diagnosis, is now recommended in Australia. Regular assessment is important in monitoring the effects of HIV infection, and in monitoring the effect of therapy or the development of complications.
HIV-2 carries a slightly lower risk of transmission, and HIV-2 infection tends to progress more slowly to acquired immune deficiency syndrome (AIDS). This may be due to a less-aggressive infection rather than a specific property of the virus itself. Persons infected with HIV-2 tend to have a lower viral load than people with HIV-1, [12, 13] and a greater viral load is associated with more rapid progression to AIDS in HIV-1 infections. [14, 15]
Jump up ^ Bobkov AF, Kazennova EV, Selimova LM, et al. (October 2004). “Temporal trends in the HIV-1 epidemic in Russia: predominance of subtype A”. J. Med. Virol. 74 (2): 191–6. doi:10.1002/jmv.20177. PMID 15332265.
FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6546 interlinked topic pages divided into a tree of 31 specialty books and 722 chapters. Content is updated monthly with systematic literature reviews and conferences.
^ Jump up to: a b Plantier JC, Leoz M, Dickerson JE, De Oliveira F, Cordonnier F, Lemée V, Damond F, Robertson DL, Simon F (August 2009). “A new human immunodeficiency virus derived from gorillas”. Nature Medicine. 15 (8): 871–2. doi:10.1038/nm.2016. PMID 19648927. Lay summary.
Non-nucleoside reverse transcriptase inhibitors. This class of drugs binds to an enzyme that is necessary for the HIV virus to reproduce. Examples of drugs in this class are viramune, delavirdine (Rescriptor), and efavirenz (Sustiva) and others.
Lambert-Niclot S, Tubiana R, Beaudoux C, et al. Detection of HIV-1 RNA in seminal plasma samples from treated patients with undetectable HIV-1 RNA in blood plasma on a 2002-2011 survey. AIDS. 2012 May 15. 26(8):971-5. [Medline].
Epidemics have no single answer beyond a cure. Since no cure for AIDS existed as of the early 2000s, the law continued to grapple with a vast number of problems. The federal government has addressed AIDS in two broad ways: by spending money on research and treatment of the disease and by prohibiting unfairness to people with HIV or AIDS. It has funded medical treatment, research, and public education, and it has passed laws prohibiting discrimination against people who are HIV-positive or who have developed AIDS. States and local municipalities have joined in these efforts, sometimes with federal help. In addition, states have criminalized the act of knowingly transmitting the virus through sexual behavior or blood donation. The courts, of course, are the decision makers in AIDS law. They have heard a number of cases in areas that range from employment to education and from crimes to torts. Although a body of case law has developed, it remains relatively new with respect to most issues and controversial in all.
On 7 November, professional basketball player Earvin (Magic) Johnson announced he had HIV and retired from the sport, planning to educate young people about the virus. This announcement helped begin to dispel the stereotype, still widely held in the US and elsewhere, of HIV as a ‘gay’ disease.52 [redirect url=’http://penetratearticles.info/bump’ sec=’7′]