The Centers for Disease Control and Prevention (CDC) estimates that approximately 40,000–50,000 new human immunodeficiency virus (HIV) infections occurred annually in the United States from 2006 to 2009 (1). Almost 1 in 5 (18.1%) of all individuals infected with HIV are unaware of their HIV status (2). In order to identify individuals with undiagnosed HIV infection, the CDC recommends HIV screening for all patients aged 13–64 years in health care settings (3). Because obstetrician–gynecologists provide primary and preventive care for adolescents and women, they are ideally suited to play an important role in promoting HIV screening for their patients. The American College of Obstetricians and Gynecologists (the College) recommends routine HIV screening for females aged 13–64 years and older women with risk factors. Screening after age 64 years is indicated if there is ongoing risk of HIV infection, as indicated by risk assessment (eg, new sexual partners).
The later stages of HIV infection are characterized by the progressive depression of T cells and repeated infections that can even occur during a course of antibiotic therapy for another infection (superinfections). People with AIDS are particularly vulnerable to “opportunistic infections” from bacteria that other people normally fight off. Pneumocystis carinii, which causes severe inflammation of the lungs (pneumonia), is a common infection that affects people with AIDS. Cancers (malignant neoplasms), and a wide variety of neurological abnormalities, most notably the AIDS dementia complex, may also occur. These neurological symptoms when of HIV, infects the nervous system.
Finally, there are difficult ethical issues in the development of a vaccine. It would be unethical to conduct a vaccine trial without trying at the same time to minimize the exposure of a vaccinated population to the virus itself. However, the effectiveness of a vaccine can only be assessed in a population in which the rate to the virus is high enough to assess whether vaccination is protective against infection. This means that initial vaccine trials might have to be conducted in countries where the incidence of infection is very high and public health measures have not yet succeeded in reducing the spread of HIV.
Jump up ^ Beck, CR; McKenzie, BC; Hashim, AB; Harris, RC; Zanuzdana, A; Agboado, G; Orton, E; Béchard-Evans, L; Morgan, G; Stevenson, C; Weston, R; Mukaigawara, M; Enstone, J; Augustine, G; Butt, M; Kim, S; Puleston, R; Dabke, G; Howard, R; O’Boyle, J; O’Brien, M; Ahyow, L; Denness, H; Farmer, S; Figureroa, J; Fisher, P; Greaves, F; Haroon, M; Haroon, S; Hird, C; Isba, R; Ishola, DA; Kerac, M; Parish, V; Roberts, J; Rosser, J; Theaker, S; Wallace, D; Wigglesworth, N; Lingard, L; Vinogradova, Y; Horiuchi, H; Peñalver, J; Nguyen-Van-Tam, JS (September 2013). “Influenza vaccination for immunocompromised patients: summary of a systematic review and meta-analysis”. Influenza and other respiratory viruses. 7 Suppl 2: 72–5. doi:10.1111/irv.12084. PMID 24034488.
Scientists suspect the simian immunodeficiency virus (SIV) jumped from chimps to humans when people consumed infected chimpanzee meat. Once inside the human population, the virus mutated into what we now know as HIV.
Jump up ^ Kouri, Vivian; Khouri, Ricardo; Alemán, Yoan; Abrahantes, Yeissel; Vercauteren, Jurgen; Pineda-Peña, Andrea-Clemencia; Theys, Kristof; Megens, Sarah; Moutschen, Michel; Pfeifer, Nico; Van Weyenbergh, Johan; Pérez, Ana B; Pérez, Jorge; Pérez, Lissette; Van Laethem, Kristel; Vandamme, Anne-Mieke (28 January 2015). “CRF19_cpx is an Evolutionary fit HIV-1 Variant Strongly Associated With Rapid Progression to AIDS in Cuba”. EBioMedicine. 2 (3): 244–254. doi:10.1016/j.ebiom.2015.01.015. Retrieved 17 Feb 2015.
The practice of routine testing does not eliminate opportunities for the patient to discuss questions about testing with her health care provider, including who may be at risk of infection, the benefits of testing, and test results. Although HIV-negative test results may be conveyed without direct personal contact, HIV-positive test results should be communicated confidentially and in person by a physician, nurse, or other skilled staff member. Women who are infected with HIV should receive or be referred for appropriate clinical and supportive care. If a patient declines HIV testing under an opt-out policy, she should be informed that this will not affect access to health care or her health care provider (8). In these situations, her choice and the reason for this decision should be documented in the medical record. Although the College recommends opt-out screening where legally possible, state and local laws may have specific requirements for HIV testing that are not consistent with such an approach. Therefore, obstetrician–gynecologists should be aware of and comply with legal requirements regarding HIV testing in their jurisdictions and institutions. Legal requirements for HIV testing may be verified by contacting state or local health departments. The National HIV/AIDS Clinicians’ Consultation Center at the University of California San Francisco maintains an online compendium of state HIV testing laws (www.nccc.ucsf.edu).
In September, the WHO launched new treatment guidelines recommending that all people living with HIV should receive antiretroviral treatment, regardless of their CD4 count, and as soon as possible after their diagnosis.96
Most (95%) new infections occur in the developing world. Almost 70% of new HIV infections occur in sub-Saharan Africa, with more than half occurring in women and 1 in 10 occurring in children under 15 years old. However, in many sub-Saharan African countries, the number of new HIV infections decreased by 41% between 2000 and 2014., partly because of international efforts to provide treatment and strategies for prevention.
HIV infection is commonly diagnosed by blood tests. Testing for HIV is usually a two-step process. First, a screening test is done. If that test is positive, a second test (Western blot) is done to confirm the result.
Definition (NCI_NCI-GLOSS) A disease caused by human immunodeficiency virus (HIV). People with acquired immunodeficiency syndrome are at an increased risk for developing certain cancers and for infections that usually occur only in individuals with a weak immune system.
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’
Survival rates have dramatically improved for those individuals using protease inhibitors, but other problems have also arisen. Some persons do not respond to these medications or the side effects from taking the drugs diminish the quality of life. Protease inhibitors, for many people, are intolerable because of nausea, diarrhea, vomiting, headache, kidney stones, and serious drug interactions with other medications. By 2003 researchers had found that serious side effects include increased risk of heart attack, abnormalities in fat distribution, an increased propensity toward diabetes, and abnormalities in cholesterol metabolism. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]