HIV and AIDS - Acquired Immunodeficiency Syndrome

AIDS is a sexually transmitted infection (STI) caused by human immunodeficiency virus (HIV). HIV invades and attacks the immune system cells (CD4 T Cells) that are responsible for fighting off infection. When HIV destroys the immune system the body becomes vulnerable to many types of infection.

There are two types of HIV that lead to the cause of the disease and these are HIV-1 and HIV-2. However, HIV-1 is the major cause of most HIV infections in the world. HIV was first discovered in the early 1980s and at the time of this writing there are about 34 million people with HIV infection worldwide.

Transmission

HIV is mainly transmitted through sexual contact such as oral sex, vaginal sex or anal sex. HIV has been found in blood, semen, saliva, vaginal fluid, urine, and breast milk of infected individual. HIV has also been found in bodily fluids of infected individual such as spinal fluid, amniotic fluid, and fluids that contain blood. From all the bodily fluids, blood and semen consists of the highest concentration of HIV.

HIV is highly transmitted through blood when come into contact with broken skin or small tear in the rectal tissues or vagina walls. The length of time between initial HIV infection and the presence of HIV antibodies in the blood take several months to occur as a result people with HIV infection are not aware of the disease during the first few months and they can infect others even if they do not experience any symptoms. People in the late stages of the disease with advanced HIV infection are highly contagious.

HIV can be transmitted from infected mother to the infant during pregnancy, childbirth or after birth when breast-feeding the baby. HIV is highly transmitted through contaminated blood transfusions and sharing of contaminated needles between drug users. Engaging in many risky behaviors such as having multiple sexual partners, unprotected sex, sharing needles, using illegal substances and under the influence of cocaine, marijuana, and alcohol can increase the risk of contracting HIV.

People who are not circumcised have high risk of contracting HIV from infected partner. The foreskins of the penis are soft and can break easily causing small tear or broken skin that increases the risk of HIV transmitting into the blood stream.

The risk of contracting HIV from saliva, tears, and urine are extremely low unless contaminated with blood. HIV cannot be transmitted from casual contact like hugging, kissing, shaking hands, coughing, sneezing, toilet seats, sharing eating utensils, or insects’ bites.

Symptoms

Initial symptoms may appear within 1 month after infection and these may include fever, headache, skin rashes, fatigue, and swollen lymph glands. Other symptoms at this stage may also include nausea, vomiting, and diarrhea. The initial symptoms may disappear within 1 to 2 weeks and these symptoms could be mistaken for other types of infection. However, some people may not experience any symptoms for 10 years or longer.

If left untreated AIDS can developed within 10 years of advanced HIV infection when CD4 T Cells count falls below 200 per cubic millimeter of blood. Later symptoms of this stage may include persistent fever, night sweats, chills, chronic fatigue, weight loss, muscle aches, persistent diarrhea or bloody stools, persistent headache, chronic dry cough, oral candidiasis, pneumonia, and swollen lymph glands.

There are several other infections associated with HIV and these include shingles, cytomegalovirus, and encephalitis. HIV patients with severe fungal infections can cause meningitis, tuberculosis, salmonella illnesses, and toxoplasmosis. Several cancers are also common among people with AIDS and these include cancers of the lymph system, cervical cancer, and Kaposi’s sarcoma which is the most common cancer in AIDS patients.

Treatment

At the time of this writing there is no cure for AIDS. Death usually occurred within 1 to 2 years when the patients developed pneumonia or cancer. Pneumocystis jiroveci pneumonia causes lung infection in people with weak immune system and is also the primary cause of many AIDS death.

The most effective treatment against AIDS is the combination of drug therapies that focus on inhibiting HIV replication to suppress the progression of the disease. The combination of drug therapies treatment have reduced many AIDS deaths and allowed people to live longer in developed nations. However, in third world countries death from HIV continue to rise because many are poor and they cannot afford the high cost of drug therapy.

The drug therapy involves the combination of protease inhibitor drug with two reverse transcriptase inhibitor drug such as zidovudine and lamivudine. The combination of three drugs against HIV has come to be known as highly active antiretroviral therapies (HAART). HAART treatment does not remove HIV from the body but remains in the brains, cells, lymph nodes, and organs where the virus stays intact.

The downside of HAART is due to the complexity and toxicity of the treatment. Depending on the complexity of drug therapy people on HAART treatment are required to take several pills daily and some people have difficulty keeping up with the schedules for taking their medications.

The side effects from HAART treatment may include insomnia, diarrhea, nausea, headache, mouth ulcers, abnormal fat distribution, nerve damage, bone loss, respiratory difficulties, increased cholesterol and triglyceride levels, liver damage, abdominal discomfort, and skin rashes.

Patients who are not able to continue with HAART treatment due to side effects or cannot keep up with the schedules for taking their medications can cause the virus to mutate and become resistance to drug therapy.

Treatment failure from HAART may occur even when people take their medications on schedule. HIV can become resistant to their current HAART treatment and the patients with recommendation from doctor can switched to another drug combination to suppress the disease.

Infected mother can be treated with zidovudine or combination of drugs to reduce mother to child transmission. The drugs are taken during pregnancy by the mother and are also administered to the newborn for the first 6 weeks after birth. However, the treatment does not prevent later transmission from mother to child during breast-feeding.

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