HIV is a very complex disease that impacts our body in many different ways. Understanding how HIV works and what it does to our body will help you better understand the disease. Understanding HIV can allow you to take control of the illness and live a healthy, productive life. These resources will explain the biology of him.
The history of this is filled with triumphs and failures; living and death. The HIV timeline stretches before us, marking our past and reaching toward out future. But where will that future lead? This HIV/AIDS timeline began early in 1981. In July of that year, the New York Times reported an outbreak of a rare form of cancer among gay men in New York and California. This "gay cancer" as it was called at the time was later identified as Kaposi's sarcoma, a disease that later became the face of AIDS. About the same time, emergency rooms in New York City began to see a rash of seemingly healthy young men presenting with fevers, flu-like symptoms, and a rare pneumonia called Pneumocystis. This was the beginning of what has become the biggest health care concern in modern history. Twenty-five years later the disease still plagues society.
In 1981, homosexual men with symptoms of a disease that now are considered typical of the acquired immunodeficiency syndrome (AIDS) were first described in Los Angeles and New York. The men had an unusual type of lung infection (pneumonia) called Pneumocystis carinii (now known as Pneumocystis jiroveci) pneumonia (PCP) and rare skin tumors called Kaposi's sarcoma. The patients were noted to have a severe reduction of a type of cell in the blood that is an important part of the immune system, called CD4 cells. These cells, often referred to as T cells, help the body fight infections. Shortly thereafter, this disease was recognized throughout the United States, Western Europe, and Africa. In 1983, researchers in the United States and France described the virus that causes AIDS, now known as the human immunodeficiency virus (HIV) and belonging to the group of viruses called retroviruses. In 1985, a blood test became available that measures antibodies to HIV that are the body's immune response to the HIV. This blood test remains the best method for diagnosing HIV infection. Recently, tests have become available to look for these same antibodies in the saliva and urine, and some can provide results within 20 minutes of testing.
The first symptoms of Human Immunodeficiency Virus infection can resemble symptoms of common cold or flu viruses. The symptoms of early infection can also be similar to the symptoms of other sexually transmitted diseases and other infections such as "mono" or hepatitis, which are much more commonly and more easily transmitted. Stress and anxiety can also produce symptoms in some people, even though they do not have HIV.
Some people who contract HIV experience very strong symptoms, but others experience none at all. Those who do have symptoms generally experience fever, fatigue, and, often, rash. Other common symptoms can include headache, swollen lymph nodes, and sore throat. These symptoms can occur within days or weeks of the initial exposure to the virus during a period called primary or acute HIV infection.
Many people who have been infected with him have few or no HIV symptoms initially; testing is the only way to know for sure if you are infected with Human Immunodeficiency Virus. There are, however, an assortment of HIV symptoms that can be associated with a new infection.
Symptoms Early After Infection - Acute Human Immunodeficiency Virus - In emergency departments and family practice offices, people come in with symptoms like fever, headache, muscle and joint pain, sore throat, rash and diarrhea. In response to these symptoms, physicians diagnose the flu and send the patient on their way. In the majority of cases, their diagnosis proves correct. But unfortunately, a number of people with these vague, indistinct symptoms have a more serious illness than the flu; these symptoms may signal the acute stages of HIV infection.
Symptoms of the Immune System - The immune system is the body's natural defense against invading foreign agents such as viruses and bacteria. HIV attacks the immune system, weakening it and making the body more susceptible to infection. After infection, some symptoms affect the immune system: Swollen lymph nodes in the neck, axilla, or groin (lymphadenopathy), Fever / night sweats.
Symptoms of the GI Tract - Human Immunodeficiency Virus can have a profound affect on the gastrointestinal system and nutrition. Like any virus, HIV can cause symptoms ranging from poor appetite to diarrhea. Here are some of the most common:
1. Rapid weight loss.
3. Poor appetite.
4. Profound fatigue
Respiratory Symptoms - Some of the most serious symptoms of HIV involve the respiratory system. Symptoms associated with breathing and respiration usually occur later in course of the disease. Unfortunately, many people's first symptom of HIV involves the respiratory system, illustrating why HIV testing is so important. Any cough or shortness of breath could be a sign of bacterial pneumonia or pneumocystis (carinii) jiroveci pneumonia (PCP).
Symptoms of the Skin and Mucous Membranes - Many of the symptoms of HIV are a result of infection by other viruses, fungi or bacteria. Often, these infections involve the skin or mucous membranes (for example, inside the mouth).
1. Skin rash
2. Red, brown, pink or purple lesion on the skin - suggestive of Kaposi's sarcoma.
3. White patches on the tongue, inside of the mouth, or gums - could be signs of thrush, Candida, or hairy oral leukoplakia.
4. Canker sores / apthous ulcers.
Neurological / Emotional Symptoms - Very early on in the epidemic, experts realized that HIV affected both the physical and emotional self. Neurological and emotional symptoms of Human Immunodeficiency Virus can include the following.
2. Numbness, tingling, or burning in the feet, hands, or face. (peripheral neuropathy).
3. Confusion, weakness, or changes in level of consciousness.
HIV is an uncommon type of virus called a retrovirus, and drugs developed to disrupt the action of HIV are known as antiretrovirals or ARVs. These come in a variety of formulations designed to act on different stages of the life-cycle of HIV.
The AIDS virus mutates rapidly, which makes it extremely skilful at developing resistance to drugs. To minimize this risk, people with HIV are generally treated with a combination of ARVs that attack the virus on several fronts at once.
The introduction of ARVs in 1996 transformed the treatment of HIV and AIDS, improving the quality and greatly prolonging the lives of many infected people in places where the drugs are available. Nevertheless, ARVs are not a cure. If treatment is discontinued the virus becomes active again, so a person on ARVs must take them for life.
Although the price of ARVs has fallen significantly in recent years, their cost remains an obstacle to access in the developing world. Moreover, the health infrastructure required to deliver antiretroviral therapy is lacking in many places.
Access to drugs depends not only on financial and human resources. It depends also on people who need them being aware of their HIV status, knowledgeable about treatment, and empowered to seek it.
Thus public information and education are important elements in widening access, alongside efforts to build or strengthen the health services. The campaign for universal access to life saving drugs for HIV and AIDS, started originally by grassroots AIDS activists, is today a major focus of attention of UN agencies and others influential organizations at national and global levels.
Causes and Risk factors:
You can become infected with Human Immunodeficiency Virus in several ways, including:
1. Sexual transmission: You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. You can also become infected from shared sexual devices if they're not washed or covered with a condom. The virus is present in the semen or vaginal secretions of someone who's infected and enters your body through small tears that can develop in the vagina or rectum during sexual activity. If you already have another sexually transmitted disease, you're at much greater risk of contracting Human Immunodeficiency Virus. Contrary to what researchers once believed, women who use the spermicide nonoxynol 9 also may be at increased risk. This spermicide irritates the lining of the vagina and may cause tears that allow the virus into the body.
Transmission through infected blood: In some cases, the virus may be transmitted through blood and blood products that you receive in blood transfusions. Since 1985, American hospitals and blood banks have screened the blood supply for HIV antibodies. This blood testing, along with improvements in donor screening and recruitment practices, has substantially reduced the risk of acquiring HIV through a transfusion.
Transmission through needle sharing: This is easily transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia puts you at high risk of Human Immunodeficiency Virus and other infectious diseases such as hepatitis. Your risk is greater if you inject drugs frequently and also engage in high-risk sexual behavior. Avoiding the use of injected drugs is the most reliable way to prevent infection. If that isn't an option, you can reduce your risk by participating in a needle exchange program that allows you to trade used needles and syringes for sterile ones.
Transmission from mother to child: Each year, nearly 600,000 infants are infected with Human Immunodeficiency Virus, either during pregnancy or delivery or through breast-feeding. But if women receive treatment for HIV infection during pregnancy, the risk to their babies is significantly reduced. In the United States, most pregnant women are pre-screened for HIV, and anti-retroviral drugs are readily available. Not so in developing nations, where women seldom know their HIV status, and treatment is often limited or nonexistent. When medications aren't available, Caesarean section is sometimes recommended instead of vaginal delivery. Other options, such as vaginal disinfection, haven't proved effective.
Other methods of transmission. In rare cases, the virus may be transmitted through organ or tissue transplants or unsterilized dental or surgical equipment.
Diagnosing HIV can be done using blood, saliva, or by using cells from the inside of the cheek. Because HIV carries such stigma and prejudices, great care is taken to protect the identity of those being tested.
Getting an HIV test is easy; understanding a Human Immunodeficiency Virus test is not so easy. There is more than one type of type test used to determine if a person has been infected with HIV. These tests detect different substances in the blood that are present when a person has been infected with HIV. One detects Human Immunodeficiency Virus proteins that circulate in the body after a person has been infected. Two others detect HIV antibodies that have been produced by the body after type infection has occurred. Let's look a little closer at these tests.
Elisa: This is the first step of an HIV test. This test detects the presence of HIV antibodies in the blood. If the test is negative then the person is determined not to be HIV infected and testing stops there. If the test is positive the second step of the test is run to confirm the positive results of the first step.
Western Blot: This test is used to confirm the positive Elisa test results. The Western Blot test detects specific protein bands that are present in an HIV infected individual. In combination with a positive Elisa, a positive Western Blot is 99.9 percent accurate in detecting that type infection has occurred.
HIV PCR: The Human Immunodeficiency Virus PCR test detects specific Deoxyribonucleic Acid (DNA) and Ribonucleic Acid (RNA) sequences that indicate the presence of HIV in the genetic structure of anyone HIV infected. After Human Immunodeficiency Virus infection occurs, RNA and DNA from the HIV virus circulates in the blood. The presence of these DNA and RNA "pieces" indicates the presence of HIV virus.
Medicine and medications:
A number of drugs have been approved for the treatment of HIV (human immunodeficiency virus) and AIDS. These medications fall into a number of different groups, or "classes," of HIV drugs. Most people with HIV or AIDS take medications from several of these classes.
Current research is focused on finding new HIV medicines, particularly medicines that can work in new ways. Because the Human Immunodeficiency Virus virus can mutate rapidly, it often becomes resistant to available medications, which is why finding new types of drugs is so important.
The available classes of medications for HIV include the following:
1. Nucleoside reverse transcriptase inhibitors (NRTIs).
2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs).
3. Nucleotide reverse transcriptase inhibitors (NtRTIs).
4. Protease inhibitors.
5. Entry inhibitors, including fusion inhibitors.
6. Integrase inhibitors.
7. Combination medications from different classes.
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
The first HIV drug discovered, zidovudine (Retrovir®), is an NRTI. Other NRTIs include:
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs):
This group of medications includes the following AIDS drugs:
NNRTIs work similarly to NRTIs. However, NNRTIs do not trick the reverse transcriptase enzyme into using the medication as a DNA building block. Instead, they bind directly to reverse transcriptase, preventing it from making DNA at all.
Nucleotide Reverse Transcriptase Inhibitors (NtRTIs): At this time, there is only one NtRTI drug on the market, tenofovir (Viread®). It works exactly the same as NRTIs. In fact, the names for the two classes of AIDS drugs are so similar that these medications are often confused for each other. The only real difference is in the chemical structures of these HIV medications.
Protease Inhibitors: This is a large class of medications that is important for AIDS treatment. These medications for HIV include:
Lopinavir and ritonavir (Kaletra®).
Saquinavir (Fortovase®, Invirase®).
These medicines work by blocking a process that this virus needs in order to multiply. Once inside an infected cell, the HIV virus uses the cell to make DNA to make new HIV viruses that can spread to other cells. The DNA is made into long strands that must be clipped into shorter, usable strands using enzymes called proteases.
Protease inhibitors work by stopping protease enzymes from clipping DNA into shorter strands. Because the long, unclipped DNA strands cannot be used to make new viruses, this helps stop the spread of HIV to uninfected cells.
Ritonavir (Norvir) is a unique medication in this class. It is not usually used for its antiviral properties. Instead, it is used to "boost" other HIV medications (usually other protease inhibitors). This means that it is used to increase the level of other medications in the blood, making them more effective.
Entry Inhibitors: These are a fairly new group of HIV drugs. They work totally different than other medications from HIV. Instead of working from the inside of cells, entry inhibitors actually work to stop HIV from entering human cells. This group of medications includes those drugs that prevent the virus from connecting to human cells (known as fusion inhibitors), although sometimes fusion inhibitors are considered a separate class. Entry inhibitor medications include:
Enfuvirtide (Fuzeon®), a fusion inhibitor.
Integrase Inhibitors: This group is the newest of all Human Immunodeficiency Virus
medications. Currently, there is only one medication in this class: raltegravir (Isentress™). Raltegravir inhibits an enzyme called integrase, which is necessary for the viral DNA to be inserted into the human DNA. By inhibiting integrase, raltegravir helps to prevent the virus from making new copies of itself. It is important to remember that raltegravir is not a cure for HIV or AIDS.
Combination Medications from Different Classes: There are many different combination HIV drugs available. These drugs are usually best used as part of an HIV "cocktail." These cocktails usually consist of three or four (or sometimes five) different medications (technically known as Highly Active Anti-Retroviral Therapy, or HAART). Using a combination of medications for HIV helps to prevent the virus from becoming resistant to one or more of the drugs.
In order to help reduce the number of pills that must be taken, many of these medications are combined in one capsule or tablet. Sometimes, these medications combine drugs from different classes, such as:
1. Efavirenz, emtricitabine, and tenofovir (Atripla™)
2. Emtricitabine and tenofovir (Truvada®).
Although there is no cure for HIV or AIDS, several options are available to help people with Human Immunodeficiency Virus
or AIDS liver longer, healthier lives. Several different classes of HIV medications work in different ways, and most people need to take a combination of drugs from several different classes.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.