No other word generates as much panic, repulsion, despair and utter helplessness as AIDS. It is, in fact, recomposing medical history as humankind’s deadliest curse. With the news of 40 million deaths due to HIV forecast in this millennium, statistics narrates their own squalid account. AIDS has been responsible for more than 25 million deaths since 1981- half as many deaths as in World War II. And it is still running high. The question is how did we receive such deadliest curse?
Between84 and 1924, some 18where near modern-day Kinshasa in West Central Africa, a hunter kills a chimpanzee. Then some of the animal\’s blood enters the hunter\’s body, probably through an open lesion. The blood carries a virus which is generally harmless to the chimp, but fatal to humans and this is now known as HIV (Human Immunodeficiency Virus). The virus spreads as colonial cities developed, but deaths are blamed on other causes.
What Is Aids & HIV
HIV (Human Immunodeficiency Virus) is responsible for spreading the deadly disease called AIDS. HIV belongs to a subset of retrovirus known as lentiviruses or slow viruses. This denotes that there is an interval of some years between the initial infection and the emergence of symptoms. HIV has two major categories: HIV-1 and HIV-2.
HIV-1 presently has approximately 10 subtypes. This is most common worldwide and the only form found in the US.
HIV-2 is less dangerous. Though it is currently restricted to West Africa—it’s also spreading.
The Human Immunodeficiency Virus (HIV) basically results in an infection, which destroys the body’s immune system. And AIDS or Acquired Immune Deficiency Syndrome is the complex stage of this disease, when the immune system becomes badly damaged, resulting in multiple infections and cancers. A person is detected HIV positive when s/he tests positive for any of the 26 diseases (Kaposi’s sarcoma, lymphoma, and pulmonary tuberculosis, recurrent pneumonia within a 12-month period, wasting syndrome and other indicators) that can easily attack the body during our immune system’s non-activity.
On afflicting the body, the virus specifically attacks T-cells- a core part of the human defence system, they activate other cells to seek and destroy transmittable foreign elements besides encouraging the immune system’s fight against infections. T-cells are targeted so that the AIDS virus parasitizes the CD4 molecules on their surface. With a shielding outer shell consisting of proteins and glyco-proteins; the AIDS virus contains genetic information inside. Although significantly smaller than the host T-cells—the virus reproduces by sponging off the host’s cellular property. Our body fights back by producing up to two billion new T-cells to substitute the infected cells, stabilizing the T-cell count for the time being. Yet from they first day, the T-cells fight a losing battle.
Although HIV targets T-cells and other cells in the body, it accumulates mainly in the lymph nodes—another important division of the immune system. Each lymph node has a netlike formation inside it. This acts as a protective filter by prohibiting virus and infected T-cells. But healthy T-cells move through these contaminated lymph nodes and thus get infected by HIV. Particularly during the early stage of the disease, lymph nodes contain more infected cells if compared to the blood.
HIV/AIDS Transmission
HIV is transmitted as the virus enters the body, generally by injecting infected cells or semen. There are several possible ways in which the virus can enter the body.
Normally, HIV infection is spread by sexual intercourse with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex.
HIV frequently spreads among injection-drug users on sharing needles or syringes infected with blood from a HIV positive person.
Women can transmit HIV to their babies during pregnancy or birth, when contaminated maternal cells go into the baby\’s circulation.
HIV can also be spread in health-care centre through accidental needle sticks or contact with contaminated fluids.
Very rarely, HIV spreads through transfusion of contaminated blood or blood components. To reduce the risk blood products are now tested.
If tissues or organs from an infected person are transplanted, the recipient may obtain HIV. Donors are now tested carefully for HIV to eliminate this risk factor.
People who already have a sexually transmitted disease, including syphilis, genital herpes, chlamydial infection, gonorrhea, or bacterial vaginosis, may develop HIV infection during sex with an infected partner.
This is important to know that HIV virus does not spread through casual contacts like preparing food, sharing towels and bedding, or via swimming pools, telephones, or toilet seats. The virus is also not likely to be spread by contact with saliva, unless it is infected with blood.
Symptoms
In the early stages, a mild flu and swollen glands are natural. But the symptoms are often instantly recognizable when AIDS reaches its severity. The symptoms include:
Loss of appetite
Weight loss
Constant fever
Prolonged fatigue
Diarrhea
Constipation
Changing bowel patterns
Swollen glands
Chills coupled with excessive sweating (especially at nights)
Lesions in the mouth
Sore throat
Persistent cough
Shortness of breath
Tumors
Skin rashes
Headaches
Memory lapses
Swelling in the joints
Pain in various parts of the body
Vision problems
Regular feeling of lethargy and ill health
With severely damaged immune systems, HIV-positive persons are prone to several types of cancer, particularly Kaposi’s sarcoma (KS), an uncommon form that develops under the skin and in the mucus membranes of the eyes, nose and mouth. Affected persons have lesions like dark-colored raised blotches. Though the lesions are usually painless, once KS affects the lungs, lymph nodes and digestive tract, the victim suffers from difficult breathing, gastrointestinal bleeding and painful swelling around the lymph nodes, especially in the legs.
Exams and Tests
HIV infection is commonly diagnosed by blood tests that identify antibodies the body makes in order to combat the virus. It may take some time for the immune system to generate enough antibodies for the antibody test in order to detect them. This time period is generally termed as the \”window period\” and may take six weeks to three months following infection. Therefore, if the initial test after exposure is found negative, a repeat test is recommended 3 months later. Early testing is vital; because early treatment for HIV is useful to avoid or reduce complications. Furthermore, high-risk behaviors can be avoided and the spread of the virus to others can be prevented.
Testing for HIV is performed in two steps. First, a low-cost screening test is performed. If that test results positive, a second test (Western blot) is recommended to confirm the test result.
Different types of screening tests are adopted. The Enzyme Immuno Assay (EIA) applied on the blood is the most common screening test. Other EIA tests are useful to detect the presence of antibodies in body fluids other than blood such as oral fluid, urine, and vaginal secretions.
Rapid tests are alternative screening tests that deliver speedy results in about 20 minutes. There are FDA-approved tests using blood or oral fluid. These tests are as accurate as traditional EIA tests.
Treatment
At present no vaccine is available for HIV or cure for HIV or AIDS. The only known methods of prevention depend on avoiding exposure to the virus or, failing that, an antiretroviral treatment immediately after a highly significant exposure, known as post-exposure prophylaxis (PEP). PEP has a very demanding four week schedule of dosage. It also has very repulsive side effects such as diarrhea, malaise, nausea and fatigue.
Antiviral therapy
Current treatment for HIV infection includes highly dynamic antiretroviral therapy, or HAART. This has proved to be extremely helpful to many HIV-infected individuals since its introduction in 1996 when the protease inhibitor-based HAART primarily became available. Current optimal HAART options comprise combinations (or \”cocktails\”) of at least 3 drugs belonging to at least two types, or \”classes,\” of antiretroviral agents.
Typical regimens contain two nucleoside analogue reverse transcriptase inhibitors (NARTIs or NRTIs) along with either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI). As development of HIV disease in children is faster than in adults, and laboratory parameters are less analytical of risk for disease progression, particularly for young infants, prescribed treatments are more aggressive for children than for adults. In developed countries where HAART is available, doctors evaluate the viral load, CD4 counts, speed of CD4 decline and patient’s willingness while deciding when to propose initiating treatment. Conventionally, treatment has been suggested for otherwise asymptomatic patients when CD4 cell counts go down to 200-250 cells per micro liter of blood. However, beginning treatment earlier (at a CD4 level of 350 cells/micro liter) may significantly reduce the risk of death.
Standard goals of HAART consist of improvement of the patient’s quality of life, easing complications, and reduction of HIV viremia below the limit of detection, but it does not recover the patient of HIV nor does it prevent the return, once treatment is stopped. It would require more than the lifetime of an individual to be totally free from HIV infection using HAART.
Prevention
Prevention is still the best bet. Even though AIDS is a fatal disease it can be prevented taking proper precautions and greater awareness is spread among people ignorant of the virus and its ill-effects on the human body. Here a few measures are listed below which can be followed by everyone in order to ward off the sinister entry of HIV:
Licentious sexual indulgence can make a person highly susceptible to the HIV. Where self-restraint seems hard, always use latex condoms. The female condom can also give protection to both partners. Use only water-based lubricants because oil lubricants (such as Vaseline) might even cause the latex condoms to tear. Use spermicidal (birth control) foams and jellies besides condoms. But by themselves, spermicides may not seem effective in preventing HIV.
Avoid alcohol or drugs during sex in order to ensure safe sex. You might lose control of your senses if you are drunk and engage in unsafe sex. Maintain safer sex practices at all times and avoid having physical relation with multiple partners rather choose monogamy. If this is a tall order, serial relationships are a not as evil as multiple ones.
High-risk sexual activities should be avoided by any means. These include: oral genital sex involving contact with semen or vaginal fluids, oral anal sex, vaginal sex without a condom, anal sex without a condom (active or passive), fisting or manual anal intercourse, the sharing of sex toys, using saliva for lubrication and blood contact of any kind during performance. Use a dental dam if it seems difficult to control oral sex. If a woman is infected, avoid sex during menstruation because menstrual blood is contagious.
For blood transfusions, use of disposable syringes and needles is mandatory. Ensure you receive blood screened and certified as HIV-free. It is preferable to get blood from close family members rather than professional donors whose medical background is indefinable.
The presence of sexually transmitted diseases (STDs) heightens the risk of contracting HIV from an infected partner. STDs could cause lesions in the skin of the vagina, penis or anus allowing the virus to enter your bloodstream. If you ever catch an STD of any kind, ensure you get prompt treatment.
The CDC recommends that an HIV-positive woman should avoid breast-feeding her baby. The infant should be given AZT for the first several weeks to significantly decrease the risk of being infected.
Myths & Facts-There are various misconceptions regarding AIDS that have still kept majority of the world’s population in dark.
Majority of the people have a belief that AIDS is supposedly a disease of gay men and intravenous drug users. The facts are different. Undoubtedly in the early years many HIV-positive cases were found amongst the Western gay community. But recently predominance rates among gays have leveled off. In its place, heterosexual transmission of the virus has been in advance among all other possible modes of transmission.
The AIDS virus does not spread through touching, hugging, kissing, and massage, sharing toilet seats, drinking or eating from same utensils used by a contaminated person or any other mode of casual contact. Working, socializing and even living with infected people do not cause the disease.
Repeated sexual interaction with an infected person without proper precautions, using an infected syringe, exposure to infected blood or sexual fluids transmit the disease.
Donating blood does not increase the risk of disease contraction because needles used for such purposes are always sterile. Since the AIDS virus cannot survive outside the human body beyond a short period, dried blood is not at all infectious. This is why; mosquitoes cannot transmit HIV as the virus does not have the ability replicate itself in the intestine of insects.
Although medical personnel are potentially at risk from infection, the chances are minimal if protective gear like gloves, masks and goggles are always used during the handling of extremely infected material.