Man : Reckless Life (HIV/AIDS)

HIV/AIDS

Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

         i.            HIV infects vital cells in the human immune system such as helper T cells (specifically CD4⁺ T cells), macrophages, and dendritic cells.

       ii.            HIV infection leads to low levels of CD4⁺ T cells through three main mechanisms:

a.       First, direct viral killing of infected cells;

b.      second, increased rates of apoptosis in infected cells; and

c.       killing of infected CD4⁺ T cells by CD8 cytotoxic lymphocytes that recognize infected cells.

When CD4⁺ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic

What's the big deal about HIV and AIDS?

What’s the big fuss about AIDS and HIV for other people to worry about - the gay people, drug users, people who sleep around the one that need the focusing. However it is a wrong for conclusion - all teens, all humanity; need to take the threat of HIV, the virus that causes AIDS, seriously. To be able to protect yourself, you need to know the facts, and know how to avoid becoming infected.

Isn't it only a problem for adults?

HIV is a big problem for young people, as well as adults. It is estimated that there were

a.       3.4 million children (under 15 year olds)

b.      5 million young people (15-24 year olds) living with HIV in 2010

c.       one third of all new HIV infections are among people aged 15-24.

Globally AIDS is the second most common cause of death among 20-24 year olds.

What's the difference between HIV and AIDS?

HIV is the virus that causes AIDS. HIV stands for the 'Human Immunodeficiency Virus'.

AIDS stands for the 'Acquired Immune Deficiency Syndrome'.

AIDS is a serious condition that breaks down the body's defense system against illness. This means that people with AIDS can get many different kinds of diseases which a healthy person's body would normally fight off quite easily.

How long does it take for HIV to cause AIDS?

Now, there are many drugs (called antiretroviral drugs) that can be used to help people with HIV. People living with HIV can be treated for a very long time with antiretroviral drugs that prevent or delay the onset of AIDS. If someone infected with HIV does not take treatment, then it usually takes around ten years for AIDS to develop - however this varies from person to person. Many people around the world do not have access to antiretroviral treatment and therefore people continue to die from AIDS.

So how do you get infected with HIV?

HIV is passed on in the sexual fluids or blood of an infected person, so if infected blood or sexual fluid gets into your body, you can become infected. This usually happens by either having sexual intercourse with an infected person or by sharing needles used to inject drugs with an infected person. People can also be born with HIV if their mother is infected and a very small number of people become infected by having medical treatment using infected blood transfusions.

Three stages of HIV infection.

1. The initial stage of infection (primary infection), which occurs within weeks of acquiring the virus, and often is characterized by a flu- or mono-like illness that generally resolves within weeks.
2. The stage of chronic asymptomatic infection (meaning a long duration of infection without symptoms) lasts an average of eight to 10 years.
3. The stage of symptomatic infection, in which the body's immune (or defense) system has been suppressed and complications have developed, is called the acquired immunodeficiency syndrome (AIDS). The symptoms are caused by the complications of AIDS, which include one or more unusual infections or cancers, severe loss of weight, and intellectual deterioration (called dementia).

HIV can't be caught by kissing, hugging or shaking hands with an infected person, and it can't be transmitted by sneezes, door handles or dirty glasses. The most common ways in which HIV is spreading throughout the world include sexual contact, sharing needles, and by transmission from infected mothers to their newborns during pregnancy, labor (the delivery process), or breastfeeding.

What is 'safe sex'?

Sex means sexual intercourse or 'penetrative sex' and cannot be described as 'safe sex'. Safe sex means sexual activities even if one person is infected with HIV, and definitely won't pass it on to the other person. Sexual activities such as kissing, cuddling, massaging and rubbing each other's bodies. But if you have any cuts or sores on your skin, make sure they are covered with plasters (band-aids). Nothing you do on your own can cause you to get HIV - you can't get infected by masturbating.

What about using drugs?

The only way to be safe around drugs is not to take them. If you are on drugs you are taking risks you normally wouldn't take, as an unsafe sex when you would normally be more careful. If you take drugs, you might find it more difficult to use a condom or you might forget altogether. One of the most common drugs this can happen with is alcohol - if you're drunk, you might not always know what you're doing, or you might not care.

If you inject drugs, always use a clean needle, syringe and spoon, water, etc each time you inject, and never share any of these with anyone else. If you snort drugs, and you use a note or a straw to snort through, shouldn't share it, as blood can be passed from the inside of one person's nose to another.

If you have a tattoo or a piercing, you should make sure that the needles and equipment used are sterile.

What is safer sex?

Safer sex also means using a condom during sexual intercourse. Using a condom is not absolutely safe as condoms can break, but condoms can be effective if they are used correctly.

Oral sex (one person kissing, licking or sucking the sexual areas of another person) does carry some risk of infection. If a person sucks the penis of an infected man, for example, infected fluid could get into the mouth. The virus could then get into the blood if you have bleeding gums or tiny sores somewhere in the mouth. The same is true if infected sexual fluids from a woman get into the mouth of her partner. But infection from oral sex alone seems to be very rare.

Can you get infected your first time?

You can become infected, if your partner has HIV and you have unsafe sex. Sexual transmission of HIV has been described from men to men, men to women, women to men, and women to women through vaginal, anal, and oral sex. The best way to avoid sexual transmission is abstinence from sex until it is certain that both partners in a monogamous relationship are not HIV infected.

Is there a cure?

There is no cure for HIV or AIDS. HIV is a virus, and no cure has been found for any type of virus. Recently, doctors have been able to control the virus once a person is infected, which means that a person with HIV can stay healthy for longer, but they have not managed to get rid of the virus in the body completely.

How can I tell if someone's infected with HIV?

There is no way to tell just by looking at someone whether they are infected with HIV. Someone can be infected but have no symptoms and still look perfectly healthy. They might also feel perfectly healthy and not know themselves that they are infected. The only way to know if a person is infected or not is if they have an HIV test.

In 1985, a blood test became available that measures antibodies to HIV that are the body's immune response to the HIV. The test used most commonly for diagnosing infection with HIV is referred to as an ELISA. If the ELISA finds HIV antibodies, the results must be confirmed, typically by a test called a Western blot. HIV antibody tests remain the best method for diagnosing HIV infection.

Recently, tests have become available to look for these same antibodies in saliva, some providing results within one to 20 minutes of testing. Antibodies to HIV typically develop within several weeks of infection. During this interval, patients have virus in their body but will test negative by the standard antibody test, the so called "window period." In this setting, the diagnosis can be made if a test is used that actually detects the presence of virus in the blood rather than the antibodies, such as tests for HIV RNA or p24 antigen.

A new test has been approved that measures both HIV antibodies and p24 antigen, shrinking the duration of the window period from infection to diagnosis. There also are many testing centers around the country that are routinely screening blood samples that are HIV-antibody negative for HIV RNA.

How can I get tested?

It's much better to talk to someone than to worry on your own. The clinic will suggest that you wait three months after your last risky sexual contact before having a test. This is because the virus is difficult to detect immediately after infection.

Will they tell my parents?

     Clinics in different places have different policies. Most (but not all) clinics have a confidentiality policy, and will not tell anyone, although some places will want to bring a parent to give consent. You can phone the clinic before you go to find out.

What will they do?

Before they do anything, the doctor or nurse will ask if you're sure you want to have a test. They will usually take a sample of blood from you to examine. If you also want to be tested for STD's, they may take a urine sample, or they might ask if they can take a swab from the vagina or penis. Some places can give you the results on the same day, in other places you may have to wait for a week or more. While you wait, you shouldn't have sexual contact with anyone.

I have HIV - what should I do?

If you have found that you have HIV, you will need to consider telling the people who you have had sex with and anyone you have shared needles with so that they can decide if they want to have a test. This can be a very difficult thing to tell someone. If you think you can't tell them, your doctor or nurse may be able to help you. Your doctor at the clinic should also be able to give you more advice about how to stay healthy. They will also be able to tell you if you need to have any other blood tests done, and talk to you about medication.

Historical HIV Timeline

Before 1970s	HIV (the virus that causes AIDS) probably transfers to humans in Africa between 1884 and 1924. HIV probably enters Haiti around 1966.
1970s	HIV probably enters the United States around 1970. African doctors see a rise in opportunistic infections and wasting. Western scientists and doctors remain ignorant of the growing epidemic.
1981	AIDS is detected in California and New York. The first cases are among gay men, then injecting drug users.
1982	AIDS is reported among hemophiliacs and Haitians in the USA. AIDS is reported in several European countries. The name “AIDS” – Acquired Immune Deficiency Syndrome – is created. Community organizations in the UK and USA promote safer sex among gay men.
1983	AIDS is reported among non-drug using women and children. Experts become more confident that the cause of AIDS is infectious. Three thousand AIDS cases have been reported in the USA; one thousand have died.
1984	Scientists identify HIV (initially called HTLV-III or LAV) as the cause of AIDS. Western scientists become aware that AIDS is widespread in parts of Africa. The world's first needle exchange program is set up in Amsterdam, the Netherlands.
1985	An HIV test is licensed for screening blood supplies. AIDS is found in China, and has therefore been seen in all regions of the world.
1986	More than 38,000 cases of AIDS have been reported from 85 countries. Uganda begins promoting sexual behavior change in response to AIDS.
1987	AZT is the first drug approved for treating AIDS. The UK and other countries act to raise awareness of AIDS.
1988	The American government conducts a national AIDS education campaign. Health ministers meet to discuss AIDS and establish a World AIDS Day.
1990	Around 8 million people are living with HIV worldwide, according to estimates made later
1991	Thailand launches Asia’s most extensive HIV prevention programmed.
1993	AZT is shown to be of no benefit to those in the early stages of HIV infection.
1994	AZT is shown to reduce the risk of mother-to-child transmission of HIV. Infant HIV infections begin to fall in developed countries, due to use of AZT.
1995	The Joint United Nations Programmed on AIDS (UNAIDS) is established.
1996	Combination antiretroviral treatment is shown to be highly effective against HIV. In developed countries, many people begin taking the new treatment. Annual global spending on AIDS in low- and middle-income countries is $300 million.
1997	AIDS deaths begin to decline in developed countries, due to the new drugs. Brazil is the first developing country to begin providing free combination treatment. In other developing countries, only a tiny minority can access treatment for HIV. Around 22 million people are living with HIV worldwide, according to estimates made later.
2000	President Thabo Mbeki of South Africa voices support for AIDS dissidents
2001	At a UN Special Session, world leaders set long-term targets on HIV/AIDS.
2002	The Global Fund is established to boost the response to AIDS, TB and malaria. Botswana begins Africa’s first national AIDS treatment programmed.
2003	AIDS drugs become more affordable for developing countries. The “3 by 5” campaign is launched to widen access to AIDS treatment. The first HIV vaccine candidate to undergo a major trial is found to be ineffective.
2004	America launches a major initiative called PEPFAR to combat AIDS worldwide. After much hesitancy, South Africa begins to provide free antiretroviral treatment.
2006	Circumcision is shown to reduce HIV infection among heterosexual men. 28% of people in developing countries who need treatment for HIV are receiving it. Annual global spending on AIDS in low- and middle-income countries is $8.9 billion. It is estimated that $14.9 billion would be needed for a truly effective response.
2007	Around 33 million people are living with HIV, according to revised estimates. Another major HIV vaccine trial is halted after preliminary results show no benefit.
2008	A controversial Swiss study claims people adhering to ARVs have a "negligibly small" risk of transmitting HIV through unprotected sex. PEPFAR is reauthorized, committing $48 billion for the next five years. Michel Sidibé is named as new head of UNAIDS as Peter Piot steps down.
2009	President Obama announces the removal of the travel ban that prevents HIV-positive people from entering the US. 4 million people in developing and transitional countries are receiving treatment for HIV; 9.5 million are still in immediate need of treatment.
2010	The United States, South Korea, China and Namibia lift their travel bans for people living with HIV. The CAPRISA 004 microbicide trial is hailed a success after results show the gel reduced the risk of HIV infection by 40%. Results from the iPrEx trial show a reduction in HIV acquisition among men who have sex with men taking PrEP.
2011	Results from the HPTN 052 trial show that early initiation of antiretroviral treatment reduces the risk of HIV transmission by 96% among discordant couples. Armenia and Fiji lift their travel restrictions for people living with HIV. FDA approval of Complera, the second all-in-one fixed dose combination tablet, expands the treatment options available for people living with HIV. The Global Fund announces the replacement of Round 11 with a Transitional Funding Mechanism (TFM), due to a lack of funds.

What are symptoms and signs of HIV infection and AIDS in men, women, and children?

The time from HIV infection to the development of AIDS varies. Rarely, 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, without antiretroviral therapy, the time from initial infection to AIDS is approximately eight to 10 years. The reason why people experience clinical progress of HIV at different rates.

Within weeks of infection, many people will develop the symptoms of primary or acute infection which typically has been described as a "mononucleosis" or "influenza" like illness but can range from minimal fever, aches, and pains to very severe symptoms. The most common symptoms of primary HIV infection are

• fever,
• aching muscles and joints,
• sore throat,
• and swollen glands (lymph nodes) in the neck.

During the first weeks of infection when a patient may have symptoms of primary HIV infection, antibody testing may still be negative (the so-called window period).

After primary infection, most individuals enter a period of many years where they have no symptoms at all. During this time, CD4 cells may gradually decline, and with this decline in the immune system, patients may develop the mild symptoms of HIV such as vaginal or oral, fungal infections of the nails, a white brush-like border on the sides of tongue called hairy leukoplakia, chronic rashes, diarrhea, fatigue, and weight loss.

With a further decline in function of the immune system, patients risk of developing more severe complications of HIV, including many more serious infections (opportunistic infections), malignancies, severe weight loss, and decline in mental function.

Most physicians think about patients with HIV diseases as having no symptoms, mild symptoms, or being severely symptomatic.

Psychological Effects of HIV/AIDS

Getting diagnosed with HIV elicits many different emotions and psychological effects.

Depression

Characterized by feelings of guilt, difficulty sleeping, feelings of hopelessness and helplessness. Some people have a preoccupation with death or thoughts of suicide. Having HIV or AIDS can lead to depression in some people. The need to counseling to discuss their feelings. In some cases, therapy and medication are required.

Anxiety

Excessive fear and apprehension or panic and accompanied by physical complaints such as chest pain, shortness of breath, headaches or other problems. People with HIV or AIDs who experience anxiety symptoms may benefit from learning relaxation exercises such as progressive relaxation, meditation or yoga. In some cases, you may need therapy or medication.

Cognitive Problems

People with HIV sometimes experience cognitive problems related to the disease, may experience dementia complex, delirium and psychosis. Symptoms such as forgetfulness, inability to make decisions, attention problems, speech difficulties, confusion or other problems.

Other Emotions

Experiencing feeling of guilt, fear, sadness, embarrassment or confusion. Support from loved ones or community groups, medical providers, counselors, psychologists and psychiatrists. Become educated about the disease and treatments available to empower you to lead a healthier life, physically and emotionally.

Treatments for HIV
              Though there is no cure for HIV there are a number of medications which can improve the sufferer’s quality of life and delay the onset of AIDS for longer periods of time. Different types of medications block the virus in various ways. HIV research shows best results when combination therapy is used by combining at least three different drugs from two different categories. This prevents the HIV virus from mutating and becoming immune to the medications being used. The categories of HIV drugs are:

A.  Drugs :

        i.            NNRTI’s: Non-nucleoside reverse transcriptase inhibitors work by disabling a specific protein which HIV needs to reproduce. Examples are efavirenz, etravirine and nevirpaine.

      ii.            NRTI’s: Nucleoside reverse transcriptase inhibitors are ‘fake’ building blocks that HIV needs to reproduce. These fake blocks contain faults which essentially slow the virus from copying itself. Examples are abacavir and combination drugs emtricitabine and tenofovir.

    iii.            PI’s: Protese inhibitors disable a protein that HIV needs to reproduce. Examples include atazanavir and darunavir.

     iv.            Entry or fusion inhibitors: This category of drugs prevents HIV from entering the CD4 cells. Examples are enfuvirtide and maraviroc.

       v.            Integarse Inibitors: This category again disables a protein, one which HIV specifically uses to insert itself into the CD4 cells.

B.      Beyond Medication: A Healthy Lifestyle

Besides taking medications, there are many different lifestyle changes which can be made to improve the quality of life of someone who’s been infected with HIV.

a.       Eating a more nutritious diet:

Improving dietary intake can help slow down the progression to AIDS, improve their weight and prevent weight loss (which usually occurs with the virus) as well as improve their overall feeling of well-being, even with the symptoms that HIV can bring on.

A healthy diet for someone with HIV includes whole grains, low fat dairy products, protein and lots of fresh fruits and vegetables. Multivitamins are also a good idea to take, but remember to consult the doctor first. Fried food and sugary drinks, such as processed juices and sodas, should be eliminated.

b.      Exercising:

Regular, moderate exercises helps improve muscle mass, improves breathing, reduces stress, increases bone strength, improves appetite, improves sleep, and helps control glucose levels. People with HIV are especially prone to dehydration, losing body mass and infections from injuries so it’s important to talk to the doctor about the type and frequency of exercise.

c.       Quitting

·         Smoking

·         Stopping illicit drug use

·         Practicing safer sex

·         Getting tested and treated for STI’s

·         Taking steps to prevent infection

C.      Support Groups for HIV

For someone who is living with HIV, having a support group to discuss day to day difficulties or even to provide support to someone else with HIV is a good way to improve mental and emotional health. Below are some links that will provide information on both online and offline support systems for people with HIV or AIDS.

"The global HIV/AIDS epidemic is an unprecedented crisis that requires an unprecedented response. In particular it requires solidarity -- between the healthy and the sick, between rich and poor, and above all, between richer and poorer nations. We have 30 million orphans already. How many more do we have to get, to wake up?"

Kofi Annan

Excerpt and extract from:

Jul 3, 2010 | By Melissa Angela Lopez

Jay W. Marks, MD on 5/3/2012

Cara-online.org/