Download HIV/AIDS are unfortunate conditions that are currently affecting the

HIV/AIDS are unfortunate conditions that are currently affecting the whole world. Some
places, especially those in sub-Saharan Africa, are affected more seriously. Nevertheless, these
are distinct circumstances. HIV is the virus human immunodeficiency virus, and it causes
acquired immunodeficiency syndrome, or AIDS. Infection with HIV is often sexually transmitted,
but it can also be transmitted by other bodily fluids as well. The four major routes of
transmission are unsafe sex, contaminated needles, breast milk, and transmission from an
infected mother to her baby at birth (Weiss, 1993). When the infection progresses in some
patients, it may cause significant problems for the immune system; hence the name,
immunodeficiency.
HIV infects primarily white blood cells in the human immune system such as helper T
cells, macrophages, and dendritic cells (Cunningham, 2010). HIV infection specifically leads to
low levels of CD4+ T cells through three main ways: First, direct viral killing of infected cells;
second, increased rates of apoptosis in infected cells; and third, killing of infected CD4 + T cells
by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4 + T cell numbers get
critically low, cell-mediated immunity is lost, and the body becomes progressively more
susceptible to opportunistic infections.
Most untreated people infected with HIV-1 eventually develop AIDS (Migueles, 2010).
These individuals generally get overwhelming infections from opportunistic pathogens or even
fulminant cancer that is usually kept at bay by the immune system. The time of progression to
AIDS is quite variable among patients, with some moving along to AIDS at a very rapid pace and
others taking considerably longer to show any signs of the disease. While there are some
treatments for persons with AIDS, most people who go untreated will die within one year after
progressing to this stage.
The central problem for a patient with HIV is the maintenance of their immune system.
Over time, their immune system eventually fails and the patient is susceptible to significant
opportunistic infections. These infections begin to appear below the critical threshold of 200
CD4+ cells per µL. At this level, cell mediated immunity is lost, and infections with various types
of microbes will begin to appear. In addition, the patient may first notice unexplained weight
loss, recurring respiratory tract infections, prostatitis, skin rashes, and oral ulcerations.
Common opportunistic infections and tumors, most of which are normally controlled by robust
CD4+ T cell-mediated immunity then start to affect the patient. Typically, resistance is lost early
on to oral Candida species and to Mycobacterium tuberculosis, which leads to an increased
susceptibility to thrush and tuberculosis. Later, reactivation of latent herpes viruses may cause
worsening recurrences of herpes simplex eruptions, shingles, Epstein-Barr virus-induced B-cell
lymphomas, or Kaposi's sarcoma (Weiss, 1993).
There are currently no available cures or vaccines for the HIV virus; however, there are
several types of treatments to combat the HIV infection in AIDS patients. For patients who are
aware that they have been exposed to the virus, they may be helped by immediate post
exposure treatment with anti-retrovirals. It is thought that treatment with these medications
may be able to halt the spread of the infection. In July 2010, a vaginal gel containing tenofovir,
a reverse transcriptase inhibitor, was shown to reduce HIV infection rates by 39 percent in a
trial conducted in South Africa (Karim, 2010). In any event, there is an ongoing problem with
resistance to anti-retrovirals has lead to physicians to prescribe a cocktail of drugs to help fight
the development of resistance to the treatment. In the United States this is known as highly
active antiretroviral therapy, or HAART (Department of Health and Human Services, 2010).
These usually include combinations of at least two drugs, with most preparations being three
different medications. Typically, these classes are two nucleoside analogue reverse
transcriptase inhibitors plus either a protease inhibitor or a non-nucleoside reverse
transcriptase inhibitor. Most health care workers do not feel there is adequate evidence that
suggests even withholding the treatments for HIV infection regardless of the CD4+ count.
Nevertheless, most experts in the US agree that treatment should be started for patients when
the CD4+ count has fallen below 350. The difficulty is that treatment should be adhered to for
the remainder of the patient’s life, and they should be prepared for all of the potential
complications that go along with taking anti-retroviral medications. Even though HAART does
not cure the disease, many patients have experienced outstanding successes with these drugs
when used regularly. Some newer drugs are being developed to help those patients who have
had difficult times with the medications because of side effects.
No one should become complacent about HIV and AIDS. While current medications can
dramatically improve the health of people living with HIV and slow progression from HIV
infection to AIDS, existing treatments need to be taken daily for the rest of a person’s life, need
to be carefully monitored, and come with costs and potential side effects. At this time, there is
no cure for HIV infection. Despite major advances in diagnosing and treating HIV infection, in
2007, 35,962 cases of AIDS were diagnosed and 14,110 deaths among people living with HIV
were reported in the United States (Kilmarx, 2008).
Almost everyone is familiar with at least some of the ways to prevent the spread of this
disease. One of the most important ways to help limit the spread of AIDS is to determine if you
have the disease yourself. The majority of people who are infected with HIV do not even know
they have the infection, so experts recommend that everyone should be tested for HIV at least
once in their lives. Not only is this important for your own health, but it is crucial to avoid
spreading the infection to others. Next, the best way to avoid HIV is to not have sexual
intercourse. While that is not likely an option for most people, there are ways to make sex safer
for all involved. Abstain from sexual activity or be in a long-term mutually monogamous
relationship with an uninfected partner. In addition, you should limit your number of sex
partners. The fewer partners you have, the less likely you are to encounter someone who is
infected with HIV or another STD. If you decide to have sex, or partake in any activities where
there is intimate genital contact, be sure to use a condom every single time. Finally, do not
inject illicit drugs or share needles. If you are having difficulty getting or staying clean, make
sure to use clean needles and paraphernalia every time (Kilmarx, 2008). Not having (abstaining
from) sex is the most effective way to avoid transmitting HIV to others. If one chooses to have
sex, using a latex condom can help protect your partner from HIV and other STDs. Studies have
shown that latex condoms are very effective, though not 100%, in preventing HIV transmission
when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane)
condoms for either the male or female can be used.
Since the first cases of AIDS were identified more than 25 years ago, millions of people
around the world have become infected with HIV, and the epidemic has claimed millions of
lives. Globally, there are an estimated 33.4 million people living with HIV/AIDS, including more
than one million in the United States. While there have been successes in addressing the
epidemic on many fronts, multiple challenges remain in the areas of prevention, care and
treatment, research, infrastructure and capacity development, and funding. As AIDS is such a
global problem, there are many public health initiatives to help stem the tide of new HIV
infections. These include Greater Than AIDS. This group is about the power of individuals acting
together to achieve a greater goal- in this case, reducing the spread of HIV. By stressing unity,
hope and empowerment, Greater Than AIDS inspires each and every one of us- in our
relationships, families and communities- to do our part to stem HIV/AIDS. MTV: It’s Your (Sex)
Life is another well known public health initiative. This extensive, Emmy-award winning public
education campaign, in partnership with MTV, informs young people about sexual health
issues, including HIV/AIDS and other sexually transmitted diseases (STDs). Even outside the US
there are well known programs, especially in Africa, where the need may be the greatest. One
example is the African Broadcast Media Partnership Against HIV/AIDS. This unprecedented panAfrican coalition of more than 35 television and radio companies from 24 countries across the
continent aims to reinvigorate the media response to the HIV/AIDS pandemic in the region.
References
Cunningham, A.; Donaghy, H.; Harman, A.; Kim, M.; Turville, S. (2010). "Manipulation of
dendritic cell function by viruses". Current opinion in microbiology 13 (4): 524–529.
Department of Health and Human Services (January 2005). "A Pocket Guide to Adult HIV/AIDS
Treatment January 2005 edition".
http://www.hab.hrsa.gov/tools/HIVpocketguide05/PktGARTtables.htm. Retrieved 2006-01-17.
Karim, Q. A., Karim, S. S. A., Frolich, J. A., Grobler, A. C., Baxter, C., Mansoor, L. E., Kharsany, A. B.
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Kilmarx P. Acquired immunodeficiency syndrome. (2008) In: Heymann DL, editor.
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Migueles, S.; Connors, M. (2010). "Long-term Nonprogressive Disease Among Untreated HIVInfected Individuals: Clinical Implications of Understanding Immune Control of HIV". JAMA : the journal
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