Acquired immune deficiency syndrome is a group of infections and conditions that are the result of contracting the human immunodeficiency virus, known as HIV. This disease is also called acquired immunodeficiency syndrome and is referred to as AIDS or Aids. Normally healthy individuals become prone to opportunistic infections and tumors. There is no complete cure for this disease. The virus is transmitted through the exchange of bodily fluids with mucus membranes, such as blood, semen, vaginal fluid, pre-seminal fluid and breast milk. Transmission can occur via sharing contaminated needles, birth, breast feeding, contaminated blood via transfusion, and exchange of fluid via anal, oral, vaginal sex.
HIV is believed to have originated in sub-Saharan Africa in the twentieth century. Worldwide 38.6 million people have AIDS. As of January 26, 2006, over 25 million people have died from this disease. It is one of the most devastating epidemics recorded in history.
The symptoms of acquired immune deficiency syndrome are the result of infections and conditions that normally do not affect individuals with typical or healthy immune systems. The infections are caused by bacteria, fungi, parasites and viruses that the body can normally defend from infection. HIV affects nearly every system of the body. AIDS patients have a serious risk of developing Kaposi’s sarcoma, cervical cancer and lymphomas.
Being HIV positive and having AIDS are two distinct entities. There are four stages of an HIV infection. The following stages were updated by the World Health Organization (WHO) in September 2005:
Stage I is defined as HIV positive blood test, but the patient is asymptomatic and not categorized as having AIDS.
Stage II is indicated by minor manifestations in the mucus membranes and recurring upper respiratory tract infections.
Stage III is defined by unexplained chronic diarrhea, lasting longer than a month, severe infections due to bacteria and pulmonary tuberculosis
Stage IV is defined by toxoplasmosis of the brain, Candida overgrowth of the esophagus, trachea, bronchi or lungs and Kaposi’s sarcoma. Stage IV indicated the HIV infection has become AIDS.
Systemic infections that cause swollen glands, night sweats, fevers, chills, weight loss and weakness also develop in patients with AIDS. Progression of the disease varies from individual to individual, depending on the specific opportunistic infectious agents that are typical to the geographic region of the patient.
Major pulmonary infections are pneumocyctis jiroveci pneumonia, and multi-drug resistant tuberculosis. Major neurological illnesses that affect AIDS patients are toxoplasmosis, progressive multifocal leukoencephalophathy (PML), AIDS dementia comlex, and cryptococcal meningitis.
Toxoplasmosis is a disease due to a single cell parasite known as toxoplasma gondiii. This parasite can infect the brain causing toxoplasma encephalitis and infect the eyes and lungs. PML is a disease in which a gradual destruction of the myelin sheath coverings of the axons of nerve cells occurs. It is caused by the JC polyomavirus. IT occurs in seventy percent of patients in the latent stages of the disease when the immune system is most compromised. Aids dementia complex is metabolic encephalopathy that invades the brain causing the secretion of neurotoxins. Neurological impairments manifest as behavioral, cognitive and motor and can appear years after infection with HIV. Cryptococcal meningitis is an infection that is caused by a fungus. Symptoms are fevers, headaches, nausea, vomiting, and fatigue. Seizures, confusion can also occur. If untreated, cryptococcal meningitis can cause death.
Gastro-intestinal illnesses present as severe diarrhea and inflammation of the esophagus, known as esophagitis. Esophagitis is usually due to a fungal overgrowth or a viral infection. Rarely, it can be the result of a mycobcteria infection. Chronic diarrhea can be caused by salmonella, listeria, campylobacter, E. coli, shigella, and parasitic infections. In some cases, the diarrhea can be the side effect of the drug cocktail used to treat the virus, HIV.
Major HIV-associated malignancies can also cause severe symptoms. The co-infection of Epstein-Barr virus, Kaposi’s sarcoma-associated herpes virus and human papillomavirus cause the malignancies. Kaposi’s sarcoma is most common malignancy affecting Aids patients, presenting as purplish bumps or nodules. High grade B cell lymphomas also are prevalent in Aids patients, causing fever, weight loss and fatigue. Cervical cancer in women is caused by the human papillomavirus. These cancers are Aids-defining symptoms. Other tumors that have an increased risk in HIV-infected patients are Hodgkin’s disease, anal and rectal carcinomas.
Patients that have AIDS are susceptible to non-specific opportunistic infections that cause low-grade fevers and weight loss.
Most individuals are unaware that they are infected with HIV. A typical HIV test screens for the HIV antibodies in the serum, plasma, dried blood, oral fluid or urine. The tests are known as HIV enzyme immunoassay and the Western blot assay. The time frame from infection to detectable antibodies is variable. It can take three to six months for the antibodies to be present before a positive test. Tests are available commercially that can detect HIV antigens, HIV-RNA and HIV-DNA.
AIDS is defined as HIV positive test result with a T cell count below 200 per µL of blood or fourteen percent of all lymphocytes.
Presently there is no cure or vaccine for HIV or AIDS. Methods of prevention are avoiding exposure. After being exposed by a susceptible partner, individuals can be treated with an antiretroviral treatment called post-exposure prophylaxis PEP. This regimen has a very exact four week schedule of medications with extreme side effects of fatigue, nausea, diarrhea, and general malaise.
Highly active antiretroviral therapy or HAART is the currently used treatment for HIV infection. Thos has been very beneficial to many patients. The optimal HAART regimen is a cocktail of three drugs, two of which belong to a specific class of retroviral agents. The retroviral agents consist of nucleoside analogue reverse transcriptase inhibitors and a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor. Viral load and patient health are the determining factors in which drugs to prescribe to patients.
HAART stabilizes the symptoms and viral load of the patient. It does not cure the patient of the HIV infection. It is a lifetime regimen. Patients who do not receive HAART who have AIDS have a typical life span of about nine months.
Prevention is vital for individuals for this deadly disease. The key to prevention is safe sex using condoms that block fluid and viral transmission. Not all condoms prevent the transmission of the virus and consumers should check the label of the condoms for safety rating. Abstinence from sex, though not realistic, is the safest method of preventing transmission of the AIDS virus.
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