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HIV & AIDS

According to the World Health Organization 34.3 million people in the world have the
AIDS virus

1. 24.5 million of them in sub-Saharan Africa.


2. Nearly 19 million have died from AIDS, 3.8 million of them children under the
age 15.
3. 5.4 million new AIDS cases in 1999, 4 million of them in Africa.
4. 2.8 million Died of AIDS IN 1999, 2.4 million of them in Africa.
5. 13.2 million children orphaned by AIDS, 12.1 million of them in sub-Saharan
Africa.
6. Reduced life expectancy in sub-Saharan Africa from 59yrs to 45yrs between
2005 and 2010, and in Zimbabwe from 61yrs to 33yrs.
7. More than 500,000 babies infected in 1999 by their mothers most of them in
sub-Saharan Africa.

The Facts: In 1959 scientist identified the AIDS virus. Only In the mid 80's a
scientist at the National Institutes for Health, with a high profile reputation in cancer
research claimed to have proved the link between HIV and AIDS, although disputed
at the time by a handful of scientist, in their desperation to find a cure, the world
stopped looking for the virus and began trying to find a treatment or vaccine.

Sixteen years later governments and private organizations across the world have
poured billions of dollars in research, treatment and prevention strategies and to
date no one has provided scientific proof of the link between HIV and AIDS.

Amongst other that disagreed with the above claims, a German born molecular
Biologist at the University of California Berkeley wrote a book "Inventing the AIDS
myth" his theory coincided with the above, that Western scientist prematurely
concluded that HIV causes AIDS and when billions of dollars became available to
study the disease, scientist jump on the band wagon and have been heading in the
wrong direction ever since.

Some scientist believe that HIV is not sufficient to cause AIDS and there must be
what they call co-factors. No one has yet found a vaccine and claims of evidence of
the isolation of the virus have been disputed.

HIV
The human immunodeficiency virus (HIV) is a frequently mutating retrovirus that
attacks the human immune system and which has been shown to cause acquired
immune deficiency syndrome (AIDS).
History
HIV was discovered and identified as the agent for AIDS by Luc Montagnier of France
in 1984.
A minority of scientists continues to question the connection between HIV and AIDS
and even the very existence of HIV (see AIDS reappraisal).

As of 27 November 2003, there were an estimated 54 862 417 worldwide HIV


infections, 30% of which were in Southern Africa.

Pathogenesis
HIV causes disease by infecting the CD4+ T cells. These are a subset of leukocytes
(white blood cells) that normally coordinate the immune response to infection. By
using CD4+ T cells to replicate itself, HIV spreads throughout the body and at the
same time depletes the very cells that the body needs to fight the virus. Once a
HIV+ individual's CD4+ T cell count has decreased to a certain threshold, they are
prone to a range of diseases that the body can normally control. These opportunistic
infections are usually the cause of death.

There are several reasons that HIV is so hard to fight. First, the virus is an RNA
virus, using the reverse transcriptase enzyme to convert its RNA into DNA. During
that process there is a large chance of mutation. Therefore, the virus becomes
quickly resistent to therapy. Second, the common notion that HIV is a killer feasting
on T cells is not true. If HIV were a killer virus, it would have died out soon because
there would be too little time for new infections. Now, HIV stays in the body for
years, infecting people through unsafe sex, blood transfusions and breastfeeding of
infants while the patient sometimes doesn't know. HIV can survive even when drugs
eliminate all detectable virons in the blood. It integrates itself into the DNA of the
host cell and can stay there for years, lying dormant, immune to all kinds of therapy
because it is just DNA. When the cell divides and the DNA is copied, the virus is
copied too. After years, the virus can become active again, seize the cell's machinery
and replicate. In recent years, the notion that the CD4+ T cells decrease because of
direct HIV infection has become doubted as well. The HIV coating protein readily
detaches from virus particles. The blood becomes filled with these proteins, which
can stick to the CD4+ T cells, gluing them together. In addition, they are recognized
by the immune system, causing the immune cells to attack their own CD4+ cells. In
summary, HIV is a guerrilla terrorist, keeping low and seeking shelter when
threatened, but always ready to hit where it hurts.

HIV Tests

Several tests exist to detect the presence of HIV, the virus that causes AIDS. They
are used for different purposes:

• to test whether an individual is infected with HIV


• to screen donated blood or organs
• to measure the amount of free virus in a patient's blood in order to monitor
the progress of the disease under antiretroviral drug therapy

Some terminology:
• The window of a test is the time period after initial infection during which the
test cannot yet detect the presence of HIV. The shorter the better.
• The specificity of a test is the percentage of HIV positive cases that are
correctly identified as positive by the test.
• The sensitivity of a test is the percentage of HIV negative cases that are
correctly identified as negative by the test. The higher the better.

Human immunodeficiency virus, or HIV, infection damages the body's immune


system. Over time, it leads to acquired immune deficiency syndrome, or AIDS.

What is going on in the body?

HIV affects the immune system in broad and devastating ways. Its main target is a
special immune system cell called the CD4+ T lymphocyte. These cells help the body
fight infections of all kinds. When HIV infects these cells, it decreases their numbers
and affects how the cells that are left function.

After an adult is infected with HIV, he or she usually has no obvious symptoms for 5
to 10 years. During this time, however, the virus is slowly attacking the immune
system. When the immune system is weakened enough, it becomes susceptible to
other organisms that the body can usually fight off or keep under control. These
other organisms include bacteria, other viruses, fungi, and parasites.

Many serious health problems occur as a result of the immune system damage
caused by HIV. The most serious is AIDS.

What are the signs and symptoms of the disease?

Following are some of the signs and symptoms of HIV infection: · abdominal pain
· altered mental status · chest pain · cough · depression, often with suicidal thoughts
· eye problems, such as blurred vision or floaters · fatigue · fever · headache · night
sweats · rashes · shortness of breath, especially with exertion · sore throat · vomiting
and diarrhea · weight loss in adults or failure to thrive in children

People infected with HIV often have other infections because of their weakened
immune system. These infections may include: · infections with unusual organisms
· recurring or ongoing upper respiratory tract infections, such as colds or tonsillitis, in
children · recurring yeast infections in women

What are the causes and risks of the disease?

HIV infection is caused by a type of virus known as a lentivirus. Seventy percent of


HIV infections worldwide are sexually transmitted, or spread by sexual contact. The
remaining 30% of the infections are spread in one of the following ways: · by contact
with HIV-infected blood or other secretions at the site of a cut or wound · by skin
punctures from needles or other sharp devices contaminated with HIV-infected blood
or other body secretions · from contaminated blood products received before March
1985, when a screening test for HIV in blood products was first used · from mother
to infant around the time of birth · through breastfeeding
Following are some of the risk factors for HIV infections: · having received blood
transfusions or blood products, especially from 1975 to March 1985 · having received
pooled plasma for treatment of hemophilia, a blood clotting disorder · intravenous
drug use · sexual activity with an infected individual, particularly male homosexual
contact

What can be done to prevent the disease?

Although practicing safer sex cannot completely protect a person from HIV, it can
lower the risk. Condoms help prevent passing along the virus. Research in
laboratories has shown that a spermicidal called nonoxynol-9 kills or stops the
growth of HIV. However, there are not yet any studies that prove spermicides prevent
HIV infection in humans. Some experts do believe that using spermicide on a
condom or putting it into the vagina can kill some HIV organisms before they can
infect the woman. It is safest to avoid sexual intercourse with people who have HIV
infection or unknown HIV status and those who use IV drugs.

A person should not share needles, syringes, or other drug paraphernalia that could
carry tainted blood or body fluids with anyone. When caring for someone in an
emergency, it is important to wear gloves to protect against HIV in body secretions.

A woman who is pregnant or thinking about getting pregnant, should ask her doctor
to test her for HIV. If a woman has HIV, steps can be taken during pregnancy and
birth to avoid passing it to her baby.

How is the disease diagnosed?

The body produces antibodies to fight off HIV infection. HIV is usually diagnosed by
blood tests called antibody titer tests. The enzyme immunoassay, or EIA, is used as a
screening test. If this test is positive, a HIV Western blot test is done to confirm the
diagnosis. The virus can also be detected by testing for viral proteins and by doing
blood cultures. Other tests may be ordered to help diagnose complications of HIV
infection, such as pneumonia.

Negative tests do not always mean that a person is free of infection. Weeks or
months might pass after exposure to the virus before antibodies can be detected in
the body.

What are the long-term effects of the disease?

HIV causes many long-term effects, including: · autoimmune disorders, which cause
the body to destroy its own tissues · cancers, such as Kaposi's sarcoma and non-
Hodgkin''s lymphoma · cytomegalovirus infections, which can affect vision
· meningitis caused by cryptococcal organisms · neuropsychiatric disorders, which
change the person's thinking and interaction with others · Pneumocystis carinii
pneumonia · premature death · toxoplasmosis, a respiratory infection · tuberculosis

What are the risks to others?


Having unprotected sexual intercourse or sharing needles or syringes puts a person
and his or her partners at risk for HIV. People with known or suspected HIV infection
should not donate the following: · blood · body organs · plasma · sperm

What are the treatments for the disease?

There are a number of medicines that effectively treat HIV. Over the past few years,
combinations of certain drugs have been very promising in controlling HIV. Some of
them are as follows: · antibiotics, such as trimethoprim-sulfamethoxazole or
pentamidine · antifungal medicines, such as amphotericin B and flucytosine
· antiparastic medicines, such as pyrimethamine · antiviral medicines, such as
zidovudine, lamivudine, nevirapine, and ganciclovir · glucocorticoids, such as
prednisone · protease inhibitors, such as indinavir

People who have HIV infection face significant health problems and stress. Following
are some helpful interventions: · Eat a healthy diet, following the food guide
pyramid. · Get plenty of rest and sleep. · Join support groups. · Take medicines to
deal with emotional symptoms. · Use psychotherapy. · Use relaxation therapy and
other stress management techniques.

What are the side effects of the treatments?

Unfortunately, most HIV medicines have many side effects, depending on the drug
being taken. Some more common side effects include: · diarrhea · nausea · rashes
· vomiting

Some less common side effects are as follows: · changes in the brain and behavior
· inflammation of the pancreas · kidney stones

What happens after treatment for the disease?

There is no cure for HIV infection at this time. The goal of treatment is to keep the
virus under control with the hope of preventing further immune damage. Currently, a
person must be treated for life.

How is the disease monitored?

Someone with HIV infection will have regular visits with the healthcare provider,
along with periodic blood tests. Any new or worsening symptoms should be reported
to the provider.