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AIDS / HIV |
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Definition
Acquired immune deficiency syndrome or acquired
immunodeficiency syndrome (AIDS or Aids) is a
collection of symptoms and infections resulting from
the specific damage to the immune system caused by the
human immunodeficiency virus (HIV)
Causative Agent
Transmission
- Sexual contact. Persons at greatest risk are
those who do not practice safe sex, those who are
not monogamous, those who participate in anal
intercourse, and those who have sex with a partner
with symptoms of advanced HIV infection and/or other
sexually transmitted diseases (STDs). In the United
States and Europe, most cases of sexually
transmitted HIV infection have resulted from
homosexual contact, whereas in Africa, the disease
is spread primarily through sexual intercourse among
heterosexuals.
- Transmission in pregnancy. High-risk mothers
include women married to bisexual men or men who
have an abnormal blood condition called hemophilia
and require blood transfusions, intravenous drug
users, and women living in neighborhoods with a high
rate of HIV infection among heterosexuals. The
chances of transmitting the disease to the child are
higher in women in advanced stages of the disease.
Breast feeding increases the risk of transmission by
10-20%. The use of zidovudine (AZT) during
pregnancy, however, can decrease the risk of
transmission to the baby.
- Exposure to contaminated blood or blood
products. With the introduction of blood product
screening in the mid-1980s, the incidence of HIV
transmission in blood transfusions has dropped to
one in every 100,000 transfused. With respect to HIV
transmission among drug abusers, risk increases with
the duration of using injections, the frequency of
needle sharing, the number of persons who share a
needle, and the number of AIDS cases in the local
population.
- Needle sticks among health care professionals.
Present studies indicate that the risk of HIV
transmission by a needle stick is about one in 250.
This rate can be decreased if the injured worker is
given AZT, an anti-retroviral medication, in
combination with other medication.
Symptoms
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Persistent generalized
lymphadenopathy
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Constitutional symptoms such
as low grade fever, fatigue and generalized weakness
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Thrush and painful ulcers in
the mouth
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Aids related cancers
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Hairy leukoplakia - A white area of diseased tissue on
the tongue that may be flat or slightly raised caused
by the Epstein-Barr virus.
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Arthritis like pin in the joints
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Signs of opportunistic infections
Diagnostics Tests
Treatment
There is no cure for AIDS at this time. However, a
variety of treatments are available that can delay the
progression of disease for many years, and improve the
quality of life of those who have developed symptoms.
-
Antiretroviral therapy suppresses the replication of
the HIV virus in the body
- Nucleoside analogues. These drugs work by
interfering with the action of HIV reverse
transcriptase inside infected cells, thus ending the
virus' replication process. These drugs include
zidovudine (sometimes called azidothymidine or AZT),
didanosine (ddI), zalcitabine (ddC), stavudine
(d4T), lamivudine (3TC), and abacavir (ABC).
- Protease inhibitors. Protease inhibitors can be
effective against HIV strains that have developed
resistance to nucleoside analogues, and are often
used in combination with them. These compounds
include saquinavir, ritonavir, indinavir, nelfinavir,
amprenavir, and lopinavir..
- Non-nucleoside reverse transcriptase inhibitors.
This is a new class of antiretroviral agents. Three
are available, nevirapine, which was approved first,
delavirdine and efavirin.
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Treatment of opportunistic infections and
malignancies
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Prophylactic treatment for opportunistic infections
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Stimulation of blood cell production
Prognosis
At the present time, there is no cure for AIDS. It is
always fatal if no treatment is provided
Prevention
- See the article on safe sex to learn how to
reduce the chance of acquiring or spreading HIV, and
other sexually transmitted diseases.
- Try not to use intravenous drugs. If IV drugs
are used, do not share needles or syringes. Many
communities now have needle exchange programs, where
used syringes can be disposed of and new, sterile
needles obtained for free. These programs can also
provide referrals to addiction treatment.
- Avoid contact with another person's blood when
the HIV status of the bleeding individual is
unknown. Protective clothing, masks, and goggles may
be appropriate when caring for people who are
injured.
- Anyone who tests positive for HIV can pass the
disease to others and should not donate blood,
plasma, body organs, or sperm. An infected person
should warn any prospective sexual partner of their
HIV-positive status, should not exchange body fluids
during sexual activity, and should use whatever
preventive measures (such as condoms) will afford
the partner the most protection.
- HIV-positive women who wish to become pregnant
should seek counseling about the risk to unborn
children, and medical advances which may help
prevent the fetus from becoming infected. Use of
certain medications can dramatically reduce the
chances that the baby will become infected during
pregnancy.
- Mothers who are HIV-positive should not breast
feed their babies.
- Safe-sex practices, such as latex condoms, are
highly effective in preventing HIV transmission.
HOWEVER, there remains a risk of acquiring the
infection even with the use of condoms, if the
condom breaks. Abstinence is the only sure way to
prevent sexual transmission of HIV.
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