Complications of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)

HIV Disease and Aging

Acquired immune deficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV) is the leading cause of death in sub-Sahara Africa. A major focal point of the epidemiology and spread of HIV infection and AIDS is HIV/AIDS related knowledge, especially as these affect AIDS risk behaviors in vulnerable populations of Africa. While HIV testing serves as the gateway to treatment, care, and prevention of HIV/AIDS; uptake of HIV testing is very low in sub-Saharan Africa. This study was conducted to assess the HIV/AIDS related knowledge, risk perception and practice of HIV confidential counseling and testing among patients in Sokoto. A descriptive cross-sectional study among 184 randomly selected patients attending the medical outpatient clinic of Specialist Hospital Sokoto, Nigeria was conducted in September 2010. Informed consent was taken and information was collected by a pre-designed questionnaire, data analysis was done using computer software, SPSS version 17. Almost all the patients (97.8%) have heard about HIV/AIDS. Although only 18.3% knew the causative agent, majority had adequate knowledge of transmission (71.1%) and prevention (62.2%) of the disease, with a few among them having some misconceptions. Most (89.4%) perceived the disease to be a serious threat to them, but some still engaged in sharing needle with another person (12.2%), and casual sex (8.3%). Barely half (57.2%) knew where to do HIV test, and only 23.9% have been tested for HIV. Inadequate awareness and poor practice of HIV testing was demonstrated in this study despite adequate knowledge and perception of risk of HIV/AIDS. This suggests the need for all the stakeholders to intensify health education aimed at removing misconceptions about the disease and improving uptake of HIV testing. Key words: Acquired immune deficiency syndrome/human immunodeficiency virus (HIV/AIDS), knowledge, risk perception, confidential counseling and testing.

Approximately 30 years ago, in June 1981, it was reported from theCenter forDiseaseControl andPrevention (CDC) that five, otherwise healthy, homosexual men in California had presented with pneumonia caused by Pneumocystis jiroveci pneumonia, a rare disease seen exclusively in individualswith a severely suppressed immune system. Several reports confirmed the initial observation and lent support to the possibility that a new sexually transmitted, infectious agent was circulating within the gay community in the United States. The clinical condition was named acquired immunodeficiency syndrome (AIDS). Two years later, a research team at the Institut Pasteur under the guidance of Francoise Barre-Sinoussi and Luc Montagnier isolated human immunodeficiency virus (HIV), the causative agent of AIDS, from a lymph node biopsy of a French patient. The isolation and characterization of HIV paved the way for the design of diagnosticmethods to identify the virus in blood andbloodproducts and towards the development of novel antiretroviral treatment (ART) to control HIV replication in infected patients. For their discoveries, Barre-Sinoussi and Montagnier were awarded the Nobel Prize in Physiology and Medicine in 2008.

Human Immunodeficiency Virus: The Initial Physician-Patient Encounter

Idiopathic AIDS Enteropathy and Treatment of Gastrointestinal Opportunistic Pathogens

HIV and sickle cell disease (SCD) are significant causes of morbidity and mortality in sub-Saharan Africa. Given their separate roles in immune dysregulation, our objective was to characterise the impact that SCD has on the presentation and progression of paediatric HIV. The study was a retrospective cohort study (study period 2004-2018). Cases of HIV+and SCD-afflicted patients (HIV+/SCD+) were obtained via electronic chart review from a paediatric HIV clinic in Kampala, Uganda and matched 1:3 with HIV+controls without SCD (HIV+/SCD-). Thirty-five HIV+/SCD+subjects and 95 HIV+/SCD- controls were analysed (39% female (51/130), age 3.6years (SD3.9)). At baseline, WHO clinical stage (64% total cohort Stage III/IV) and nutritional status (9.4% severe acute malnutrition) were similar for both groups, whereas HIV+/SCD+had higher though non-significant baseline CD4 count (1036 (SD713) vs 849 (SD638) cells/microlitre, P=0.20, two-tailed t-test). There were 19 deaths, 6 (17%) HIV+/SCD+and 13 (14%) HIV+/SCD-, with unadjusted/adjusted models showing no significant difference. Nutritional progression and clinical stage progression showed no significant differences between groups. Kaplan-Meier analysis showed a slower rate of treatment failures in the HIV+/SCD+cohort (P=0.11, log-rank survival test). Trajectory analysis showed that in the time period analysed, the HIV+/SCD+cohort showed a more rapid rise and higher total CD4 count (P=0.012, regression analysis). The study suggests that SCD does not adversely affect the progression of HIV in patients on ART. Further, HIV+/SCD+achieved higher CD4 counts and fewer HIV treatment failures, suggesting physiological effects due to SCD might mitigate HIV progression.

Repeated exposure to HIV does not necessarily result in infection and HIV infection does not inevitably lead to the development of the AIDS. Multiple immunological and genetic features can confer resistance to HIV acquisition and progression at different steps in viral infection; a full understanding of these mechanisms could result in the development of novel therapeutic and vaccine approaches for HIV infection. In this review, we focus on the genetic mechanisms associated with resistance to HIV infection and to the progression to AIDS.

Gastrointestinal Disease in Simian Immunodeficiency Virus-Infected Rhesus Macaques Is Characterized by Proinflammatory Dysregulation of the Interleukin-6-Janus Kinase/Signal Transducer and Activator of Transcription3 Pathway

HIV and AIDSThe general public first acknowledgement of AIDS in the United States occurred in the early 1980s when Rock Hudson became infected and subsequently died. In the 1990s, largely due to categorization of the virus as Gay Related Immune Deficiency (GRID), and subsequent neglect by the nation's political system, the virus quickly spread to previously uninfected populations (Shilts, 1986). Human Immunodeficiency Virus (HIV) is caused by exposure to infected blood, semen, vaginal fluids, and breast milk. When an individual's CD-4 or T cell count falls below 200 and/or the individual begins to experience serious complications, the Acquired Immune Deficiency Syndrome (AIDS) is diagnosed as a disease. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. As the science of treatment improved and public health surveillance and treatment systems were established, HIV infected individuals with knowledge of the risks of infection and access to health care progressed much more slowly to AIDS. New AIDS cases experienced a dramatically curbed escalation in 1996 with the introduction of Highly Active Antiretroviral Therapy (HAART). [http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf]. Although cases of AIDS decreased markedly due to improvements in treatment, overall HIV infections did not.Although modes of infection have been clear for some time, reporting mechanisms within the country have been obscured by many issues including the requirement of the Centers for Disease Control and Prevention (CDC) to report all HIV infections using a confidential, albeit not anonymous, system of name-based reporting, to which some states, like California, have objected. Due to the extensive window period that can average 10 to 15 years wherein HIV infected individuals experience no symptoms, comprehensive data collection and reporting on HIV infection becomes imperative if the US is to accurately target HIV prevention and management efforts, particularly among underserved populations.The Reporting System: HIV versus AIDSPublic health in the US begins at the local level and involves both private and public health providers. Early work with other sexually transmitted diseases such as Gonorrhea and Syphilis at the local level initiated and improved the reporting process from the local level to the state. [http://www.cdc.gov/std/Syphilis2003/SyphSurvSupp2003.pdf]. Nationally, the Atlantabased CDC initiated the collection of AIDS case data from the states.As an understanding of HIV's progression to AIDS matured, terms such as ARC, (AIDS Related Complex), were eliminated and the staging became reduced to HIV and AIDS as measured by T cell or CD-4 cell counts and more recently viral load. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. Although AIDS cases are reported by each state to the CDC, many states have been slower in their progression to HIV reporting. A major issue among and between the states and the CDC arose as to the classification system to be used for reporting of HIV and AIDS cases, one that has still not been fully resolved for 19 states and the District of Columbia. Exposure categories for adults are further broken down into the two categories of HIV and AIDS. This paper analyzes the categories of exposure for adults, with emphasis placed on the emergence of HIV and AIDS in the Latino population, particularly among women.Due to HIV underreporting or reporting practices that do not meet the CDC requirements of name-based case identification, the most recent edition of the CDC's HIV/AIDS Surveillance Report includes HIV data from only 31 states. [http://www.cdc.gov/hiv/stats/2004SurveillanceReport.pdf]. The underreporting of HIV to the CDC is problematic for a number of reasons, as it fails to provide the nation with the information needed for an effective HIV/AIDS prevention and management strategy. This is particularly true among underserved populations such as Latinos, who are often uninsured or underinsured and may lack access to culturally and linguistically appropriate health care and HIV prevention information. …

This a basic report on the current status of acquired immune deficiency syndrome AIDS/HIV. It deals with the current status of this horrible disease. It defines the basic information and terminology and lists the method of management for non medical readers. This report would give the reader the primer to understand this disease. THE EPIDEMIOLOGICAL BACKGROUND The epidemiology and burden of HIV in the developing world had two distinct viruses. HIV types 1 and 2 (HIV-1/HIV-2) cause AIDS. HIV-1 is responsible for the great majority of infections globally. The life cycle of the virus can be viewed at web link http://www.aids.org/factSheets/400-HIV-Life-Cycle.html While HIV-2 is very rare outside West Africa, individual cases of HIV-2 infection have been described in other parts of Africa, Europe, the Americas, and Asia (India), but most people with HIV-2 infection have some epidemiological link to West Africa. Several reports published by international health agencies like the World Health Organization WHO and the United Nations agencies UNFPA conclude that AIDS is the leading cause of death in sub-Saharan Africa and the fourth biggest killer worldwide.[Table 1] Figure 1 The ranges around the estimates in this table define the boundaries within which the actual numbers lie. Since the epidemic began more than 24 years ago at least 60 million people worldwide have been infected with the virus and currently more than 45 million people live with HIV. The cumulative number can be read from UNFPA AIDS Clock at http://www.unfpa.org/aids_clock/main.htm These reports warn that the rates of infection are rising fastest in Eastern Europe and Russia. In 2001, there were an estimated 250000 new infections in this region. Russia has seen a 15-fold increase in infections over the years. Most of Basic Facts About HIV And AIDS 2 of 5 these cases are related to illegal drug use. Sub-Saharan Africa continues to be the worst affected area. The report says that AIDS killed 2.3 million people in 2001 and that there were 3.4 million new HIV infections. The region is the only one where more women than men are infected by the virus. More than 28 million people in the region currently live with HIV, a prevalence of 8%. Most of these people, the report says, do not know they have the virus. The epidemic also “threatens human welfare, developmental progress, and social stability on an unprecedented scale.” Hardest hit countries could lose 20% of their gross domestic product by 2020. Steep drops in life expectancies are now beginning to occur. If it were not for HIV and AIDS, the average life expectancy in sub-Saharan Africa would be 62 years; it currently stands at 47 years. The report says that marked increases in rates of infection in Asia and the Pacific, which have some of the world's most populous countries, are also of “particular concern.” Reported HIV infections in China rose by 67% in the first six months of 2001, compared with the previous year. India has a prevalence of about 1% representing an estimated 3.86 million peo.[3] HUMAN IMMUNODEFICIENCY VIRUS AND ACQUIRED IMMUNODEFICIENCY SYNDROME HUMAN IMMUNODEFICIENCY VIRUS (HIV) The abbreviations HIV stands for the virus named 'human immunodeficiency virus'. HIV is a member of retroviruses that infect cells of the human immune system (mainly CD4 positive T cells and macrophages—key components of the cellular immune system), and destroy or impair their function. Infection with this virus results in the progressive depletion of the immune system, leading to 'immune deficiency'. The immune system is considered deficient when it can no longer fulfill its role of fighting off infection and diseases. Immunodeficient people are much more vulnerable to a wide range of infections, most of which are very rare among people without immune deficiency. Diseases associated with severe immunodeficiency are known as 'opportunistic infections', because they take advantage of a weakened immune system. ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AIDS stands for 'acquired immunodeficiency syndrome' and describes the collection of symptoms and infections associated with acquired deficiency of the immune system. Infection with HIV has been established as the underlying cause of AIDS. The level of HIV in the body and the appearance of certain infections are used as indicators that HIV infection has progressed to AIDS. MANIFESTATION OF AIDS THE SYMPTOMS OF HIV INFECTION Most people infected with HIV do not know that they have become infected because no symptoms develop immediately after the initial infection. Some people have a glandular fever-like illness (with fever, rash, joint pains and enlarged lymph nodes), which can occur at the time of development of antibodies to HIV and usually takes place between six weeks and three months after an infection has occurred this is called seroconversion. Despite the fact that HIV infection does not cause any initial symptoms, an HIV-infected person is highly infectious and can transmit the virus to another person. The only way to determine whether HIV is present in a person's body is by taking an HIV test. HIV infection causes a gradual depletion and weakening of the immune system. This results in an increased susceptibility of the body to infections and can lead to the development of AIDS. WHEN WE CAN SAY THAT A PERSON DOES HAVE AIDS? The term AIDS applies to the most advanced stages of HIV infection. The majority of people infected with HIV, if not treated, develop signs of AIDS within 8-10 years. MEDICAL MANAGEMENT OF AIDS AIDS is identified on the basis of certain infections, grouped by the (WHO): Stage 1 HIV disease is asymptomatic and not categorized as AIDS Stage II (includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections) Stage III (includes unexplained chronic diarrhea Basic Facts About HIV And AIDS 3 of 5 for longer than a month, severe bacterial infections and pulmonary tuberculosis) or Stage IV (includes Toxoplasmosis of the brain, Candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's Sarcoma) HIV diseases are used as indicators of AIDS. Most of these conditions are opportunistic infections that can be treated easily in healthy The length of time taken by infected patient to show signs of the disease can vary widely between individuals. With a healthy lifestyle, the time between infection with HIV and becoming ill with AIDS can be 10–15 years, sometimes longer. Antiretroviral therapy can slow down the progression of AIDS by decreasing viral load in an infected body. There is no cure for HIV/AIDS. Progression of the disease can be slowed down but cannot be stopped completely. The right combination of antiretroviral drugs can slow down the damage that HIV causes to the immune system and delay the onset of AIDS. The available treatment and care consist of a number of different elements, including voluntary counseling and testing (VCT), support for the prevention of onward transmission of HIV, follow-up counseling, advice on food and nutrition, treatment of STIs, management of nutritional effects, prevention and treatment of opportunistic infections (OIs), and the provision of antiretroviral drugs. They are used in the treatment of HIV infection. Antiretroviral drugs work as follow: Inside an infected cell, HIV produces new copies of itself, which can then go on to infect other healthy cells within the body. The more cells HIV infects, the greater its impact on the immune system (immunodeficiency). Antiretroviral drugs slow down the replication and, therefore, the spread of the virus within the body, by interfering with its replication process in different ways. NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS: HIV needs an enzyme called reverse transcriptase to generate new copies of itself. This group of drugs inhibits reverse transcriptase by preventing the process that replicates the virus's genetic material. NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS: This group of drugs also interferes with the replication of HIV by binding to the reverse transcriptase enzyme itself. This prevents the enzyme from working and stops the production of new virus particles in the infected cells.

World AIDS Day 2021: highlighting the pulmonary complications of HIV/AIDS.

World AIDS Day: 40 years of an evolving pulmonary landscape.

The HIV/AIDS grants economy in New York City, 1983-1992.

Importance of hepatitis C coinfection in the development of QT prolongation in HIV-infected patients

The tragic history of AIDS in the hemophilia population, 1982-1984.