Aids

Acquired Immunodeficiency Syndrome (AIDS) is a likely life-threatening and chronic condition caused by the Human Immunodeficiency Virus (HIV). It damages the immune system as HIV disrupts the body's ability to fight the organisms that cause disease. It is contracted through needle sharing and unprotected sex. An HIV test confirms diagnosis. Medications may suppress the virus and delay the onset of AIDS.

Stages

Acute retroviral syndrome: an illness with symptoms like mononucleosis. It often develops within a few days of infection with HIV, but may occur several weeks after the person is infected. The symptoms can range from mild to severe and sometimes disappear on their own after 2 to 3 weeks. But many people do not have symptoms or they have such mild symptoms that they do not notice them.

Stage 1 (HIV infection): There are no AIDS-related conditions. The CD4+ cell count is at least 500 cells per micro liter or the percent of CD4+ cells is at least 29% of all lymphocytes.

Stage 2 (HIV infection): There are no AIDS-related conditions. The CD4+ cell count is 200 to 499 or the percent of CD4+ cells is 14% to 28% of all lymphocytes.

Stage 3 (AIDS): The CD4+ cell count is lower than 200 or the percent of CD4+ cells is less than 14% of all lymphocytes, or an AIDS-related condition is present.

Symptoms

First stage - The first stage known as Acute Infection or Seroconversion, happens within two to six weeks after exposure or becoming infected.

The initial symptoms of acute HIV infection include:

• Headache
• Nausea and vomiting
• Diarrhea
• Sore throat
• Fatigue
• Aching muscles
• Red rashes that doesn't itch, usually on the torso Fever

Second stage

Generally there are no symptoms at this stage. This is when people may not know they are infected and can pass on HIV to others. This period can last for 10 or more years. During symptom-less period, HIV is slowly killing the CD4 T-cells and is destroying the immune system. Blood tests can reveal the number of CD4 T-cells. For an HIV-infected person, if, the number of CD4 T-cells steadily drops, it makes them vulnerable to other infections and puts them in danger of developing AIDS.

Third stage

The CD4 T-cell number when drops below 200, people are diagnosed with AIDS.

Some of the severe symptoms include:

• Being tired all of the time
• Swollen lymph nodes in the neck or groin
• Fever lasting for more than 10 days
• Night sweats
• Unexplained weight loss
• Purplish spots on the skin that don't go away
• Shortness of breath
• Severe, long-lasting diarrhoea
• Yeast infections in the mouth, throat or vagina
• Easy bruising or unexplained bleeding

Causes and Transmission

HIV can be transmitted through sexual contact or blood transfusion, shared syringes or from mother to child during pregnancy, childbirth or breast-feeding. HIV destroys CD4 cells, a specific type of white blood cell that plays a large role in helping our body fight disease. Our immune system weakens as more CD4 cells are killed. One may have HIV infection for years before it progresses to AIDS.

One can become infected with HIV in several ways. These are:

By having sex: One may become infected if one has vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enters his/her body. The virus can enter the body through mouth sores or small tears that sometimes develop in the rectum or vagina during sexual activity.

From blood transfusions: HIV virus may be transmitted through blood transfusions, in some cases. Hospitals and blood banks now screen the blood supply for HIV antibodies, so this risk is very small.

By sharing needles: HIV virus can be transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia can put at high risk of HIV and other infectious diseases, such as hepatitis.

During pregnancy or delivery or through breast-feeding. Mothers infected with the virus can infect their babies but by receiving treatment during pregnancy, the risk is lowered. There are several strategies for prevention of HIV virus and the spread of AIDS.

Prevention strategies

Pharmaceutical

The only universally and medically proven method for the prevention of the spread of HIV during sexual intercourse is the correct use of condoms. Condoms are also the only method promoted by health authorities worldwide. For HIV positive mothers who want to prevent the spread of HIV to their child during birth, antiretroviral drugs have been medically proven to diminish the likelihood of the spread of the infection. Scientists throughout the world are currently researching other prevention systems.

Social strategies

Social strategies include sex education, needle-exchange programs, safe injection sites, safe sex, serosorting, sexual abstinence and immigration regulation

Advertising and campaigns

Advertising and campaigns are designed to educate people about the danger of HIV/AIDS and simple prevention strategies are also an important way of preventing HIV/AIDS. More importantly, information sent out through advertising and social marketing proved to be effective in promoting favourable attitudes and intentions towards future condom use, even though they did not bring any important change in the actual behavior except those targeting at specific behavioral skills.

Pre-exposure

Early treatment of the HIV-infected people with antiretrovirals protected 96% of partners from infection. Universal precautions within the health care environment are considered effective in decreasing the risk of HIV. Use of Intravenous drug is an important risk factor and harms reduction strategies such as needle-exchange programs and opioid substitution therapy that appear effective in decreasing this risk.

Post exposure

Post-exposure prophylaxis is a course of antiretrovirals administered within 48 to 72 hours after exposure to HIV positive blood or genital secretions. The use of the single agent zidovudine lessens the risk of subsequent HIV infection five-fold following a needle stick injury.

Mother to child

Programs preventing the transmission of HIV from mothers to children can reduce rates of transmission by 92-99%. This involves the use of a combination of antivirals during pregnancy and after birth in the infant and also includes bottle feeding rather than breastfeeding.

Diagnosis

Several types of tests can help the doctor to determine what stage of the disease you have. These tests include:

CD4 count. CD4 cells are a kind of white blood cells which are specifically targeted and destroyed by HIV. Even if there are no symptoms, HIV infection advances to AIDS when your CD4 count dips below 200.

Viral load. This test helps to measure the amount of virus in one’s blood. Studies have shown that people with higher amount of virus fare more poorly than those with lower amount of virus.

Drug resistance. Blood tests help to determine whether the strain of HIV one has, will be resistant to certain anti-HIV medications or not.

Treatment

There's no cure for HIV/AIDS, but various drugs can be used in combination to control the virus. Each class of anti-HIV drugs blocks the virus in distinct ways. It is always best to combine at least three drugs from two classes to avoiding strains of HIV that are immune to single drugs.

The classes of anti-HIV drugs include the followings:

Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs help in disabling a protein needed by HIV to make copies of itself. Examples are efavirenz, etravirine and nevirapine.

Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks. HIV virus requires this to make copies of itself. Examples are Abacavir, the combination drugs of emtricitabine-tenofovir and lamivudine-zidovudine.

Protease inhibitors (PIs). PIs help in disabling protease, another protein that HIV needs to make copies of itself. Examples are atazanavir, darunavir, fosamprenavir and indinavir.

Entry or fusion inhibitors. These drugs block the virus’s entry into CD4 cells. Examples are enfuvirtide and maraviroc.

Integrase inhibitors. These drugs help to disable integrase, a protein that HIV uses to insert its genetic material into CD4 cells. Examples are raltegravir, elvitegravir and dolutegravir.