AIDS

AIDS
· Definition:
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS or Aids) is a set of symptoms and infections resulting from the damage to the human immune system caused by the human immunodeficiency virus (HIV)

· Route of transmission:
Transmission of HIV occur one of the following routes
1. Sexual route-homosexuality, heterosexuality, oral sex.
2. Parental route- infected blood transfusion, blood products, syringes, needles, blade, and surgical instrument.
3. Perinatal/ Tran placental- from mother to baby through placenta or breast milk.

· Causes:
Having Unprotected Sex
Most people become infected with HIV through sexual activity. You can contract AIDS by not using a condom when having sexual relations with a person infected with HIV. During sex, the vagina, vulva, penis, rectum, and mouth can provide entry points for the virus.
Other risky behaviors include having:
Sex with someone without knowing his or her HIV status
More than one sex partner
Sex with someone who has more than one sexual partner
Anal intercourse
Sharing Needles or Syringes
Using a needle or syringe that contains even a small amount of infected blood can transmit HIV infection.


Having Certain Medical Conditions
Sexually transmitted diseases (STDs) and vaginal infections caused by bacteria tend to increase the the risk of HIV transmission during sex with an HIV-infected partner. Examples of STDs include:
Syphilis
Genital herpes
Chlamydia
Gonorrhea
For men, not being circumcised can also increase the risk of getting HIV infection.
Having Certain Medical Procedures
Having a blood transfusion or receiving blood products before 1985 increases your risk of HIV infection and AIDS. Before blood banks began testing donated blood for HIV in 1985, there was no way of knowing if the blood was contaminated with HIV, and recipients could become infected through transfusions.
Receiving blood products, tissue or organ transplantation, or artificial insemination increases your risk of HIV infection and AIDS. Even though blood products are now screened for HIV, there is still some degree of risk because tests cannot detect HIV immediately after transmission.
Being a Healthcare Worker
Exposure to contaminated blood and needles puts healthcare workers at risk for HIV infection.
You cannot get AIDS/HIV from touching someone or sharing items, such as cups or pencils, or through coughing and sneezing. Additionally, HIV is not spread through routine contact in restaurants, the workplace or school.





Symptoms:
These symptoms are as follows:
extreme fatigue
rapid weight loss from an unknown cause (more than 10 lbs. in two months for no reason)
appearance of swollen or tender glands in the neck, armpits or groin, for no apparent reason, lasting for more than four weeks
unexplained shortness of breath, frequently accompanied by a dry cough, not due to allergies or smoking
persistent diarrhea
intermittent high fever or soaking night sweats of unknown origin
a marked change in an illness pattern, either in frequency, severity, or length of sickness
appearance of one or more purple spots on the surface of the skin, inside the mouth, anus or nasal passages
whitish coating on the tongue, throat or vagina
forgetfulness, confusion and other signs of mental deterioration

Test/diagnosis:
ELISA Test — ELISA, which stands for enzyme-linked immunosorbent assay, is used to detect HIV infection. If an ELISA test is positive, the Western blot test is usually administered to confirm the diagnosis. If an ELISA test is negative, but you think you may have HIV, you should be tested again in one to three months. ELISA is quite sensitive in chronic HIV infection, but because antibodies aren't produced immediately upon infection, you may test negative during a "window" of a few weeks to a few months after being infected. Even though your test result may be negative during this window, you may have a high level of the virus and be at risk of transmitting infection.
Home Tests — The only home test approved by the U.S. Food and Drug Administration is called the Home Access Express Test, which is sold in pharmacies.
Saliva Tests — A cotton pad is used to obtain saliva from the inside of your cheek. The pad is placed in a vial and submitted to a laboratory for testing. Results are available in three days. Positive results should be confirmed with a blood test.
Viral Load Test — This test measures the amount of HIV in your blood. Generally, it's used to monitor treatment progress or detect early HIV infection. Three technologies measure HIV viral load in the blood — reverse transcription polymerase chain reaction (RT-PCR), branched DNA (bDNA) and nucleic acid sequence-based amplification assay (NASBA). The basic principles of these tests are similar. HIV is detected using DNA sequences that bind specifically to those in the virus. It is important to note that results may vary between tests.
Western Blot — This is a very sensitive blood test used to confirm a positive ELISA test result.
Other Tests
If you're infected with HIV, additional blood tests may be ordered to check for other infections. Tests may be administered to check the effects of medications on your liver and kidneys and other organs. Other common tests include:
CD4+T Cell Count — As soon as HIV enters the body, it begins to destroy or disable your bodys CD4+T cells, the immune system's key infection fighters. The CD4+T cell count is a blood test that measures the number of CD4+T cells and helps assess the immune system's health. The CD4+T cell count correlates with a person's risk of developing opportunistic infections and is a useful marker for HIV disease staging and treatment planning. The Center for Disease Control and Prevention (CDC) recommends CD4+T testing every three to six months in all HIV-infected patients, though the need may vary by individual.
HIV Resistance Testing — Resistance to anti-retroviral drugs is fairly common in some HIV-positive patients. Resistance testing can be useful to determine the drugs not to use in a patient with increasing levels of the virus despite therapy or in a previously untreated individual who may have been infected with a virus that is resistant to one or more of the HIV drugs.

· Treatment:
Antiretroviral medications are used to control the reproduction of the virus and to slow or halt the progression of HIV-related disease.
1. Non nucleoside Reverse Transcriptase Inhibitors (NNRTIs), such as nevirappine (Viramune) and efavirenz (Sustiva), bind to and block the action of reverse transcriptase, a protein that HIV needs to reproduce.
2. Nucleoside Reverse Transcriptase Inhibitors (NRTIs), such as zidovudine (Retrovir), tenofovir DF (Viread), and stavudine (Zerit), are faulty versions of building blocks that HIV needs to make more copies of itself. When HIV uses an NRTI instead of a normal building block, reproduction of the virus is stalled.
3. Protease Inhibitors (PIs), such as lopinavir/ritonavir (Kaletra), disable protease, a protein that HIV needs reproduce itself.
4. Fusion Inhibitors, such as enfuvirtide (Fuzeon), are newer treatments that work by blocking HIV entry into cells
The goals of therapy are to:
Suppress viral load (or the amount of HIV in a sample of blood)
Restore or preserve immune function
Improve quality of life
Reduce morbidity (the occurrence of opportunistic infections or number of hospitalizations) and mortality (death)
Reduce the transmission of HIV/AIDS
Prevention of AIDS and HIV Infection:
The only way to protect from contracting AIDS sexually is to abstain from sex outside of a mutually faithful relationship with a partner whom the person knows is not infected with the AIDS virus. Otherwise, risks can be minimized if they:
Don't have sexual contact with anyone who has symptoms of AIDS or who is a member of a high risk group for AIDS.
Avoid sexual contact with anyone who has had sex with people at risk of getting AIDS.
Don't have sex with prostitutes.
Avoid having sex with anyone who has multiple and/or anonymous sexual partners.
Avoid oral, genital and anal contact with partner's blood, semen, vaginal secretions, feces or urine. Unless they know with absolute certainty that their partner is not infected, a latex condom should be used during each sexual act, from start to finish. The use of a spermicidal agent may provide additional protection.
Avoid anal intercourse altogether.
Don't share toothbrushes, razors or other implements that could become contaminated with the blood of anyone who is or might be infected with the AIDS virus.
Exercise caution regarding procedures, such as acupuncture, tattooing, and ear piercing, etc., in which needles or other non sterile instruments may be used repeatedly to pierce the skin and/or mucous membranes.
Such procedures are safe if proper sterilization methods are employed or disposable needles are used. Ask what precautions are taken before undergoing such procedures.
If an individual is scheduling surgery in the near future, and is able, they could consider donating blood for their own use. This will eliminate completely the already very small risk of contracting AIDS through a blood transfusion. It will also eliminate the risk of contracting other blood borne diseases (such as hepatitis) from a transfusion.
If a person is an IV drug user, adhere to the prevention tips mentioned earlier, as well as:
Get professional help for terminating the drug habit.
Do not share needles or syringes. Be aware that some street sellers are resealing previously used needles and selling them as new.
Clean the needle before using.
Some people apparently remain well after infection of the AIDS virus. They may have no physically apparent symptoms of illness. However, if proper precautions are not used with sexual contacts and/or intravenous drug use, these infected individuals can spread the virus to others.
Anyone who thinks he or she is infected, or who is involved in high-risk behaviors, should not donate his/her blood, organs, tissues, or sperm as they may now contain the AIDS virus.