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Welcome, medical contents search April 25, 2013
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more about AIDS

Acquired immuno deficiency syndrome, human immunodeficiency virus, or HIV

  • AIDS results from an infection with one of two of the Human Immunodeficiency Viruses (HIV), a human retrovirus that primarily infects and destroys certain types of white blood cells (helper-inducer subset of T-lymphocyte white cells), as well as other body cells and tissues.
  • The "killer" virus is transmitted via blood, semen, and other bodily fluids, usually as a result of sexual contact and IV needle sharing among drug users.  It affects all age groups.
  • According to the latest published reports (Newsweek, MS-NBC, 6-20-01) the AIDS epidemic has claimed 22 million lives since its discovery 20 years ago, and currently lays claim to 36 million HIV-positive worldwide, including 800,000 - 900,000 in the U.S (300,000 of whom, it is estimated, don't know that they are infected).

  • HIV syndrome occurs 3 to 6 weeks after infection and includes:
    1. Unexplained wasting/failure to thrive
    2. Diarrhea (acute or chronic), oral canker sores, persistent fever, complicated and diffuse chickenpox
    3. Repeated and persistent oral or mouth Thrush (oral candidiasis) and other persistent fungal infections
    4. Recurrent or persistent episodes of pneumonitis and/or other infections
    5. Bleeding or immune thrombocytopenic purpura
    6. Generalized enlarged lymph nodes with or without malignancy
    7. Enlarged liver and spleen
    8. Enlarged salivary glands
    9. Unexplained hepatitis, kidney disease, heart muscle disease
    10. Skin tumors (Kaposi's sarcoma) -- distinctive, irregular, purple lesions

  • Intravenous drug use and Abuse (contaminated needles).
  • Receipt of infected or contaminated blood and/or blood products (before screening of HIV antibodies begun)
  • Unprotected sexual contact with an HIV infected sex partner(s) (homosexual or heterosexual)
  • Tattoos using contaminated needles and/or paraphernalia
  • Newborn infant of a mother infected with HIV, or a mother belonging to high-risk group (IV drug user, multiple sex partners) -- accounting for 80% of all new pediatric infections.

  • Examination -- may be normal
  • Signs & symptoms of AIDS-defining illnesses (see below)
  • Laboratory Findings:

- HIV antibody test -- the HIV virus multiplies in the body for weeks or months before the body responds by making antibodies to it, at which time the HIV test is considered positive.  Decreased CD4 lymphocyte (also known as T-helper cells) count (the lower the count the more likely to develop infections and illness)

    1. Symptoms begin to occur with CD4 count falling below 350/ml
    2. Anemia
    3. Polyclonal hypergammaglobulenimia
    4. High cholesterol
    5. Skin antigen testing fails to react to typical antigens

  • Children who receive contaminated blood transfusion or blood products (e.g., hemophiliacs, before 1985)
  • Unprotected sex, sex with multiple sexual partners, homosexual/bisexual men
  • IV drug users
  • Street youth and adolescent high-risk behavior
  • Sexual Abuse
  • Jail or prison system inmates
  • Prostitution and unprotected sexual relationships
  • Tattoos
  • Malnutrition or weak immune system (body's natural defenses)
  • Poor hygiene

  • The goal of treatment is to keep CD4 count above 200/ml, prevent/control opportunistic infections, and improve the quality of life.
  • Anti-retroviral drugs (Highly Active Anti Retroviral Therapy or HAART) -- these interfere with the HIV virus' ability to replicate.  Some common ones are listed below:
    1. Nucleoside analogs
    2. Zidovudine (AZT)
    3. Zalcitabine (ddC)
    4. Lamivudine
    5. Stavudine
  • Protease inhibitors:
    1. Indinavir
    2. Ritonavir
    3. Nelfinavir
    4. Saquinavir
  • Triple therapy -- has been found that combining two nucleoside analogue drugs with one protease inhibitor can substantially reduce the viral burden, infection rate, and death rate in HIV infection.
  • Post-exposure prophylaxis (e.g., after a needle stick)
    1. AZT probably beneficial
    2. AZT plus other antiretroviral drugs probably will be shown to be more effective.

  • Before the more effective "triple therapy" was developed, various regimens were recommended to prevent specific infections.  For example, Trimethoprim-Sulfamethoxazole for Pneumocystitis carinii included various regimens that are now reserved for those who fail to respond or are intolerant of "triple therapy."
  • Abstinence
  • Safe sex (use of condoms and oral barriers)
  • HIV testing prior to a relationship
  • Stop intravenous drug Abuse, sharing of dirty needles, and other high-risk behaviors.
  • Healthy lifestyle and join support groups if at risk

more about AIDS

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