Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

What is Monogamous Relationship?

You (who have been tested for STD/STIs and don't have any) are having sex with only one partner (who also has been tested for STD/STIs and doesn't have any) who only has sex with you. And you both keep it that way! 

Stated another way, you are both STD/STI free and only have sex with each other. People of any sexual orientation can engage in monogamous relationships. The only thing implied by the term monogamy is that the relationship consists of two people who are romantically and/or sexually exclusive. Theoretically, outside of abstinence, this is really the safest type of "safer sex" that you can have. 

Celebrated on 1st December of each year, World AIDS Day, aims to spread awareness about HIV / AIDs. It is an STD wherein, HIV stands for human immunodeficiency infection and AIDS stands for acquired immune deficiency syndrome. The disease hinders the immune system in keeping up our body s security against sickness. HIV causes individuals to end up wiped out with infections that regularly would not affect them and HIV leads to AIDS.

Understanding the Symptoms:

HIV has few or no signs or symptoms for up to ten years or more before side effects of AIDS tends to manifest. There is no cure for HIV/AIDS, yet treatment is accessible. A few people have HIV symptoms not long after being infected. These include:

There are a few phases of HIV illness. The primary HIV side effects may include swollen glands in the throat, armpit, or crotch.
Other early HIV symptoms incorporate slight fever, headaches, exhaustion, and muscle throbs.
These symptoms may keep on going for just a couple of weeks. At that point, there are typically no HIV indications for a long time. That is the reason it can be difficult to know whether or not a person is suffering from HIV.
The symptoms of AIDS show up in the most advanced phase of the HIV disease. These are as follows:

Along with a severely damaged immune system, a person with AIDS may likewise have thrush. A thrush is a thick, whitish covering on the tongue that is brought about by a yeast infection and now and then joined by a sore throat.
Serious or repetitive vaginal yeast infection.
Pelvic inflammatory illness.
Serious and frequent infections.
Unexplained fatigue that might be followed by headaches, dizziness.
Loss of more than ten pounds of weight that is not because of physical exercise or consuming fewer calories.
Risk Factors: There are a lot of ways in which you can get the infection. HIV is transmitted through blood, semen, vaginal fluids and breast milk. The most well-known ways in which HIV is spread, are:

Having sexual intercourse without a condom with somebody who has HIV/AIDS.
Using needles or syringes that have been used by someone who has HIV/AIDS.
Being punctured with a needle or surgical instrument that has been contaminated with HIV.
Getting HIV blood, semen or vaginal discharge into open injuries or wounds.
Babies born to women with HIV/AIDS can get HIV from their mothers during birth or from breastfeeding.
There are numerous ways in which you can protect yourself from HIV. These are as follows:

The most secure way is to limit the number of sexual partners you take on.
Try to have safer sex and always use protection.
Get your partners tested for HIV.
HIV tests are a typical piece of social insurance.
In case that you think you may have been infected by HIV, talk to a specialist or a doctor about testing. Discussing what risks you might have taken can help you choose whether testing is ideal for you.

This World AIDS Day - Let's Spread the Awareness About HIV/AIDS

HIV: QUICK FACTSIntroductionThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).

Epidemiology

According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.

Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate.Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.

Gag gene: Encodes group-specific antigen; the inner structural proteins
Pol gene: Encodes polymerase; it also contains integrase and protease
Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule
Pathophysiology

HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.

Mode of Transmission
Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus.Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.

Signs and Symptoms There are 3 categories of infection 

Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions
Category B: HIV infection with symptoms that are directly attributable to HIV infection
Category C: HIV infection with AIDS-defining opportunistic infections
Investigation

A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.

Management

Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. 
CD4 count is no longer a criterion for starting the therapy.
Use of nucleoside reverse transcriptase inhibitors and protease inhibitors.
For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.

HIV - Quick Facts Need To Know!

Sexually Transmitted Diseases (STDs) are infections that you can get from having sex with someone who already has the infection. The causes of STDs are bacteria, parasites, and viruses. These infections often do not cause any symptoms, and can still be passed unknowingly from the infected partner to the other. However, some common symptoms include genital itching, lesions, flu / fever like symptoms and feeling pain / pressure in the lower part of the stomach.

There are many kinds of STDs including Chlamydia, gonorrhea, genital herpes, syphilis and HIV.

The important thing to understand and know is that these STDs can be prevented.

3 ways of preventing STDS are:

1. Precautions before having sex

There are some things you can do to reduce your risk of contracting STDs before having sex. This include:

  Limiting the number of sexual partners
  Talking honestly with partners about your sexual history
  Getting tested, along with your partner, before having sex
  Getting timely vaccination against HPV and HBV

If you have been diagnosed with an STD you should tell your partner about it and also explicitly ask your partner if they have had an STD.

2. Practice safe sex

Use a latex condom every time you have sex and use a water-based lubricant. If your sex life involves intercourse, anal or vaginal, make up your mind to never have sex without a condom. If you or your partner is at a high risk of STDs, be consistent about barrier use during oral sex as well. Avoid sharing towels or underclothing to reduce the risk of an STD. Check the expiration date of the condom and make sure that it has an air bubble, which shows it has not been punctured. Dispose the condom properly and never reuse it.

3. Don't drink Alcohol or use drugs before having sex

It's impossible to make responsible choices about your sex life under the influence of drugs or alcohol. When you are under the influence of any one of them, you are not in your mind and are likelier to choose a partner you wouldn't have picked otherwise. In that case, you may be at a higher risk of contracting an STD. Also, if you are on birth control pills and you vomit, the pills could lose some effectiveness.



3 Ways You Can Prevent STDs (Sexually Transmitted Diseases)

If you indulge in unprotected sex, there are chances that you might get infected with HIV or the human immunodeficiency virus (a virus that gradually attacks the immune system). HIV is an infectious virus which can cause to AIDS or acquired immunodeficiency syndrome if left untreated. HIV may be transmitted via different ways, and becoming infected with HIV by having anal or vaginal sex without a condom is the commonest of all. Although there are several treatments for HIV, Ayurveda is considered to be the best form of natural treatment.

Ayurvedic treatment for HIV
Here are a few Ayurvedic remedies for treating HIV:

The first step is to provide a healthy atmosphere to the patient. The patient should be given easily digestible foods, which provide nourishment to the body. Regular and easy exercises should be undertaken by the patient, who should also participate in productive activities.
Several Ayurvedic tonics and rejuvenators or rasayanas are given to the patient in order to boost his immunity level. The overall system gets strengthened, and the appetite gets stimulated.
When the patient gains some strength, shodhana techniques are used for eliminating toxins from the body via purgation, emesis and enemas. Certain ghee-based medicines are also given to the patient. Proper medication purifies the blood. Measures for correction of liver issues should also be taken.
Your diet should consist of preparations made of ghee and soups. You should avoid oily, spicy and acidic food items. A little amount of alcohol may be taken as that aids the digestive process.
Regular exercise causes the blood to heat, which may weaken or eliminate the virus in some cases.
There are some herbo-mineral compounds, which are prepared using an Ayurverdic formula. These compounds have rasayana and vajikara effects and are considered to be effective for HIV patients.
There are several proprietary Ayurvedic medicines, which help in improving the condition of patients infectedwith HIV. These may include Chyawanprash, Raktavardhak and Sookshma Triphala. These keep the HIV infectionat bay. Shatavari Kalpa,Guduchi and Kalmegh are other effective Ayurvedic medicines.
Chyawanprash is an effective Ayurvedic remedy which is used for the treatment of HIV. It is considered the best Ayurvedic tonic for rejuvenation from HIV. The Indian gooseberry or aamlaki is the main ingredient of Chyawanprash, which is rich in vitamin C. It also contains naturally-occurring antioxidants. Gooseberries are antifungal, antibacterial and antiviral in nature. Chyawanprash comprises of 35 Ayurvedic herbs, which enhances the effect of the main ingredient in treating HIV.
Ayurvedic remedies and methods for the treatment of HIV are harmless and totally safe. There are no side effects, and Ayurvedic remedies only improve the symptoms of HIV, and no deterioration is caused in the condition of the patient.

Ayurveda - Can It Help Treat HIV?

In most diseases, early detection of the disease is the key to control the symptoms, cure, reduce progression and improve prognosis. This holds true for sexually transmitted diseases too. As soon as there is a mild degree of suspicious of having contracted a sexually transmitted disease, it is advisable to go for a test. Most of the STDs can develop into serious complications over a period of time, ranging from infertility to even death.

Complications: Why early diagnosis is important: When left undiagnosed and untreated, most STDs progress to cause severe damage from sterility to cancer to even death. Listed below are some complications associated with each of the common STDs.

Chlamydia: If left untreated, can lead to epididymitis and testicles shrinking and infertility in males. This is a condition where there is pus formation in the scrotum. In women, it can lead to pelvic inflammatory disease which is deep-seated and unable to cure completely. This brings with it symptoms ranging from abdominal pain to uterine infections to sterility.
Syphillis: Undiagnosed syphilis can lead to blindness and deafness. It can also be passed onto the newborn and lead to severe disabilities.
Gonorrhea: If diagnosed early, it can be cured completely with antibiotics. However, if left untreated, it can lead to infertility.
HIV/AIDS: Early diagnosis can help in curtailing the disease. If detected late, then the damage is quite extensive and treatment is both expensive and cannot help restore a lot of functions. 
Symptoms of Sexually transmitted diseases: If there is a doubt of having contracted an STD, then it is very important to get tested for the same. Some of the most common symptoms are listed below.

Women: The most common symptoms in women including painful urination, burning sensation, abnormal vaginal discharge (sometimes bleeding), warts, and abdominal pain.
Men: Testicular pain, urethral pain, painful urination, pain and inflammation in the prostate, sores, fever, and abdominal pain.
Prevention: Always practice safe sexual practices. When in doubt, refrain from sex until diagnosis and treatment is complete.

Testing for STDs: Some of the standard tests include:

1. Herpes- HSV I & II - 
2. Testing HIV-- Kits and ELISA available for testing 
3. Blood test for syphilis antibodies 
4. Chlamydia and Gonorrhoea - from urine as well as swabs for culture
It is understandable that getting tested for STDs is an embarrassing situation. However, there are options available where anonymity can be maintained when getting tested for STDs. This is a wise choice to make as the risk is not just for the person affected but for the partner and in some cases even for the fetus. Early testing can help prevent complications like infertility and cancer.

STD Testing - Why You Should Never Delay?

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