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!

Hiv or the human immunodeficiency virus is the lentivirus which causes hiv infection and leads to acquired immunodeficiency syndrome or aids.

The symptoms of hiv vary from person to person. There are three main stages of hiv infections, where each stage has different symptoms.

Here are some facts about the three stages of hiv infections along with the accompanying symptoms.

Acute hiv infection stage
This is the first stage of hiv infection and after three to four weeks of becoming hiv infected, people experience symptoms, which are similar to flu. This flu usually does not last more than two weeks.

Symptoms include:
Fever
Rashes on the body
A sore throat
Swelling of different glands
Headache
Joint and muscle pain
Improper digestion

These symptoms appear and indicate that the body is reacting to the hiv. Infected cells circulate throughout the blood, and the immune system produces hiv antibodies in order to attack the viruses. This process is termed as seroconversion, and it takes place within 45 days of getting infected. The levels of virus in your blood are quite high during this stage.

Clinical latency stage
This is the second stage of hiv infection, which follows the early stage. This stage is also known as chronic hiv stage. During this stage, hiv is active, but is reproduced at a very low level. People in this stage may not receive symptoms related to hiv or may get mild indications.

In case of people who do not take medicines for hiv treatment, this stage lasts for a long period. Some people, however, progress faster through this stage. Medicines should be taken to keep the virus in check. During this stage, people can transmit hiv to others very easily in spite of not experiencing any symptoms. People who are on medication stay suppressed virally and have a low level of hiv in their blood, and the risk of transmission is less.

Symptomic hiv infection or aids stage
This is the third stage of hiv infection, which is characterized by severe damage to the immune system of an hiv-virus affected person. A patient is likely to have serious infections and gets bacterial or fungal diseases. The infections are termed as opportunistic infections. The patient is now said to be having aids.

The symptoms of this stage are:
Loss of weight
Diarrhoea
Sweating at night
Fevers and persistent coughing
Problems in the mouth and skin
Infections on a regular basis
Illness and development of other diseases.

Hiv infection affects the body via three stages and leads to aids in the third stage. Each stage is accompanied by several symptoms.

Stages and Symptoms of HIV Infections

People who suffer from human immunodeficiency virus, commonly known as'hiv, are known as hiv positive people. The virus is the agent of aids that is currently incurable. Hiv is known to alter the human immune system and makes people much more susceptible and vulnerable to diseases and infections. 

Body fluids such as semen, blood, breast milk, vaginal fluids etc. Of an infected individual contains the virus, which can be passed from one person to another during blood-to-blood and/or sexual contact. Hiv positive women may even pass on this virus to their children during pregnancy, delivery or by breast feeding them. Hiv is also transmitted during oral, anal or vaginal sex, by contaminated hypodermic needles and by blood transfusion. 

Mentioned below are a few issues that a hiv positive woman have to face apart from discrimination and stigma, fear of infecting their children or partners, violence and abandonment. 

1. Menstrual disorders: changes in menstrual cycles are frequently reported by hiv infected women. However, menstrual dysfunctions are due to varied reasons that aren't directly related to the disease. Although most of the hiv positive women suffer from amenorrhea i. E. The unusual absence of periods, it is not just due to hiv but also because of weight loss or immunosuppression. 
 
2. Contraception: it is very important that the contraception a hiv positive woman chooses not only acts as birth control, but also to prevent the transmission of sexually transmitted diseases and hiv. Although condoms do not provide exceptional pregnancy prevention, they are excellent at preventing transmission of the hiv virus. Permanent sterilization is usually the most chosen contraceptive method for hiv serodiscordant couples.

3. Surgical complications: hiv positive women are at a higher risk of undergoing gynecologic surgery. This is because they are more vulnerable to pelvic infectious disease that requires surgical intervention. There is also a greater risk of developing vulvar cancer in hiv positive women. 

4. Fertility: there has been an increase in the number of seropositive women contemplating pregnancy and childbirth. Most couples resort to assisted reproduction to lower the risk of horizontal hiv transmission. Studies show that undergoing hiv treatment and having an undetectable viral load is helpful in preventing the transmission of hiv. It is important to consult a medical expert if you are unable to get pregnant after at least 6 months of trying. Fertility problems are more common in hiv positive women than hiv negative women.

Issues for HIV Positive Women

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?

For nearly 30 years, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) have been shrouded in myths and misconceptions. In some cases, these mistaken ideas have prompted the very behavior that cause more people to become HIV positive. Here are the top five myths about HIV, along with the facts to dispute them.

Myth No. 1: I can get HIV by being around people who are HIV-positive.

The evidence shows that HIV is non communicable and does not spread through touch, tears, sweat or saliva. You cannot catch HIV by:

    Breathing the same air as someone who is HIV-positive
    Touching a toilet seat or doorknob handle after an HIV-positive person
    Drinking from a water fountain
    Hugging, kissing, or shaking hands with someone who is HIV-positive
    Sharing eating utensils with an HIV-positive person
    Using exercise equipment at a gym

You can get it from infected blood, semen, vaginal fluid, or mother's milk.

Myth No. 2: I can get HIV from mosquitoes.

Because HIV is spread through blood, people have worried that biting or bloodsucking insects might spread HIV. Several studies, however, show no evidence to support this, even in areas with lots of mosquitoes and cases of HIV. When insects bite, they do not inject the blood of the person or animal they have last bitten. Also, HIV lives for only a short time inside an insect.

Myth No. 3: I'm HIV positive, my life is over.

In the early years of the disease epidemic, the death rate from AIDS was extremely high. But today, antiretroviral drugs allow HIV positive people and even those with AIDS to live much longer, normal and productive lives.

Myth No. 4: My partner and I are both HIV positive there's no reason for us to practice safer sex.

Practising safer sex, wearing condoms or using dental dams can protect you both from becoming exposed to other (potentially drug resistant) strains of HIV.

Myth No. 5: You can't get HIV from oral sex.

It's true that oral sex is less risky than some other types of sex. But you can get HIV by having oral sex with either a man or a woman who is HIV positive. Always use a latex barrier during oral sex.

Top 5 Myths & Misconceptions About HIV & AIDS!

HIV/AIDS is a type of sexually transmitted disease which is caused by the Human Immunodeficiency Virus (HIV). The HIV virus attacks the immune system and makes the body vulnerable to other diseases. AIDS is the last stage of the HIV infection; HIV takes about 10 to 12 years to fully culminate into AIDS. AIDS completely destroys the immune system and leads to fatal health conditions and diseases such as cancers and other infections because of AIDS.

Causes-

HIV is a retrovirus that infects the vital organs of the human immune system. The virus progresses in the absence of antiretroviral therapy. The rate of virus progression varies widely between individuals and depends on many factors (age of the patient, body s ability to defend against HIV, access to healthcare, existence of coexisting infections, the infected person s genetic inheritance, resistance to certain strains of HIV).

HIV can be transmitted through:

Sexual Transmission. It can happen when there is contact with infected sexual secretions. This can happen while having unprotected sex, including vaginal, oral and anal sex or sharing sex toys with someone infected with HIV.
Perinatal Transmission. The mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding.
Blood Transmission. The risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries, thanks to meticulous screening and precautions. Among drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.
Contrary to popular belief, HIV can never spread by means of kissing as the virus cannot survive outside the body.

Symptoms-

The early symptoms of HIV appear within a few weeks of contamination by the virus. The early symptoms include headache, pain in the muscles and the joints, rashes and inflated lymph nodes. These symptoms tend to disappear within 2 to 3 weeks.
The next set of symptoms might appear after a few years and these are persistent. The symptoms include, but are not limited to fatigue, loss of body weight, inflated lymph nodes, fever, a sensation of numbness near the limbs, pain when you try to swallow, sores in the mouth and sweating at night.
If you are diagnosed with HIV, you should:

Try to maintain a daily diet containing vegetables, legumes, and fruits which provide you energy.
Try to include a little bit of fat, carbohydrates (at least 3 servings of vegetable per day), calcium (dairy products) and low-fat protein sources (generally 80-150 gram per day of fish, skinned chicken, low-fat cheese etc.) in your everyday meal.
Maintain a daily calorie intake of 17-25 calories per pound depending on whether the person is losing weight.
Vitamins and minerals are particularly necessary to repair the cells damaged by the HIV virus.
So, it is necessary to intake foods such as eggs, milk, peanuts, green vegetables, meat, beans and broccolis on a regular basis, if you have been diagnosed with HIV.

If you are suffering from HIV, you must maintain the following food safety measures:

You should try to restrict the intake of fat
Restrict your alcohol intake
You should try to avoid fast foods
You should also limit your regular sugar intake and should avoid foods with extra sugar

HIV/AIDS - Diet, Nutrition & Food Safety You Must Follow!

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