Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

HIV or Human Immunodeficiency Virus is a type of immune disorder which attacks the immune system of the body and slowly destroys it overtime. The HIV virus targets the immune system and makes the body susceptible to other diseases. HIV infection can progress to AIDS although it may take up to 10 or 12 years to fully go into the last stage.

Risks and Causes
HIV is a communicable disease which spreads through only the following methods

    It can spread from one person to another by means of unprotected sexual intercourse due to the exchange of bodily fluids.
    The virus spreads if you share drug needles with someone who is already contaminated with HIV virus. It can also occur due to improperly trained medical staff that may reuse syringes although this is very uncommon.
    The HIV virus transmits from the mother to the child during pregnancy through the placenta.
    Any exchange of blood in significant amounts such as blood transfusion from a contaminated patient will result in infection as well although this is very rare.

Any other form of contracting the disease such as through kissing or food is a untrue and only propagates due to ignorance.

Symptoms
The initial symptoms of HIV infection are noticed after a few weeks although it can take a few months to come up as well. The initial symptoms may include
1. Severe headache along with intense pain in the muscles and the joints of the body.
2. Frequent appearances of rashes
3. inflation of the lymph nodes
4. Itchy skin
5. Disorders which stay for sustained periods such as an upset stomach or a cold.

The early symptoms disappear within 2 to 3 weeks without any treatment. The later symptoms might appear after few years (sometimes up to or more than a decade), which will stay. This is usually the time HIV is diagnosed. The symptoms now may also include
1. severe muscle fatigue
2. severe loss in body weight,
3. High fever and recurrent instances of sweating at the night time.
HIV is suspected if the later symptoms tend to last for a long time without any other diagnosable cause.

Treatment
HIV can be treated by means of antiretroviral therapy which reduces the rate at which the virus multiplies. However, there is no cure for HIV as of yet.
Prevention
In order to prevent yourself from getting HIV, you should adopt the following precautionary measures:
1. You should use protection every time when engaging in sexual intercourse and if you are unsure of your partner s HIV status.
2. You should use new blades in barbershops for shaving purposes in order to prevent yourself from HIV as well
3. If you are diagnosed with HIV/AIDS while you are pregnant, to prevent spreading it to your unborn baby, you might immediately need undergo a medical check-up and follow the doctor s advice.
4. Ensure that disposable syringes are used whenever they are being use for medical tests or treatments.

HIV / AIDS - Things You Should Remember About It

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!

Hearing that a person is HIV positive instantly makes us wary of him or her and unconsciously we may begin avoiding social interactions with them. However, HIV does not spread through the air or by water and hence there is no reason to ostracize HIV positive people. To understand how to prevent the transmission of HIV it is essential to first understand how the virus is transferred from one person to another. There are three ways in which this virus can be transmitted from an HIV positive person to another. These are:

Through blood
Through bodily fluids such as semen and vaginal or rectal fluids
From a mother to a child
Keeping this in mind, here are a few ways to prevent the transferring of HIV from one person to another:



Use only Disposable Syringes: Getting pricked by a needle that has been used on a HIV positive patient can increase your risk of suffering from the disease. Hence, insist on using a fresh needle for blood tests etc. Also ensure that the syringe and needle and destroyed after being used.
Registered Blood Banks: In case you need a blood transfusion, get blood only from registered blood banks. These blood banks need to run HIV screening tests before collecting blood and hence are guaranteed to have only HIV negative blood as opposed to local quacks.
Use a Condom: The only way to prevent the transference of HIV cells while having intercourse is by using a condom. This is essential not only for vaginal intercourse but for anal intercourse as well.
Get Tested: Today, an HIV screening test can be easily done and your results are guaranteed to be kept confidential. STDs can increase your risk of getting infected with HIV or spreading it to others. Get tested regularly for STDs and insist that your partners are checked for it as well. This is crucial if you have more than one sexual partner.
Limit the Number of Sexual Partners: The more number of people you have sex with, the higher your chance of getting infected with the virus and transmitting it to others. Remember, HIV has no overt symptoms that are visible to the naked eye.
HIV cannot be cured but it can be controlled through medication. Hence, if you suffer from this disease, follow the doctor's prescription religiously to prevent transmitting the virus to your partner. If you wish to discuss about any specific problem, you can consult a doctor.

HIV/AIDS - How To Prevent It?

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!

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?

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