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?

HIV infection and AIDS (commonly referred to as HIV/AIDS) are caused by the Human Immunodeficiency Virus (HIV). HIV is transmitted sexually and through exchange of body fluids, such as blood. The HIV attacks our defense system (immune system) giving opportunity to many illnesses to attack the body. These infections (called opportunistic infections) range from common cold and diarrhea to life-threatening illnesses including uncommon pneumonias and cancers. The type, range and intensity of opportunistic infections vary with the severity of the HIV infection and the extent to which our immunity is compromised. 

AIDS is the last stage disorder of the HIV infection. Though there is no complete cure for the HIV-infection till date - despite thousands of scientists across the world working on it, spending countless hours of research involving billions of dollars - there has been tremendous progress in medicare improving the quality of life of the HIV-infected, in extending their life-span to almost normal levels and in preventing mother-child transmission. 

The key factors in extending the life-span, and in keeping good immunity and good health are 

balanced and nutritious diet

regular physical exercise

correct, consistent and lifelong use of the prescribed medicines

periodic medical checkups

staying psychologically positive and strong

good family support and

good lifestyle habits.

The last one involves maintaining good personal hygiene, avoiding smoking (active as well as passive), alcohol, recreational drugs, unhygienic and disease-prone environments and sedentary life style. Those who follow these will guidelines certainly have better prognoses. 

Diet:

A nutritious diet is of utmost importance to the HIV-infected, as adequate nutrition contributes to the development of the immune system, prevents malnutrition and wasting, achieves and maintains optimal body weight and strength, enhances the body s ability to fight opportunistic infections, helps delay the progression of HIV, improves the effectiveness of drug treatments, and improves the quality of life. 

Ensure that the food contains adequate macronutrients, that is, carbohydrates, proteins and fat, otherwise the patient may end up with - protein-energy malnutrition, manifesting itself in the weight loss and wasting that is typical of AIDS patients.

As per WHO, an HIV-infected person has additional nutrient requirements: 10-15 percent additional energy intake and 50 to 100 percent increase in protein intake as compared to a non HIV-infected person.

Consuming micronutrients (especially Vitamins A, B6 and B12, iron and zinc) is important for building a strong immune system and fighting infections.

Try and maintain a daily diet containing rice/roti, vegetables, legumes, and fruits which provide you energy and micronutrients. Choose foods that are low in saturated fat, trans fat, and cholesterol.

Eat at least two servings of fish each week. Oily fish, which contain omega-3 fatty acids, are best. If you cannot eat fish, you can also get omega-3 fats from omega-3 eggs, walnuts, flax seeds.

Better avoid fast foods.

Living with HIV/AIDS: Diet, Nutrition, and Food Safety

Certain diseases are a major cause of concern as often these diseases can cause severe health complications. Various campaigns and awareness have been spread both by the government and NGOs for practicing safe sex to fight against these sexually transmitted diseases. Here are a few tips on how to avoid contracting sexually transmitted diseases.

1. Selective Abstinence: Selective abstinence is when people indulge in certain sexual activities, but limit in what they do to avoid the chances of contracting sexually transmitted diseases. People who do practice selective abstinence run a lower risk of contracting sexually transmitted diseases, which is also dependent on the type of sexual activity they indulge in as certain sexual acts have a higher chance of spreading STDs than others.

2. Using condoms: Using latex condoms decreases the chances of contracting sexually transmitted diseases. If you use lubricants, make sure that they are water based. Condoms are however not 100% effective at preventing sexually transmitted diseases, but reduce the chance of infection to a great extent. It is highly advised to learn how to properly use condoms.

3. Mutual monogamy: Another way to avoid getting infected by STDs is to practice mutual monogamy. If you and your partner do not have sex with anyone else, then it greatly reduces the chances of getting infected with sexually transmitted diseases.

4. Getting tested: Getting tested for sexually transmitted diseases as well as asking your partner to do so decreases the chances of transmitting sexually transmitted diseases. Refrain from having sex if either of you test positive.

5. Avoid alcohol and recreational drugs: Avoiding the usage of recreational drugs and alcohol reduces the chances of contracting STDs. Indulging in sexual activities while being highly intoxicated can both cause you to forget practicing safe sex.

6. Practicing healthy habits: Practicing certain healthy habits also reduces the chances of contracting sexually transmitted diseases. These include avoiding sharing towels and undergarments, washing before and after sexual intercourse and getting a vaccination for hepatitis B.

7. Low risk and high risk activities: Certain sexual activities such as open mouth kissing and hand to genital contact have a lower risk of infection. Other activities such as oral sex, vaginal intercourse, and genital to genital contact have a higher chance of infection. Understanding the risks better would allow you to avoid contacting diseases easily.

7 Tips to Avoid Sexually Transmitted Diseases

One of the most common physically transmitted diseases is chlamydia. Chlamydia is a type of infection caused by the bacteria "Chlamydia trachomatis". The symptoms of Chlamydia are similar to the symptoms of Gonorrhoea (a bacterial sexually transmitted infection). Chlamydia infection causes permanent fallopian tube damage in women, leads to future ectopic pregnancy (the fertilised egg attaches itself outside the uterus) and infertility.

Symptoms of Chlamydia 
Men and women afflicted with chlamydia exhibit different symptoms.
The symptoms of chlamydia in women include:
1. Abnormal, sometimes foul-smelling, vaginal discharge
2. Bleeding between menstrual cycles
3. Painful periods
4. Abdominal pain, accompanied with fever
5. Pain during intercourse
6. Burning or itching around or in the vagina
7. Painful urination

Men usually display the following symptoms if they have chlamydia:
1. Minimal amounts of cloudy or clear discharge from the head of the penis
2. Painful urination
3. Itching and burning around the slit of the penis
4. Swollen and painful testicles

Treatment options available
1. Chlamydia is diagnosed by taking a swab from the cervix (in women) or the urethra (in men). These swabs will be sent to the laboratory for analysis. Urine samples can also be taken to check for the appearance of bacteria.

2. Since chlamydia is a bacterial infection, it can be easily treated with antibiotics. Oral antibiotics such as azithromycin or doxycycline are commonly prescribed by doctors. Azithromycin is usually prescribed in a large, single dose. The dose may also be stretched out for five days. Doxycycline is taken two times daily for a week.

3. With the right antibiotic therapy, the infection will clear up in 1 to 2 weeks approximately. It is very important that you finish the medication course if you wish you heal completely without having to suffer from further bouts of this disorder.

4. Women with critical chlamydia may need hospitalisation, pain medicine and IV (intravenous, or directly through the vein) antibiotics. Pregnant women with chlamydia infection can be safely cured with antibiotic such as erythromycin ethylsuccinate, amoxicillin and azithromycin.

Your partner needs testing and treatment as well to avoid further spread and reinfection. It is vital not to engage in any sexual activity while the treatment is ongoing. A further retest should be done three months later to make sure the infection is rectified.

Symptoms of Chlamydia and Ways to Treat the Disease

The year 2014 has seen a massive increase in the number of patients affected by Gonorrhoea. The most infected age group is between 15 and 24. This is mainly due to lack of knowledge in this age group about the disease. Here are some facts about Gonorrhoea that one must know.

Gonorrhoea Transmission
Gonorrhoea, also known as drip, is transmitted when a normal person comes in contact sexually with an infected person. Infected fluid of a mother can also pass to her newborn infant during delivery. The disease can affect both the genders.

Cause of Gonorrhoea
Neisseria gonorrhoeae bacteria cause the disease. The bacteria grow in mucus membranes and usually grow in the warm and moist areas of humans' reproductive tracts such as uterus and fallopian tube of women. These can also grow in anus, mouth as well as throat. As a matter of fact, the infection can be passed even via oral or anal sex.

Symptoms of Gonorrhoea
An infected person will develop symptoms of the disease in 2 to 14 days. Men may feel burning or painful sensation while urinating. Other symptoms are as follows:

1. Swollen and painful testicles
2. Swollen or redness at the tip of the penis
3. Penis may have a drip or discharge
4. Frequent urination
5. Recurrent soreness of throat

Females have milder symptoms of the infection. This makes it difficult to diagnose, and is sometimes misinterpreted as common vaginal yeast or other bacterial infection.

Following are a few symptoms of the disease in women:

1. Burning or painful urination
2. Frequent urination
3. Vaginal discharge
4. Soreness in throat
5. Fever
6. Lower abdominal pain
7. Pain while sexual intercourse

If the disease is not treated, infection spreads in blood stream leading to rashes, fever and even pain in the joints. Such unnoticeable symptoms make it difficult to treat.

Testing Methods of Gonorrhoea
One method is that penile or vaginal discharge samples are taken from patients and examined under a microscope by adding reactive stain. However, this is not an accurate assessment.
Another test is conducted where exposing samples are incubated. In case of infection, colony of gonorrhoea shows growth. Preliminary test may take 24 hours. Final assessment may take around three days. Samples can be from the patient's anus, joint fluid, blood, throat, vagina or tip of the penis.

Treatment
The disease is treatable under proper medical supervision. However, the bacterial resistance to Azithromycin drug has made it more difficult for treatment.

Protection
It is highly recommended to have a protected intercourse. Women of age group less than 25 need to have STI evaluation once a year.

Know All About Gonorrhoea

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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