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!

Gonorrhea : Disease + Symptoms

Gonorrhea is a contagious disease that can affect both men and women. It is caused by a bacterium called Neisseria gonorrhoeae that can easily grow in the mucus membranes of the human body.

It is mostly transmitted when an uninfected person gets in sexual contact with an infected person. It can also be spread when a mother's infected body fluids come in contact with her newborn during childbirth.

It is a common infection and the symptoms vary for both men and women. The symptoms are:

Symptoms in Women:

- White or greenish-yellow vaginal discharge
- Burning sensation while urinating
- Pain in the lower abdomen and in the pelvic region
- Occurrence of Conjunctivitis
- Spotting or light bleeding after sexual intercourse
- Bleeding between periods
- Vulvitis

Symptoms in Men:

- White or greenish-yellow discharge from the penis
- Swelling and pain in the testicles
- Burning sensation while urinating

The symptoms come to notice usually within 2 to 10 days of the infection in case of women and it takes approximately 14 days for them to be recognized in the case of men. However in a few cases, the symptoms may take as long as 30 days to appear or they may appear so negligibly that they are hardly noticeable if they occur at all.



Gonorrhea is Contagious. But is it Only Sexually Transmitted?

The HIV (human immunodeficiency virus) is a critical disease. This virus invades a person's immune system which is the body's defense against infections such as viruses and bacteria. The immune system doesn't work properly and becomes deficient once attacked by HIV. One social acknowledgement to HIV that has gained enough recognition is the HIV counselling due to the crucial need to counsel the patient about sexual behavior and the risks associated with it. 

Importance of HIV counselling 
The human immunodeficiency virus has become an epidemic in nature and has reached to a distressing proportion worldwide as it is in its third decade. Thus, counselling becomes remarkably crucial part of the treatment. 

HIV prevention counselling is a significant mode of behavioral invasion particularly in the deficiency or lack of an effective curative treatment or vaccine. HIV counselling varies from other forms of counselling sessions. Apart from being a health obstacle, the disease is equally overwhelming for the family as well as people around you. family. It is also connected with endless and intense human suffering which stimulates multiple emotional responses. Such reactions involve self-denial, grief, fear, loss, anxiety, anger, annoyance, depression self-blaming, pity, self-condemnation isolation and suicidal thoughts. 

Also, the risk of passing the virus to the partner during sexual activity is high and the patient must be aware of safe sex and the risks associated with unprotected sex. Hence, counselling becomes paramount. 

Counselling session s information Self-care counselling: 
The patient must be well informed about the disease and should be supported in embracing attitudes, actions, and beliefs which will defend and serve as a protective shield to the body s immune system. Improving, enhancing, and transforming nutrition is required. A few other things that are emphasized are, encouraging physical activity, avoiding objects, actions, and events that threaten the body, overcoming anxiety and stress that compromise the psychological, mental, physical and welfare of the body, and seeking and giving support for self-care. 

Types of counselling: 

Patient centered counselling: It changed the focus of counselling from a single informative one to one that concentrated on a patient s circumstances and needs. This involved active listening, to render better support and managing client's particular prevention needs. 
Risk reduction counselling: This includes examining client s awareness about sexual activity and their feelings.Using their current HIV knowledge as an appealing tool, the limitations they have for protected sex is discussed. A better understanding is ensured in the patients so that unsafe behaviors can be avoided. 
Grief counselling: People who are contaminated with HIV have an elevated risk of acquiring depression. Counselling helps you to deal with any emotional outburst. 
Aims of counselling in HIV infection-

Prevention is the first purpose of HIV counselling. It decides whether the lifestyle puts that individual at a higher risk. Helping to recognize and distinguish the definitions of high-risk behavior. The counselling contributes to behavioral change and also aims at working with the person and his family to obtain and sustain that change in approach and behavior.

HIV Counselling - Why It Is Important To Get It?

4 Effects of HIV on the Body

HIV, which is short for Human Immunodeficiency Virus, penetrates your body and directly attacks your immune system. In this process, the virus weakens your body's natural defense mechanism against diseases and infections. A compromised immune system makes the body prone to minor infections, which healthy people would generally overcome. The virus itself doesn't cause any physical symptoms. It only serves to ease the entry of other bacteria and viruses into the body.

The following are some of the ways HIV affects your body:

1. Immune system

The human immunodeficiency virus destroys CD4 cells, the white blood cells that help the immune system ward off foreign substances. If left unchecked, HIV can develop into AIDS. During such time, the virus may damage the immune system to an extent that it wouldn't be able to ward off minor infections that a healthy immune system would. A person with HIV could thus suffer from fever, chills, sweats, shortness of breath, white spots in the mouth, fatigue, skin rash and weight loss from time to time.

2. Respiratory system

As HIV develops into AIDS, the body can contract infections such as pneumocystis pneumonia (PCP), tuberculosis and Kaposi's sarcoma. These conditions lead to serious respiratory problems. PCP is found to be one of the most common infections among people with HIV. 85% of the people would develop the infection if the condition is left untreated.

3. Skin problems

As in healthy individuals, many skin conditions can also occur in people with HIV or AIDS. But a compromised immune system heightens the condition and causes difficulty in treatment. Dermatitis, psoriasis, and hives are common conditions. They are also prone to a rare type of skin cancer known as Kaposi's sarcoma.

4. Gastrointestinal System

Gastrointestinal disorders are the most common ailments for people diagnosed with HIV and AIDS. Problems faced include diarrhea, nausea, vomiting, weight loss, abdominal pain and gastrointestinal bleeding. 50% of the people suffering from HIV encounter gastrointestinal disorders at some point of their illness.



4 Effects HIV has on the Body

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 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

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