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!

An STD or sexually transmitted disease is usually an infection which spreads from one person to another during sexual contact. Some STDs can also be transferred through touch, since they spread by skin contact. People hardly like to talk or discuss about STDs, but it is very important to rule out the possibilities of STD. Whether one likes it or not, if STD testing is ignored, then it can lead to long term consequences.

Why STD Testing is Important

Often STDs have no signs and symptoms, and the only way to know that are you suffering from an STD is to get tested for it. So it is a good idea to get yourself tested, as you never know if you might have STD even though you don't show symptoms. Also, when STDs are diagnosed, most of them can be cured.

Consequences of Not Getting Tested

If one has STD and is not getting tested for the same, then it could lead to health problems which can cause permanent damages or might prove to be fatal. Some of the problems are:

1. Undiagnosed and untreated STDs can lead to damaged reproductive system, leading to sterile men and women. 
2. Chlamydia, if untreated can lead to epididymitis and shrinkage of testicles and infertility in men. It also leads to pelvic inflammatory disease. But good news is, it can be treated easily.
3. Syphillis can make a person blind and deaf, and can also be passed on to babies. 
4. Gonorrhea, which can also be treated easily with antibiotics, can lead to infertility or death if untreated. 
5. Even HIV/AIDS if diagnosed in early stages can enable the patient to lead a normal life and does not mean only death, contrary to conventional perceptions.  

Symptoms of STD

While, gonorrhea, chlamydia and human papilloma virus (HPV) have no symptoms, the common symptoms of STDs might vary. 

1. In women, the common symptoms are pain and burning sensation during urination, blood in vaginal discharge as also abnormal vaginal discharge, abdominal pain, blisters, warts, and swollen glands. 
2. Men often experience inflammation of the testicles, prostate, sores, fever, urethral discharge and pain during urination.

If these symptoms are observed, it is vital to get tested for STDs. Also the best way to protect your partner is not to practice unsafe sex and to refrain from the same until diagnosed and treatment is complete.
 
Getting yourself tested for STD is also beneficial, as it can prevent against complications like cancers and infertility. The standard STD panel of tests consists of Herpes IgG antibody and HIV antibody blood tests, along with a blood test for syphilis antibody and DNA urine test for gonorrhea and Chlamydia.

The Dangers of Putting Off STD Testing

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

Chlamydia is a Sexually Transmitted Disease. It is generally found in men and women under the age of 25. Researchers have found that in the United States about 2.9 million individuals develop this disease every year. 

Here are things that you must know about the disease:

What is it all about?
It is caused due to bacterial infection and is transferred sexually. You can be infected with disease by having vaginal, oral or anal sex with the patient. You must be aware of the fact that you can develop chlamydia even if your partner doesn t ejaculate inside your vaginal tract. If you had suffered from this disease in the past, you can still get it again by having unprotected sex with an infected person.

What are the symptoms of this disease?
There aren t any obvious symptoms for this disease. Most of the patients show no sign of developing this disease. Thus, you never get to know when you were infected actually. However, some patients do reflect some symptoms after 4 to 5 days of infection. These symptoms include abnormal penis or vaginal discharge and painful, burning urination. Men can also develop a bleeding rectum.

How do you know for sure that you are infected?
Well, you can get yourself tested to confirm about the infection.

What happens if you don t get treated?
If the patient doesn t seek medical help, he or she is posing threat to his or her health. Women may develop pelvic inflammatory diseases, infertility or ectopic pregnancy. In men, it can cause pain and fever as the infection spreads along the tube carrying sperm.

Is there any treatment?
This disease is curable. But it is important to avoid sexual contact with anyone during the period of treatment or medication. First, you need to undertake the test to confirm the infection. You shouldn t have sex for seven days after the treatment is over. It is advisable to get yourself tested thrice in a year.

Chlamydia - Things You Must Know About It!

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?

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

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