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?

With changing times the nature and effects of virus and bacteria are also changing and due to this, one of the biggest risks of unprotected sex is catching a sexually transmitted disease or STD. An STD can be contacted by any form of intercourse including oral, vaginal and anal sex. STDs are serious diseases that should not be ignored and require treatment and medication. Some common STDs are:
1. Chlamydia
2. Hepatitis B
3. Genital Herpes
4. Syphilis and
5. Gonorrhea 

The only way to protect yourself from an STD is to abstain from unprotected sex and always use a condom. Sometimes STD infections have no symptoms and can remain dormant for years, hence it is essential to get yourself regularly treated for STDs if you have more than one sexual partner. On the other hand some STDs have visible symptoms such as:

Skin rash
A rash in the genital area is most often a sign of STDs. This can be in the form of bumps, sores or warts. It may or may not be accompanied by itchiness. A rash caused by a STD usually results in redness and inflammation. Herpes sores may subside within a week or so but just because the rash is gone does not mean the infection has been treated. Hence even if the rash disappears before your doctor's visit, ensure you mention it. 

Painful urination
A burning sensation or pain while urinating is a symptom for a number of STDs. There may also be a change in the colour of urine. Some STDs associated with painful urination as Chlamydia, gonorrhea and trichomoniasis. However, this may also be triggered by kidney stones or a urinary tract infection. 

Painful intercourse
Pain during intercourse is one of the most overlooked symptoms of a sexually transmitted disease. While a little pain may be normal, any sudden increase in pain or new type of pain should not be ignored. This should be kept in mind especially when having intercourse with a new partner or if there is a change in sexual habits. When it comes to men's sexual health, pain at the time of ejaculation can be a symptom of a STD.

Abnormal discharge
Abnormal discharge from the vagina or penis can be a symptom of a number of infections not all of which are STDs. Strangely coloured and odorous vaginal discharge can be a symptom of yeast infections or a Sexually transmitted disease like trichomoniasis or gonorrhea. Bleeding in between periods can also be a symptom of a STD.  Abnormal discharge from the penis can be a sign of Chlamydia, gonorrhea or trichomoniasis.

Learn the Signs and Symptoms of STDs

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

What is Monogamous Relationship?

You (who have been tested for STD/STIs and don't have any) are having sex with only one partner (who also has been tested for STD/STIs and doesn't have any) who only has sex with you. And you both keep it that way! 

Stated another way, you are both STD/STI free and only have sex with each other. People of any sexual orientation can engage in monogamous relationships. The only thing implied by the term monogamy is that the relationship consists of two people who are romantically and/or sexually exclusive. Theoretically, outside of abstinence, this is really the safest type of "safer sex" that you can have. 

Celebrated on 1st December of each year, World AIDS Day, aims to spread awareness about HIV / AIDs. It is an STD wherein, HIV stands for human immunodeficiency infection and AIDS stands for acquired immune deficiency syndrome. The disease hinders the immune system in keeping up our body s security against sickness. HIV causes individuals to end up wiped out with infections that regularly would not affect them and HIV leads to AIDS.

Understanding the Symptoms:

HIV has few or no signs or symptoms for up to ten years or more before side effects of AIDS tends to manifest. There is no cure for HIV/AIDS, yet treatment is accessible. A few people have HIV symptoms not long after being infected. These include:

There are a few phases of HIV illness. The primary HIV side effects may include swollen glands in the throat, armpit, or crotch.
Other early HIV symptoms incorporate slight fever, headaches, exhaustion, and muscle throbs.
These symptoms may keep on going for just a couple of weeks. At that point, there are typically no HIV indications for a long time. That is the reason it can be difficult to know whether or not a person is suffering from HIV.
The symptoms of AIDS show up in the most advanced phase of the HIV disease. These are as follows:

Along with a severely damaged immune system, a person with AIDS may likewise have thrush. A thrush is a thick, whitish covering on the tongue that is brought about by a yeast infection and now and then joined by a sore throat.
Serious or repetitive vaginal yeast infection.
Pelvic inflammatory illness.
Serious and frequent infections.
Unexplained fatigue that might be followed by headaches, dizziness.
Loss of more than ten pounds of weight that is not because of physical exercise or consuming fewer calories.
Risk Factors: There are a lot of ways in which you can get the infection. HIV is transmitted through blood, semen, vaginal fluids and breast milk. The most well-known ways in which HIV is spread, are:

Having sexual intercourse without a condom with somebody who has HIV/AIDS.
Using needles or syringes that have been used by someone who has HIV/AIDS.
Being punctured with a needle or surgical instrument that has been contaminated with HIV.
Getting HIV blood, semen or vaginal discharge into open injuries or wounds.
Babies born to women with HIV/AIDS can get HIV from their mothers during birth or from breastfeeding.
There are numerous ways in which you can protect yourself from HIV. These are as follows:

The most secure way is to limit the number of sexual partners you take on.
Try to have safer sex and always use protection.
Get your partners tested for HIV.
HIV tests are a typical piece of social insurance.
In case that you think you may have been infected by HIV, talk to a specialist or a doctor about testing. Discussing what risks you might have taken can help you choose whether testing is ideal for you.

This World AIDS Day - Let's Spread the Awareness About HIV/AIDS

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/AIDS is a STD 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 disorder caused by HIV infection. This disorder destroys the human immune system which might lead to other life- threatening diseases such as cancer. If diagnosed with HIV, one must necessarily maintain a healthy dietary regime because the nutrients one derives go on to contribute to the development of the immune system, thus providing resistance to the side effects of the HIV medicines.

The early symptoms of HIV/AIDS appear within a few weeks after sexual contact. The early symptoms include a headache, pain in the muscles and the joints, rashes and inflamed lymph nodes. The early symptoms tend to disappear within 2 to 3 weeks. The next set of symptoms might appear after a few years which might be persistent. The symptoms include fatigue, loss of body weight, inflated lymph nodes, fever and sweat during the 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 and Food Safety You Must Follow

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