What is HIV AIDS?
AIDS is also known as Acquired Immunodeficiency Syndrome, while HIV stands for Human Immunodeficiency Virus. This disease occurs when the virus damages your immune system by ruining the white blood cells (cells which fight infection). AIDS is defined as the later and more severe stage of HIV.
HIV aids usually spreads by engaging in unprotected sex with people already infected by the virus. It can also be spread by getting in contact with the blood of an infected person. This generally occurs by using needles which have been contaminated. Women who have hiv aids can also pass it on to their child while giving birth or during the course of pregnancy.Blood test is performed to diagnose hiv aids, there isn’t any cure for hiv but consuming certain medicines can fight the virus and reduce pain and discomfort. The drugs used for the treatment of hiv strengthens the immune system so that the condition doesn’t escalate to AIDS. These drugs can have uncomfortable and serious side effects. These drugs don’t usually work for everyone, they only work for a selected number of people. These medications can also help people with hiv aids live longer than usual.
Where does HIV arise from?
The exact reason where the hiv virus came from is not known but according to scientists, a chimpanzee found in Central Africa is the source of the infection (simian immunodeficiency virus or SIV). This virus was transmitted to humans and was mutated into HIV when humans started hunting these chimpanzees and consumed their meat during the olden days.
When hiv starts reaching advanced stages, people may experience signs such as continuous vaginal yeast infections, pelvic inflammatory disease, frequent and severe infections, unexplained tiredness, headaches, dizziness, extreme weight loss, frequent diarrhea, night sweats, frequent fever and dry coughing. Most people can also experience discolored purplish growths on the skin, unexplainable bleeding, abnormal skin rashes, extreme numbness on the muscles, paralysis and mental confusion.
How does HIV spread?
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.
A healthy immune system and optimum physical strength is maintained by an adequate nutritional status of the body. Unexpected loss of weight, loss of appetite, low dietary intake due to ulcers in the mouth and an altered rate of metabolism are common in HIV infected individuals. It is essential to regain the lost weight and the muscle mass in the early stages of the infection since the correction of nutritional status becomes difficult with the progression of the disease.
Certain measures like definitive anti-retroviral therapy combined with the treatment of opportunistic infections like TB, Candidiasis and other bacterial infections along with the provision of nutritive aid in the form of a balanced diet, regular physical activity, and use of appetite stimulants help in improving the general health of the body. A widespread deficiency of essential nutrition and micro-nutrients is observed among the HIV-infected people. Supplement composition, treatment given and characteristics of the patient vary widely across researches done.
The World Health Organization (WHO) recommends an intake of 1 Recommended Dietary Allowance (RDA) of each of the required micronutrient. This may sometimes require taking supplements of the micronutrients.There is a direct relation between HIV infection and malnutrition, where each makes an individual more susceptible to the other. HIV infection can increase the severity of malnutrition and vice versa.
Malnutrition can worsen the progression of HIV, which further in turn further worsens malnutrition. This is an unending cycle, until an intervention occurs. An increase in the nutritional needs, poor intake of nutrients and increased losses through vomiting and diarrhea lead to a poor nutritional status.
These diseases further strain the immune system and cause disease progression. It is important to know that nutrition acts as an adjunct to appropriate anti-retroviral therapy. Multivitamins, supplements of beta-carotene and Vitamin A, zinc, selenium and probiotics help in maintaining optimum nutrition in an HIV infected individual. Anabolic agents and appetite stimulants help in overcoming muscle wasting. Nutrient-dense meals consumed in small portions at frequent intervals are better accepted in the body rather than the regular 3 large meals.
Water consumption during meals should be avoided, to prevent a feeling of fullness in the stomach due to water rather than food. A healthy and balanced nutrition is essential in living a normal life. Maintaining the lost weight and stamina of the body, replacement of the lost nutrients, vitamins and minerals aid in improvement of the immune function. Proper nutrition can delay progression of the HIV infection into AIDS disease by improving the response of the body to the treatment given.
How did we achieve HIV-Free Generation?
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:
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.
HIV infection is the causative factor of the acquired immune deficiency syndrome (AIDS). Worldwide research is being conducted and treatment strategies are being formulated to combat this fatal disease. Fighting HIV is not an easy task, since the disease cannot be completely reversed. However, worldwide use of anti-retroviral therapy has helped in controlling the spread and transmission of disease. Use of medications, regular screening and close contact with caregivers and physicians is necessary for proper management of the disease. Despite, available treatment options, a difficult obstacle that arises before or during the treatment is drug resistance.
Drugs are aimed at targeting the disease-causing pathogens like bacteria and viruses. These pathogens, over a period of time, develop the ability to acquire resistance against the targeted drugs. The pathogens continue multiplying despite the presence of the drug in the system. In today’s scenario, the potent drug combination of anti-retroviral therapy (ARV) has been successful in remarkably reducing HIV-related mortality. However, an increased emergence of resistance to the drug therapy is concerning.
Amongst the various drug classes available in the ARV, no drug is resistance-proof. The drugs belonging to the same class have a similar mechanism of action against the virus. So resistance developed against a particular class of drug inevitably leads to resistance against all the other drugs belonging to that class. An individual with HIV infection may have one or more drug-resistant mutations, which makes the person less sensitive to one or more anti-retroviral drugs. When the replication of virus in the system is not suppressed fully, a resistance towards it develops.
Non-compliance of the ARV results in resistance. Resistant viruses can spread the infection and affect ARV therapy. Drug resistance is usually attributed to inadequate adherence to the regimen. But in some cases, strict adherence to the drug is seen, yet there is a presence of resistance due to poor absorption. This implies that since the drug is not getting adequately absorbed in the body, it is unable to prevent the replication thus leading to drug resistance.
Anti-retroviral treatment is aimed at limiting the replication of HIV in the body. Various drug classes target different steps of replication, which stops further replicating and infecting of the cells. The nucleo-capsid contains viral genome and three enzymes vital to HIV life cycle:
Drugs targeted on these steps are as follows
The emergence of drug resistance can be managed by evaluation of drug absorption and ensure strict adherence to the drug schedule. Genotype tests can be done to look for drug-resistant mutations in genes. Phenotype tests are done for measuring the ability of a virus in an individual to undergo replication in different drug concentrations. A successfully administered and effectively acted first-line drug treatment, preferably a 3-drug combination, reduces the chances of drug resistance in future.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Anybody can get infected with human immunodeficiency virus (HIV) irrespective of his or her age, sex, race, and religion. The infected person can transmit the infection even when the signs and symptoms are not evident. So, let’s see the possible reasons for which one can get infected.
First, let us know which fluids in the body can contain HIV (when the person is infected):
Other body fluids which don’t contain HIV are:
The ways for transmission of HIV infection are:
In order of higher to lower possibility of transmission: When homosexual men have unprotected anal intercourse. When heterosexual men and women have unprotected vaginal, anal, or oral sex. Sharing sexual toys and objects with an infected person. Having another sexually transmitted infection which produces open sores or cuts on the genitals through which HIV can enter in the body. When the person providing oral sex has mouth ulcers, sores, or bleeding gums. Lack of circumcision in men as studies have demonstrated that circumcised men have relatively lower chances to get HIV infection. Using drugs to enhance sex, as this can lead to sex with multiple partners, unprotected sex, or using same needles or syringes for drug administration and traumatic sex.
HIV does not transmit through:
In case you have a concern or query you can always consult an expert & get answers to your questions!
What is HIV AIDS?
Where does HIV arise from?
How does HIV spread?