HIV/AIDS
December 1, is World’s AIDS Day. At the initiative of the World Health Organization, for the first time, this date was marked as World AIDS Day on December 1, 1988. At that time, around 7 million people were infected with HIV. In 5 years there were already 14 million, today more than 36.9 million people in the world are living with HIV (“Global Statistics”).
The first notice of new disease was placed in 1981 in the American weekly newspaper “Morbidity and Mortality Weekly Report”. According to some scientists the human immunodeficiency virus derived from green monkeys immunodeficiency virus. This virus, allocated from one species of African monkeys, is very similar in its genetic structure to the human immunodeficiency virus. Thus, the transfer could occur through the consumption of meat and blood of infected animals. Scientists have suggested that overcoming of the species barrier could occur due to mutations of monkey virus through radiation. According to other version stated by a number of scientists, HIV is artificially created virus. They claim that in 1969 the Pentagon has created bacteriological weapons, which could suppress the immune system of the human. There is a hypothesis that the virus was transmitted to a man during the development of polio vaccine by the American scientists from Philadelphia. However, the majority of scientists believe that AIDS was a new disease, the result of the changes in society at the intersection of 70-80s of the 20th century.
HIV infection is a long-term infection, which is caused by infection with human immunodeficiency virus. The causative agent of HIV belongs to a group of slow lentiviruses and a subgroup of retroviruses. The genetic program of a virus is coded in its RNA. In order for the cell to understand the command of the virus, it includes a special enzyme - reverse transcriptase, through which information from viral RNA goes to the cell of the DNA and directs it. The consequence of this mechanism is the construction of viral components that are mainly accumulated in blood cells, nervous system, and others. The amount of virus in the blood has a special term - viral load, it determines the state of the disease. Along with increasing of viral load control by the immune system does not work, that leads to the development of symptoms of the disease. The HIV is characterized by the progressing defeat of immune system of the person, which is shown by secondary infections, tumors, and other pathological manifestations. AIDS (Acquired Immune Deficiency Syndrome) is the last stage of the HIV (“Sex Never Gets Old”, 3). The pathogens of the HIV/AIDS is the human immunodeficiency virus, which affects blood cells, called CD4 lymphocytes which provide homeostasis of the human body and protect it from infectious diseases, development of malignant tumors and other illnesses. The HIV causes profound damage to the immune system and a person becomes vulnerable to various infections agents. The disease develops slowly, for 8 - 12 years and ends with a clinical picture of the AIDS. Unfortunately, by this time AIDS is an incurable disease.
The source of HIV are the infected people (patients and virus carriers) who are contagious throughout the whole life. The virus was detected in all patients’ biological fluids (blood, semen, vaginal mucus, saliva, tears, urine, sweat, breast milk). However, the greatest epidemiological value has its amount in the blood, semen, vaginal mucus and breast milk, through which the infection can be transmitted.
The HIV infection, like hepatitis B, C, D, can be transmitted only through certain mechanisms: during sexual intercourse with an HIV-infected person, the virus enters the body of a sexual partner through the mucous membrane of the genitals (vagina, penis), the rectum or the mouth; through blood, primarily through the use of common needles and syringes by intravenous administration of drugs as well as through contaminated with blood, unsterile medical instruments; unborn child can get the disease from an HIV-infected mother - infection occurs during pregnancy, childbirth, or breastfeeding. The probability of birth of the HIV-infected child is 20-45%. The use of drug therapy makes it possible to significantly reduce the risk of having an infected child. The sexual way of HIV infection – is the most common in the world. Historically, the situation occurred that the first victims of AIDS were men of homosexual orientation in developed countries, especially the United States, Canada, France, and only later, the epidemic swept heterosexual population. Unprotected (without a condom) sexual intercourses are more dangerous for women than for men. The risk of such infection is 0.3-0.5%. Prudent behavior regarding sexual relations and the usage of condoms, which should always be marked – "against infectious diseases", protect from infection through sex. The risk of infection through parenteral way fully depends on the concentration of virus in the blood and the dose that enters the body of a healthy person. Thus, when injecting narcotic substances, the risk is 1-10%, through blood transfusion up to 95-98%.
The main reason for the fast spread of HIV is that a long time after getting the disease the infected person do not feel signs of it while infecting his sexual partners and those with who he takes intravenous drugs with one needle. The clinical stage of HIV infection starts from the moment when a person becomes infected with HIV. The virus enters the cells, or macrophages, where it multiplies and then affects other cells. The virus affects not infected cells and violates their functions. Over time, the dysfunction of cells manifests as clinical symptoms. HIV symptoms begin with a primary infection and a brief acute illness followed by chronic disease, then months or years after the virus stay in the body his late manifestations are becoming AIDS. The disease is characterized by its irregular and unpredictable nature.
The first symptoms are shown in 3-8 weeks after the disease enters the body, the acute illness strikes the immune system of the HIV carrier, the first stage usually lasts 2-3 weeks and is characterized by symptoms such as fever, rash, joint pain, muscle pain, and sore throat. These symptoms may be poorly expressed and usually disappear after a while. Meanwhile, the virus is developing in the body of an infected person and the immune system responds to it by the production of antibodies to the virus. Usually, HIV antibodies can be detected in the blood in 6-26 weeks after infection. These antibodies, unlike antibodies to the majority of other microorganisms, are not capable of destroying the virus. Moreover, in some cases, these antibodies cannot be detected even after months or years after infection, but still these people can transmit the illness. After the postponed acute disease, the immune system functioning is sharply degraded, however, for a long time, patients usually have no symptoms. The asymptomatic period can last 8 - 10 years or more and then develops into AIDS. The infected people may have such symptoms of AIDS as swelled up glands, especially the area of the neck, groin, armpits, and this swelling can proceed without any obvious reason to it; the constant feeling of fatigue; night fever and profuse sweating; weight loss by 10% or more; chronic diarrhea (“HIV/AIDS”). Sometimes a set of these symptoms is called AIDS-related condition. Furthermore, such diseases as stomatitis candidiasis, herpes zoster, pulmonary tuberculosis, pneumonia and bacterial folliculitis, usually can be diagnosed before the possibility to discover AIDS in the blood, which indicates an increased risk of further diagnosing of the AIDS.
With the assistance of the National Institute of Allergy and Infectious Diseases (NIAID) scientists all over the world spend a huge amount of studies on HIV. All their efforts are focused on getting an HIV vaccine and new drugs to treat the disease and related pathologies. The scientists also are studying the exact mechanisms of HIV/AIDS damage to the immune system. These studies make it possible to define the exact target for the action of antiviral drugs and vaccines. Furthermore, NIAID supports research on the characteristics of the disease in people of different racial or ethnic origin (Peters et al). Scientists are analyzing and testing chemical barriers such as local microbicides that people can input in the vagina or rectum way to prevent the infection during sexual relations. Scientists all over the world are looking for other ways to prevent the spread of infection, for example by detecting and treating sexually transmitted diseases, agitating for safe sex lifestyles and preventing the spread of the illness from mothers of children.
Unfortunately, today there is no effective cure for AIDS, scientists developed the so-called antiretroviral drugs that affect the level of virus in the blood, reduce it and thereby greatly extend the lives of HIV-infected people. Indication for antiretroviral therapy is the stage of the disease and the laboratory parameters of its progression such as the number of CD4 and viral concentration or viral load in the blood (“Antiretroviral Therapy”). The main goal of treatment of HIV is the reduction of the quantity of a virus in the blood of the disease carrier for the longest term. Medicines that can permanently delay the progression of the disease differ in their mechanism of action and are divided into three groups: 1 - nucleoside analogs of reverse transcriptase - are compounds that prevent viral activity of the enzyme reverse transcriptase. 2 - Non-nucleoside reverse transcriptase inhibitors. 3 - The Protease Inhibitors these drugs affect different virus enzyme, protease and lead to the formation of viruses that are not capable of infecting new cells (“Treatments and drugs”). Numerous observation of patients with AIDS showed that a monotherapy contributes to the rapid formation of virus strains that have more aggressive properties. At the same time, the combination of drugs consisting of two reverse transcriptase inhibitors and one Protease Inhibitor leads to the slowing of the reproduction of the virus. Within two weeks after the start of comprehensive anti-virus treatment, the number of virus particles significantly decreases, and later, indicators of immune status improve. Now monotherapy applies only to HIV-positive pregnant women to prevent transmission to the baby.
The best and the cheapest way to prevent HIV infection are preventive means, the compliance, and application of which would eliminate risky moments of your life. The main tool of prevention is comprehensive knowledge about the disease, ways of transmission and factors that contribute to this. Thus, there is an opportunity to protect yourself, to reduce damage from HIV and drugs for the individual and society. Today, treatment, unfortunately, cannot lead to recovery, but it can bring you to the normal rhythm of life because it prevents virus replication and disease progression. Various treatment methods of AIDS have side effects. In order the treatment to be effective, it is forbidden to consume alcohol, drugs, and smoking. The one should join the group of HIV-positive people by using associations, centers, and more. HIV can affect anyone, so it is important to provide psychological support to HIV-infected individuals. A HIV-positive person has right to carry on his/her private life, to have friends, to get information, and education. Every person has the right to live!
Works Cited
“Antiretroviral Therapy to Reduce HIV Transmission”. National Institute of Allergy and
Infectious Diseases, U.S. Department of Health & Human Services. 2016. Web. Accessed 02 Apr 2016 at <https://www.niaid.nih.gov/topics/HIVAIDS/Research/prevention/Pages/art.aspx>
“HIV/AIDS”. World Health Organization. 2015. Web. Accessed 02 Apr 2016 at
<http://www.who.int/mediacentre/factsheets/fs360/en/>
“Global Statistics”. AIDS.gov, U.S. Department of Health & Human Services. 2015. Web.
Accessed 02 Apr 2016 at <https://www.aids.gov/hiv-aids-basics/hiv-aids-101/global-statistics/>
Peters, N. Kent, Dennis M Dixon, Steven M Holland, and Anthony S Fauci. “The Research
Agenda of the National Institute of Allergy and Infectious Diseases for Antimicrobial Resistance”. National Institute of Allergy and Infectious Diseases. 2007. Web. Accessed 02 Apr 2016 at <http://jid.oxfordjournals.org/content/197/8/1087.full#>
“Sex Never Gets Old”. State of New York, Department of Health. Web. Accessed 02 Apr
2016 at <https://www.health.ny.gov/publications/9102.pdf>
“Treatments and drugs”. Mayo Foundation for Medical Education and Research. 2015.
Web. Accessed 02 Apr 2016 at <http://www.mayoclinic.org/diseases-conditions/hiv-aids/basics/treatment/con-20013732>
