 |
HIV is the virus that causes AIDS. There are medical treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. In 1983, scientists discovered that HIV (human immunodeficiency virus) is the virus that causes AIDS. As with other diseases, early detection of infection allows for more options for treatment and preventative healthcare.
Causes
Symptoms
Exams and Tests
Diagnosis
Treatment
Managing HIV/AIDS
Self-Care for HIV/AIDS Patients
Caring for those with HIV/AIDS
Causes of HIV/AIDS
AIDS is caused by infection with a virus called human immunodeficiency virus (HIV). This virus is passed from one person to another through blood-to-blood and sexual contact. In addition, infected pregnant women can pass HIV to their babies during pregnancy or delivery, as well as through breastfeeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.
How does HIV cause AIDS?
HIV destroys a certain kind of blood cell (CD4+ T cells) that is crucial to the normal function of the human immune system. In fact, loss of these cells in people with HIV is an extremely powerful predictor of the development of AIDS. Studies of thousands of people have revealed that most people infected with HIV carry the virus for years before enough damage is done to the immune system for AIDS to develop. However, sensitive tests have shown a strong connection between the amount of HIV in the blood and the decline in CD4+ T cells and the development of AIDS. Reducing the amount of virus in the body with antiretroviral therapies can dramatically slow the destruction of a person's immune system.
What is AIDS?
AIDS stands for Acquired Immunodeficiency Syndrome.
Acquired - means that the disease is not hereditary but develops after birth from contact with a disease causing agent (in this case, HIV).
Immunodeficiency - means that the disease is characterized by a weakening of the immune system.
Syndrome - refers to a group of symptoms that collectively indicate or characterize a disease. In the case of AIDS, this can include the development of certain infections and/or cancers, as well as a decrease in the number of certain cells in a person's immune system.
A diagnosis of AIDS is made by a physician using specific clinical or laboratory standards.
What is HIV?
HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another when infected blood, semen or vaginal secretions come in contact with an uninfected person's broken skin or mucous membranes.* In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breastfeeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.
*A mucous membrane is wet, thin tissue found in certain openings to the human body. These can include the mouth, eyes, nose, vagina, rectum and opening of the penis.
Where did HIV come from?
The earliest known case of HIV-1 in a human was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggested that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.
We know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York among a number of male patients who had sex with other men. These were conditions not usually found in people with healthy immune systems.
In 1982 public health officials began to use the term "acquired immunodeficiency syndrome," or AIDS, to describe the occurrences of opportunistic infections, Kaposi's sarcoma (a kind of cancer) and Pneumocystis carinii pneumonia in previously healthy people. Formal tracking (surveillance) of AIDS cases began that year in the United States.
In 1983, scientists discovered the virus that causes AIDS. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy-associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).
For many years scientists theorized as to the origins of HIV and how it appeared in the human population, most believing that HIV originated in other primates. Then in 1999, an international team of researchers reported that they had discovered the origins of HIV-1, the predominant strain of HIV in the developed world. A subspecies of chimpanzees native to west equatorial Africa had been identified as the original source of the virus. The researchers believe that HIV-1 was introduced into the human population when hunters became exposed to infected blood.
How long does it take for HIV to cause AIDS?
Prior to 1996, scientists estimated that about half the people with HIV would develop AIDS within 10 years after becoming infected. This time varied greatly from person to person and depended on many factors, including a person's health status and their health-related behaviors.
Since 1996, the introduction of powerful antiretroviral therapies has dramatically changed the progression time between HIV infection and the development of AIDS. There are also other medical treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. Because of these advances in drug therapies and other medical treatments, estimates of how many people will develop AIDS and how soon are being recalculated, revised or are currently under study.
As with other diseases, early detection of infection allows for more options for treatment and preventative healthcare.
Source: Centers For Disease Control
Symptoms of HIV/AIDS
The symptoms of AIDS are similar to the symptoms of many other illnesses. A medical test is the only way to determine if a person is infected with the HIV virus.
The only way to know if you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years. The following may be warning signs of infection with HIV:
- Rapid weight loss
- Dry cough
- Recurring fever or profuse night sweats
- Profound and unexplained fatigue
- Swollen lymph glands in the armpits, groin or neck
- Diarrhea that lasts for more than a week
- White spots or unusual blemishes on the tongue, in the mouth or in the throat
- Pneumonia
- Red, brown, pink or purplish blotches on or under the skin or inside the mouth, nose or eyelids
- Memory loss, depression and other neurological disorders
However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again, the only way to determine whether you are infected is to be tested for HIV infection.
Similarly, you cannot rely on symptoms to establish that a person has AIDS. The symptoms of AIDS are similar to the symptoms of many other illnesses. AIDS is a medical diagnosis made by a doctor based on specific criteria established by the CDC.
Source: Centers for Disease Control
Exams and Tests for HIV/AIDS
There are several ways to test for the presence of the HIV virus. Depending on which test you chose, it may take anywhere from an hour to a few days. Ask your doctor which test might be best for you.
In most cases the EIA (enzyme immunoassay), performed on blood drawn from a vein, is the standard screening test used to detect the presence of antibodies to HIV. A reactive EIA must be used with a follow-up confirmatory test such as the Western Blot to make a positive diagnosis.
There are EIA tests that use other body fluids to identify antibodies to HIV. These include:
- Oral Fluid Tests - use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test and requires a follow-up confirmatory Western Blot using the same oral fluid sample.
- Urine Tests - use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. Reactive test results must be confirmed with a blood-based Western Blot.
Home testing kits These kits can be purchased in most pharmacies and via the Internet and involve no actual testing of the blood by the person using the kit. The only "at-home" components of the testing process involve the collection of a small sample of blood using a finger stick and the receipt of the results over the phone.
First, the blood sample is mailed to the manufacturer for a standard EIA test. The consumer must call a phone number several days later to receive the results and be offered the choice of speaking to a trained counselor. A positive result must be confirmed with a blood-based Western Blot (which cannot be done with a home-based test kit).
Rapid tests
A rapid test is a screening test that produces very quick results, in approximately 20-60 minutes. In comparison, results from the other more commonly used HIV antibody screening test, the enzyme immunoassay (EIA), are not available for several days to a few weeks.
Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made.
There are other tests that are used in screening the blood supply and for rare cases when standard tests are unable to detect antibodies to HIV.
Four rapid HIV tests have been approved by the Food and Drug Administration (FDA) for use in the United States.
- The OraQuick Rapid HIV-1 Antibody Test was approved November 7, 2002, for use by trained personnel in the diagnosis of HIV infection. OraQuick is a simple, rapid test that can detect antibodies to HIV in finger-stick whole-blood specimens and provide results in as little as 20 minutes. OraQuick is also the only rapid test approved for oral fluid collection using a mouth swab.
- Reveal, a second FDA-approved moderate-complexity rapid HIV test, remains available in the United States for use with serum or plasma specimens. These rapid tests are considered to be just as accurate as the commonly used EIA.
- Uni-Gold HIV-1 antibody test uses a blood specimen to provide test results within 10 minutes.
- Multispot HIV-1/2 rapid test also provides results in 10 minutes.
Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests (including the EIA), a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be given. How long should one wait to get tested?
The tests commonly used to detect HIV infection are actually looking for antibodies produced by an individual's immune system when they are exposed to HIV. Most people will develop detectable antibodies within two to eight weeks (the average is 25 days). Ninety seven percent will develop antibodies in the first three months following the time of their infection. In very rare cases, it can take up to six months to develop antibodies to HIV.
Where can I get tested for HIV infection?
Many places provide testing for HIV infection. Common testing locations include local health departments, clinics, offices of private doctors, hospitals and sites specifically set up to provide HIV testing. To find a testing site near you, visit the National HIV Testing Resources website. at (link to http://www.hivtest.org)
Between the time of a possible exposure and the receipt of test results, individuals should consider abstaining from sexual contact with others or use condoms and/or dental dams during all sexual encounters.
It is important to seek testing at a place that also provides counseling about HIV prevention and AIDS. Counselors can answer any questions you might have about risky behaviors and ways you can protect yourself and others in the future. In addition, they can help you understand the meaning of the test results and describe what HIV/AIDS-related resources are available in the local area.
Consumer-controlled test kits (popularly known as "home test kits") were first licensed in 1997. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access HIV-1 Test System is approved by the Food and Drug Administration. (The accuracy of other home test kits cannot be verified.) The Home Access HIV-1 Test System can be found at most local drug stores. The testing procedure involves pricking a finger with a special device, placing drops of blood on a specially treated card and then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning in for the results. Callers may speak to a counselor before taking the test, while waiting for the test result, and when the results are given. All individuals receiving a positive test result are provided referrals for a follow-up confirmatory test, as well as information and resources on treatment and support services.
Source: Centers for Disease Control
HIV/AIDS Diagnosis
If you suspect you have been exposed the HIV virus, getting tested and diagnosed is not only important to your health but vital in helping prevent the spreading of HIV to others.
If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:
- See a licensed healthcare provider, even if you do not feel sick. Try to find a healthcare provider who has experience in treating HIV. There are now many medications to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.
- Have a TB (tuberculosis) test. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
- Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as cocaine) can weaken your immune system. There are programs available that can help you reduce or stop using these substances.
There is much you can do to stay healthy. Learn all that you can about maintaining good health. Not having (abstaining from) sex is the most effective way to avoid transmitting HIV to others. If you choose to have sex, use a latex condom to help protect your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.
Source: Centers for Disease Control
HIV/AIDS Treatment
Seeking treatment for your HIV/AIDS condition is a very important step to take control of your condition. The National Institutes of Health support studies designed to further extend and improve the quality of life of those infected with HIV.
CDC recommends that you be in the care of a licensed health care provider, preferably one with experience treating people living with HIV. Your health care provider can assist you with treatment information and guidance.
Not having (abstaining from) sex is the most effective way to avoid transmitting HIV to others. If you choose to have sex, use a latex condom to help protect your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not perfect, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.
National Institutes of Health reports
When AIDS was first recognized in 1981, patients with the disease were unlikely to live longer than a year or two. Since then, scientists have developed an effective arsenal of drugs that can help many people infected with HIV (human immunodeficiency virus) live longer and healthier lives. The treatment and prevention of HIV is a high priority for the National Institute of Allergy and Infectious Diseases (NIAID). Research supported by NIAID has greatly advanced our understanding of HIV and how it causes AIDS. This knowledge provides the foundation for NIAID's AIDS research effort and continues to support studies designed to further extend and improve the quality of life of those infected with HIV.
What drugs have been developed for HIV infection?
Twenty drugs have been approved for treating individuals with HIV infection. They are called antiretroviral drugs because they attack HIV, which is a retrovirus.
Once inside the cell, HIV uses specific enzymes to survive. The first approved classes of antiretroviral drugs that were approved work by interfering with the virus' ability to use these enzymes. They fall into two categories:
- Reverse transcriptase (RT) inhibitors. RT inhibitors interfere with an enzyme called reverse transcriptase or RT that HIV needs to make copies of itself. There are two main types of RT inhibitors, and they each work differently.
- Nucleoside/nucleotide drugs. These drugs provide faulty DNA building blocks, halting the DNA chain that the virus uses to make copies of itself.
Non-nucleoside RT inhibitors bind RT so the virus cannot carry out its copying function.
Protease inhibitors (PI). Protease Inhibitors interfere with the protease enzyme that HIV uses to produce infectious viral particles.
The newest class of antiretroviral drugs works by changing the shape of the gp41 envelope protein surrounding HIV. This class of drug is called fusion inhibitors.
Fusion inhibitors interfere with the virus' ability to fuse with and enter the host cell.
Source: Centers for Disease Control
Managing HIV/AIDS
People infected with the HIV virus should try to maintain a healthy diet and fitness schedule. If you are being treated for HIV/AIDS, it is important to maintain your strength through a combination of a healthy diet and fitness routine.
Persons with Acquired Immunodeficiency Syndrome (AIDS) are susceptible to many types of infection including illness from foodborne pathogens. They are at higher risk than are otherwise healthy individuals for severe illness or death. Affected persons must be especially vigilant when handling and cooking foods. The recommendations provided here are designed to help prevent bacterial foodborne illness.
When the AIDS virus damages or destroys the body's immune system, the person becomes more vulnerable to infection by foodborne bacteria and other pathogens. For example, the common pneumonia, which is caused by a bacterial infection of the lungs, can occur in any individual but occurs much more frequently in persons with AIDS. In addition, when pneumonia strikes a person with AIDS, it causes a more severe illness and is thus more dangerous.
What types of food-borne bacteria are of particular concern to people with AIDS?
Certain types of food-borne illness are caused by bacteria that can grow on food. The bacteria can infect humans when the food is improperly handled or inadequately cooked. As with many other types of infections, persons with AIDS are at higher risk for developing severe illness or dying from these illnesses. Three types of bacteria are of particular concern for persons with AIDS: Salmonella, Campylobacter jejuni and Listeria monocytogenes.
For information on proper handling and preparation of food visit the USDA website.
Source: Food Safety and Inspection Service United States Department of Agriculture - Revised May 2000
Self-Care for HIV/AIDS Patients
People living with AIDS should take care of themselves as much as they can for as long as they can. They need to be and feel as independent as possible. They need to control their own schedules, make their own decisions and do what they want to do as much as they are able.
They should develop their own exercise program and eating plan. In addition to regular visits to the doctor, many people with AIDS work at staying healthy by eating properly, sleeping regularly, doing physical exercises, praying or meditating, or other things.
An exercise program can help maintain weight and muscle tone and can make a person feel better if it is tailored to what the person can do. Well-balanced, good-tasting meals help people feel good, give them energy, and help their body fight illness. People with HIV infection are better off if they don't drink alcoholic drinks, smoke or use illegal drugs.
Keeping up-to-date on new treatments and understanding what to expect from treatments the person is taking are also important.
Source: Centers for Disease Control
Caring For Those With HIV/AIDS
People living with AIDS should take care of themselves as much as they can for as long as they can. They need to be and feel as independent as possible. They need to control their own schedules, make their own decisions, and do what they want to do as much as they are able. They should develop their own exercise program and eating plan. In addition to regular visits to the doctor, many people with AIDS work at staying healthy by eating properly, sleeping regularly, doing physical exercises, praying or meditating, or other things. If the person you care caring for finds something that helps them, encourage them to keep it up. An exercise program can help maintain weight and muscle tone and can make a person feel better if it is tailored to what the person can do.
Well-balanced, good-tasting meals help people feel good, give them energy and help their body fight illness. People with HIV infection are better off if they don't drink alcoholic drinks, smoke, or use illegal drugs. Keeping up-to-date on new treatments and understanding what to expect from treatments the person is taking are also important.
There are some simple things you can do to help someone with AIDS feel comfortable at home:
- Respect their independence and privacy.
- Give them control as much as possible. Ask to enter their room, ask permission to sit with them, etc., asking "Can I help you with that?" lets them keep control.
- Ask them what you can do to make them comfortable. Many people feel shy about asking for help, especially help with things like using the toilet, bathing, shaving, eating and dressing.
- Keep the home clean and looking bright and cheerful.
- Let the person with AIDS stay in a room that is near a bathroom.
- Leave tissues, towels, a trash basket, extra blankets, and other things the person might need close by so these things can be reached from the bed or chair.
- If the person you care caring for has to spend most of their time in bed, be sure to help them change position often. If possible, a person with AIDS should get out of bed as often as they can. A nurse can show you how to help someone move from a bed to a chair without hurting yourself or them. This helps prevent stiff joints, bedsores and some kinds of pneumonia. They may also need your help to turn over or to adjust the pillows or blankets. A medical "trapeze" over the bed can help the person shift position by themselves if they are strong enough. If they are so weak they can't turn over, have a nurse show you how to use a sheet to help roll the person in bed from side to side. Usually a person in bed needs to change position at least every four hours.
Bedsores
Bedsores or other broken skin can be serious problems for someone with AIDS. In addition to changing position in bed often, to help keep skin healthy, put extra-soft material (sheepskin, "egg crate" foam or water mattresses) under the person, keep the sheets dry and free from wrinkles, and massage the back and other parts of the body (like hips, elbows, and ankles) that press down on the bed. Report any red or broken areas on the skin to the doctor or nurse right away.
Exercises
Even in bed, a person can do simple arm, hard, leg and foot exercises. These are usually called range-of-motion exercises. These exercises help prevent stiff, sore points and help keep the blood moving. A doctor, nurse, or physical therapist can show you how to help.
Breathing
If someone is having trouble breathing, sitting them up may help. Raise the head of a hospital-type bed or use extra pillows or some other soft back support. If they have severe trouble breathing, they need to see a doctor.
Comfort
A good back rub can help a person relax as well as help their circulation. A nurse, physical therapist, or book on massage can give you some tips on how to give a good back rub. Put books, remote controls, water, tissues, and a bell to call for help within easy reach. If the person can't get up, put a urinal or bedpan within easy reach.
SOURCE: CDC - National Center for HIV, STD and TB Prevention
For more information on caring for someone with AIDS at home visit:
|
|