AIDS

By: Joel Jose Punnakottil. University of Houston Clear Lake BIOL.3335.01

Introduction
Acquired immune deficiency syndrome (aids) is a disease of the human immune system caused by infection with human immune deficiency virus (HIV). The illness alters the immune system, making a person more vulnerable to infections and diseases. Health conditions worsen as the disease progresses (1). Both the virus and the disease are often referred together as HIV/AIDS. People with HIV have what is known as HIV infection. AIDS is the late stage of HIV infection. The development of numerous opportunistic infections in an aids patient can ultimately lead to death.

Epidemiology
HIV is a retrovirus that infects the vital organs of the human immune system. The disease progresses in the absence of anti retroviral drugs. The rate of disease progression varies widely between individuals and depends on many factors such as (age of patient, bodys ability to defend against HIV, access to health care, existence of coexisting infections, infected persons genetic inheritance, resistance to certain strains of HIV). (2)

Modes of transmission:

HIV is found in human body fluids such as vaginal fluids, rectal mucous, blood, semen, preseminal fluid, breast milk. If any of these fluids enter the body, a person can become infected with HIV. (4) Sexual transmission: It can happen when there is contact with infected sexual secretions (rectal, genital, or oral mucous membranes). This can happen while having unprotected sex including vaginal, oral, and anal sex or sharing toys with someone infected with HIV. Perinatal transmission: The mother can pass the infection onto her child during child birth, pregnancy and also through breast feeding. Blood transmission: The risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries due to meticulous screening and precautions (3). HIV easily spreads among drug users, sharing and reusing syringes contaminated with HIV infected blood. Individuals who give and receive tattoos and piercings are also at risk and should be careful (3). Signs and symptoms of HIV/AIDS AIDS is the late stage of HIV infection, when a persons immune system is severely damaged and has difficulty fighting diseases and certain cancers. Before the development of certain medications, people with HIV could progress to AIDS in just a few years (4). With the development of anti retroviral drugs people can live longer even decades- with HIV before they develop AIDS. Many people with HIV have no symptoms for several years. Other people may develop symptoms similar to flu, usually 2 to 6 weeks after catching the virus. Symptoms can last up to four weeks (6).

Symptoms of early infection include fever, chills, joint pain, muscle ache, sore throat, sweats (particularly at nights), enlarged glands, a red rash, tiredness, weakness, weight loss. Asymptomatic HIV infections: after the initial symptoms disappear, there will not be any further symptoms for many years. During this time the virus carries on developing and damages the immune system (3). This process can take up to 10 years. The infected person will experience no symptoms, feel well, and appear healthy. LATE stage HIV infection: If left untreated, HIV weakens the ability to fight infection. The person becomes vulnerable to serious illnesses. This stage of infection is known as AIDS. Signs include blurred vision, diarrhea (which is usually persistent or chronic), dry cough, fever above 37C lasting for weeks, permanent tiredness, shortness of breath, weight loss, white spots on the tongue or mouth. During late stage HIV infection the risk of developing a life threatening illness is much greater (2). Examples include esophagitis, meningitis, subacute encephalitis, peripheral neuropathy, pneumonia, cancer such as Kaposis sarcoma, lung cancer, lymphomas, toxoplasmosis, Tb etc (1).

Mortality and morbidity report:

HIV disease continues to be a serious health issue for parts of the world. Worldwide, there were about 2.5 million new cases of HIV in 2011. About 34.2 million people are living with HIV around the world (4). In 2010, there were about 1.8 million deaths in persons with AIDS, and nearly 30 million people with AIDS have died worldwide since the epidemic began. At the end of 2009, an estimated 1,148,200 persons aged 13 and older were living with HIV infection in the United States, including 207,600 (18.1%) persons whose infections had not been diagnosed (4).

Incidence is the number of new HIV infections that occur during a given year. CDC estimates that approximately 50,000 people in the United States are newly infected with HIV each year. In 2010 (the most recent year that data are available), there were an estimated 47,500 new HIV infections.a Nearly two thirds of these new infections occurred in gay and bisexual men (4). Black/African American men and women were also highly affected and were estimated to have an HIV incidence rate that was almost 8 times as high as the incidence rate among whites (2).

Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6203a7.htm?s_cid=mm6203a7_e From 2000 to 2010, HIV disease death rates decreased approximately 70% for both black and white men aged 2544 years. Rates decreased by 53% for black men aged 4554 years and 34% for white men aged 4554 years (6). Throughout the period, HIV disease death rates for black men were at least six times the rates for white men. The estimated number of AIDS diagnoses in the United States, by race or ethnicity in the year 2011 is as follows: African American (15,958), White (8,304), Hispanic/Latino (6,355). In 2011, the estimated number of persons diagnosed

with AIDS in the United States was 32,052. Of these, 24,088 AIDS diagnoses were among adult and adolescent males, 7,949 were among adult and adolescent females, and 15 diagnoses were among children aged less than 13 years (5).

Prevention and Control

HIV transmission can occur when bodily fluids containing HIV from an infected person enter the body of an uninfected person. HIV can enter the body through: lining of the anus or rectum, lining of the vagina or cervix, opening to the penis, mouth that has sores or bleeding gums, cuts and sores, use of infected needles (syringes).Unprotected sex can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV (2). Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C .Strategies such as needle-exchange programs are used to reduce the infections caused by drug abuse. Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood (3). At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. During Pregnancy Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby (2). Precautions have to be taken to protect the babys health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected (3).

Bibliography:
1. HIV/AIDS. (2013, November 14). In Wikipedia, The Free Encyclopedia. Retrieved 16:40, November 21, 2013, from http://en.wikipedia.org/w/index.php?title=HIV/AIDS&oldid=581590788 2. Management of HIV/AIDS. (2013, November 17). In Wikipedia, The Free Encyclopedia. Retrieved 16:41, November 21, 2013, fromhttp://en.wikipedia.org/w/index.php?title=Management_of_HIV/AIDS&oldid=5820 42506 3. HIV/AIDS in the United States. (2013, October 29). In Wikipedia, The Free Encyclopedia. Retrieved 16:41, November 21, 2013, fromhttp://en.wikipedia.org/w/index.php?title=HIV/AIDS_in_the_United_States&oldid= 579195606 4. AIDS Drug Assistance Programs. (2011, September 13). In Wikipedia, The Free Encyclopedia. Retrieved 16:43, November 21, 2013, fromhttp://en.wikipedia.org/w/index.php?title=AIDS_Drug_Assistance_Programs&oldid =450255405 5. http://www.cdc.gov/hiv/statistics/basics/index.html 6. http://www.cdc.gov/hiv/statistics/basics/index.html