HIV INFECTION AND AIDS

Abstract
Retroviruses are enveloped viruses, with an RNA genome. The name is derived from the fact that
the virus particle contains an RNA-dependent DNA Polymerase (Reverse transcriptase). This
enzyme converts the RNA genome into DNA, which then integrates into the host chromosomal
DNA. The reverse transcriptase is highly error prone and rapid genetic variation is a feature of
this group. The most common retrovirus in human is HIV (human immunodeficiency virus).
Since 1981, the first cases presented with immune deficiency syndrome were detected in the
United State of America. Several years after that, in 1984 it was known that the syndrome was
caused by HIV infection. HIV targeted cells who carry CD4 receptor molecule as the main
receptor, though other co-receptor is also needed for HIV to infect the cells, such as CCR5 and
CXCR4. Transmissions: Commonly through sexual transmission, Blood transfusion, Mother to
infant and rarely accidental occupational exposure
Primary HIV infection may present with the clinical picture of a febrile illness approximately 2
4 weeks after exposure. The symptoms may include skin rash, myalgia, fatigue, sore throat,
diarrhoea, lymphadenopathy, hepatosplenomegaly and, rarely, neurological symptoms. While
this seroconversion illness may occur in up to 7080% of individuals, it is often not viewed as
serious or related to HIV infection, due in part to its self-limited course. Primary HIV infection
seldom results in presentation to health care settings.
In line with the course of time of infection, when the immune system becomes progressively
damaged by HIV, reflected by an increased of HIV viral load and a steady decline of the CD4
lymphocyte count to 200 350 cells/L, the patient may develop symptoms that are commonly
associated with HIV disease. These include persistent fever, night sweats, significant weight loss,
oral thrush, herpes zoster and chronic diarrhoea. A range of opportunistic infection will occur
.Thrombocytopenia and lymphopenia may be present on blood testing.
It should be noted that any organ system can become involved in opportunistic infections and
the clinical presentation of acquired immunodeficiency syndrome (AIDS) is therefore highly
variable. Please see WHO Classification for disease staging and also CDC classification of HIV
infection based on laboratory examination and the list of diseases referred as AIDS defining

illnesses (ADI). So, infection with HIV will covered a very wide range, from asymptomatic to
severe clinical manifestation of opportunistic infection.
Diagnosis of HIV infection can be made if there are risk factors of HIV infection, clinical
manifestation of disease mentioned above, especially in late stage will presented with AIDS
defining illness and laboratory test positive for HIV-antibody.
Treatment to HIV/AIDS, include treatment to the specific manifestation of opportunistic
infection, antiretroviral treatment, supportive treatment, symptomaticdrugs, supportive
counseling, psychotreatment.