HIV/AIDS: An Overview HCA 24O Health and Disease Instructor: Pamela Williams By: Marilyn Reeves July 17,

2011

The causative agent of AIDS is the human immunodeficiency virus, which is called HIV, a retrovirus; that is it carries its genetic information as RNA rather than DNA. The virus infects primarily helper T4 lymphocytes. The virus replicates within these lymphocytes, killing them and spreading to others. These lymphocytes normally activate B-cell lynphocytes; thus. The bodys immune response is crippled, and the body is susceptible to infections and tumors that healthy immune system could easily control. HIV is transmitted by contaminated body fluids, semen, vaginal secretions, and breast milk. This means HIV is transmitted through unprotected anal, oral, or vaginal intercourse, birth, breastfeeding, and addicts sharing needles while doing drugs. Before full blown Aids develops the virus destroys the immune system of the HIV- some positive individual. Before the law required testing of donated blood transfusions, some recipients of blood transfusions developed AIDS. Blood donors do not contract the virus from giving blood because a new needle is used with each donor; there is a long and variable latent period of two to eight years between HIV infection and the development of full-blown AIDS. Once infected, the individual is infected for life. The late stage of HIV disease is Aids. The definition of Aids is a chronic, potentially lifethreatening condition caused by damaging the immune system. Aids is an acquired immunodeficiency syndrome caused by HIV. During the late stage individuals immune systems are severely damaged, they most likely will start experiencing what is called opportunistic infections. They are called opportunistic infections because they are caused by organisms that do not normally induce illness in people with normal immune systems, but take the opportunity to

flourish in people with compromised immune systems. Some of the most common opportunistic infections include Pneumocystis carinii pneumonia, Mycobactreium vium complex disease, cytomegalovirus, toxoplasmosis, and candidiasis. Before developing these more serious illnesses an individual may experience problems such as, chronic oral or vaginal thrush (a fungal rash or spots), recurrent herpes blisters on the mouth (cold sores), or genitals, ongoing fevers, persistent diarrhea, and significant weight loss. Some individuals may become quite ill even if they have not yet been diagnosed with AIDS. The quick answer to the difference between HIV and AIDS is HIV is a virus and AIDS is a definition. HIV simply means you are infected with the virus. An individual with AIDS is when the numbers of specific types of cells of their immune system drop below a certain level, or when they develop one of the opportunistic infections (Bosky, Elizabeth, PH. D., About.com Guide). HIV infection affects the innate as well as the acquired immune systems. Critically, it changes the function of macrophages, which link the innate and acquired responses through ability to present antigen to CD4 T lymphocytes. Patients with HIV infection have a reduced capacity to deal with subsequent pathogen exposure and many suffer from chronic pulmonary infections. Although there are two subspecies of HIV most infection and disease are due to HIV1. The most obvious immunological problem caused by the virus is the gradual loss of CD4 T lymphocytes, but there are a number of other immunological abnormalities, including a wide range of defects in the innate immune system. The abnormalities in the innate immune function contribute to the lung pathology associated with HIV infection. These include down regulation of the normally continuous, no production by the lung epithelium or upregulation of no production by tissue macrophages, abnormalities in systemic and pulmonary glutathione metabolism and

alterations of macrophage function. Effects of HIV 1 on macrophages are of particular immunological importance as these cells link the innate and acquired immune systems via their ability to act as antigen-presenting cells. Antigen-presenting cell functioning is also dyregulated in HIV-1. Thus HIV induced defects in macrophage function have profound effects for both innate and specific immune resistance to pathogens in infected patients. In addition to altering healthy innate immune mechanisms certain primary defects in innate immunity predispose patients to a worse outcome with Hiv-1 infection. These include nullalleles of C4 associated with poor antibody responses to HIV-1 and rapid progression; homozgosity for loci conferring low serum levels of mannose-binding protein associated with increased HIV susceptibility and faster disease progression; polymorphisms of the tumor necrosis fact or promoter as that have do with differential rates of disease progression; a G-to-A substitution in the promoter of encoding the cx-chemokine stromal cell-derived factor, leading to accelerated progression of aids; mutations in B-chemokine receptors, which are associated with protection from infection and long-term nonprogression to aids. There are treatments that improve a patients quality of live as well as extending their life. One treatment is HIV antiretroviral drug treatment. This is the main type of treatment for HIV or Aids. It is not a cure, but it can stop people from being ill for many years. The treatment consist of drugs that have to be taken every day for the rest of a persons life. The aim of antiretroviral treatment is to keep the amount of HIV in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV might have caused already.

The drugs are most often referred to as: Antiretrovirals ARVs Anti-HIV or anti-Aids drugs Combination Therapy: Taking two or more antiretroviral drugs at a time: Taking a combination of three or more anti-HIV drugs is sometimes referred to as Highly Active Antiretroviral Therapy (HAART)

There is no vaccine for HIV infection and no cure for AIDS. H over it is possible to protect yourself and others from infection. This means you need to educate yourself about HIV and behavior that allows HIV-infected fluids; blood, semen, vaginal secretions, and breast milk into your body. 1. Use a new condom every time you have sex If you do not know the HIV status of you partner, use a new condom every time you have anal or vaginal sex. 2. Do not use dirty needles if you use drugs. Do not use the same needles someone else has used. Consider getting help for your addiction. 3. Tell your partners if you are HIV positive. They have the right to know and seek medical treatment.

4. If you are pregnant get medical care right away. Think about your baby. Providing a framework for Partnership and Action is the World Health Organization; Department of HIV/AIDS-Family and Community Health. They created the framework for partnership and action. The foundations for generating action to meet the daunting challenges posed by HIV/AIDS are clear policies, effective strategic planning and sound decision-making processes. These foundations help to create strong partnerships, to make the best use of human and financial resources, and to generate positive outcomes. The global community in general and health sector in particular now have an exceptional opportunity to redouble their efforts against a devastating global pandemic and to show what can be achieved through bold leadership and concerted effort. Four specific objectives have been identified: 1. To advise health ministrys on the core components of an effective healthsector response to HIV/AIDS; 2. To support health ministries in developing the policy, planning, prioritysetting, implementation and monitoring frameworks needed to generate such a response as part of overall national strategic plans; 3. To enhance and promote the comparative advantages, expertise and experience that health ministrys can contribute to national strategic planning for HIV/AIDS; 4. To help the health sector to meet the goals contained in the United Nations General Assembly Declaration of Commitment on HIV/AIDS.

RESOURCES; Sarah Howie, Robert Ramage, and Tim Hewson; INNATE IMMUNE SYSTEM DAMAGE IN HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 INFECTION The Stages of HIV Disease The Body www.thebody.com/content/art2506.html HIV/AIDS Treatment www.emedicinehealth.com/hivaids/page6_em Introduction to HIV and AIDS Treatment www.avert.org/treatment.htm Prevention www.mayoclinic.com/health/hiv-aids/DS000005/DSECTION=prevention Department of HIV/AIDS Family and Community Health WORLD HEALTH ORGANIZATION Mulvihill, M.L., Zelamn, M., Holdawat, P., Tompary, E., & Raymond, J. (2006) Instructors resource manual: Human diseases: A systemic approach (6th ed.) Upper Saddle River, NJ: Pearson Prentice Hall.