OTHER NAMES
acquired immune deficiency syndrome
DEFINITION
AIDS is caused by the HIV (Human Immunodeficiency Virus). AIDS is the final and most serious stage of HIV disease. It is characterized by signs and symptoms of severe immune deficiency. AIDS stands for acquired immune deficiency syndrome.
CAUSES, INCIDENCE, AND RISK FACTORS
This virus attacks the immune system and leaves the body vulnerable to a variety of life-threatening illnesses. These illnesses are often caused by common bacteria, yeast, and viruses that ordinarily do not cause disease.
HIV has been found in blood, semen, saliva, tears, nervous system tissue, breast milk, and female genital tract secretions; however, only blood, semen, female genital tract secretions, and breast milk have been proven to transmit infection to others. Transmission of the virus occurs through sexual contact including oral, vaginal, and anal sex; via blood through transfusions or needle sharing; and from a pregnant women to the ferns or a nursing mother to her baby. Other transmission methods are rare and include accidental needle injury, artificial insemination through donated semen, and kidney transplantation through the donated kidney.
The infection is NOT spread by casual contact such as hugging and touching, by inanimate objects such as dishes or toilet seats, or by mosquitoes. It is not transmitted TO a person who donates blood (although it can be transmitted from the blood to the person receiving the transfusion—this is why blood banks screen donors and test the blood thoroughly); it is also not transmitted TO a person who, for example, donates a kidney for transplantation.
AIDS is preceded by HIV infection, which may produce no symptoms for up to 10 years before a person is diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection and later, to advanced HIV diseases or AIDS. In a study of people infected with the HIV virus from 1977 through 1980, some have no signs or symptoms of HIV infection, and some have only enlarged lymph nodes. It is suspected that all persons infected with HIV will, given enough time, progress to AIDS; this theory has not been definitively proven.
PREVENTION
AIDS is a fatal, incurable, sexually-transmitted disease (STD). It is transmitted by both heterosexual and homosexual practices.
Some sexual practices, such as anal intercourse, carry higher risk of transmission than other sexual practices, such as vaginal
intercourse. Transmission occurs more readily from an infected man to a woman than from an infected woman to a man.
The second most common mode of transmission is by contact with infected blood. Sharing needles when using IV drugs is a major cause of HIV transmission. This is very common in some states.
As more women become infected with HIV, the incidence of ferns HIV infection is increasing. One in three infants bom to
HIV-infected women will be boru HIV positive. Some of these infants test positive only because of materual antibodies, and will
become negative by 15 months. Those that do not become negative are actually infected with the virus and will develop AIDS.
Breast feeding also transmits the infection to the infant. Mothers who are HIV positive should not breast feed.
acquired immune deficiency syndrome
DEFINITION
AIDS is caused by the HIV (Human Immunodeficiency Virus). AIDS is the final and most serious stage of HIV disease. It is characterized by signs and symptoms of severe immune deficiency. AIDS stands for acquired immune deficiency syndrome.
CAUSES, INCIDENCE, AND RISK FACTORS
This virus attacks the immune system and leaves the body vulnerable to a variety of life-threatening illnesses. These illnesses are often caused by common bacteria, yeast, and viruses that ordinarily do not cause disease.
HIV has been found in blood, semen, saliva, tears, nervous system tissue, breast milk, and female genital tract secretions; however, only blood, semen, female genital tract secretions, and breast milk have been proven to transmit infection to others. Transmission of the virus occurs through sexual contact including oral, vaginal, and anal sex; via blood through transfusions or needle sharing; and from a pregnant women to the ferns or a nursing mother to her baby. Other transmission methods are rare and include accidental needle injury, artificial insemination through donated semen, and kidney transplantation through the donated kidney.
The infection is NOT spread by casual contact such as hugging and touching, by inanimate objects such as dishes or toilet seats, or by mosquitoes. It is not transmitted TO a person who donates blood (although it can be transmitted from the blood to the person receiving the transfusion—this is why blood banks screen donors and test the blood thoroughly); it is also not transmitted TO a person who, for example, donates a kidney for transplantation.
AIDS is preceded by HIV infection, which may produce no symptoms for up to 10 years before a person is diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection and later, to advanced HIV diseases or AIDS. In a study of people infected with the HIV virus from 1977 through 1980, some have no signs or symptoms of HIV infection, and some have only enlarged lymph nodes. It is suspected that all persons infected with HIV will, given enough time, progress to AIDS; this theory has not been definitively proven.
PREVENTION
AIDS is a fatal, incurable, sexually-transmitted disease (STD). It is transmitted by both heterosexual and homosexual practices.
Some sexual practices, such as anal intercourse, carry higher risk of transmission than other sexual practices, such as vaginal
intercourse. Transmission occurs more readily from an infected man to a woman than from an infected woman to a man.
The second most common mode of transmission is by contact with infected blood. Sharing needles when using IV drugs is a major cause of HIV transmission. This is very common in some states.
As more women become infected with HIV, the incidence of ferns HIV infection is increasing. One in three infants bom to
HIV-infected women will be boru HIV positive. Some of these infants test positive only because of materual antibodies, and will
become negative by 15 months. Those that do not become negative are actually infected with the virus and will develop AIDS.
Breast feeding also transmits the infection to the infant. Mothers who are HIV positive should not breast feed.
Although there may be other modes of transmission, they are extremely rare and none have yet been unquestionably proven.
Prevention of AIDS requires self-discipline and strength of character. The requirements oflen seem personally restrictive but they are effective and can save lives.
1. Do not have sexual intercourse with:
- people known or suspected to be infected with AIDS
- multiple partners
- a person who has multiple partners
- people who use IV drugs
2. Do not use intravenous drugs. If IV drugs are used, do not share needles or syringes. Avoid exposure to blood from injuries, nosebleeds, and so on, where the HIV status of the bleeding individual is unknown. Protective clothing, masks, and goggles may be appropriate when caring for people who are injured.
3. People with AIDS or asymptomatic individuals who have a positive antibody test may pass the disease on to others and should not donate blood, plasma, body organs, or sperm. From a legal, ethical, and moral standpoint, they should warn any prospective sexual partner of their HIV positive status. They should not exchange body fluids during sexual activity and must use whatever preventative measures (such as a latex condom) that will afford the partner the most protection.
4. HIV positive women should be counseled before becoming pregnant about the risk to their infant and medical advances which may help prevent the ferns from becoming infected.
5. HIV positive women should not breast feed their infant.
Safer sex behaviors may reduce the risk of acquiring the infection. There remains a risk of acquiring the infection even with the use of condoms. Abstinence is the only sure way to prevent sexual transmission of the virus.
SYMPTOMS
- prolonged, unexplained fatigue
- swollen glands (lymph nodes)
- fever lasting more than 10 days
- chills
- excessive sweating especially night sweats
- mouth lesions including yeast lesions and painful, swollen gums
- sore throat
- cough
- shortness of breath
- changes in bowel habits including constipation
- frequent diarrhea
- symptoms of a specific opportunistic infection (such as candida, pneumocystis, and so on)
- tumor (Kaposi sarcoma)
- skin rashes or lesions of various types
- unintentional weight loss
- general discomfort or uneasiness (malaise)
- headache
Additional symptoms that may be associated with this disease:
- speech impairment
- muscle atrophy
- memory loss
- decreasing intellectual function
- joint swelling
- joint stiffness
- joint pain
- cold intolerance
- bone pain or tenderness
Prevention of AIDS requires self-discipline and strength of character. The requirements oflen seem personally restrictive but they are effective and can save lives.
1. Do not have sexual intercourse with:
- people known or suspected to be infected with AIDS
- multiple partners
- a person who has multiple partners
- people who use IV drugs
2. Do not use intravenous drugs. If IV drugs are used, do not share needles or syringes. Avoid exposure to blood from injuries, nosebleeds, and so on, where the HIV status of the bleeding individual is unknown. Protective clothing, masks, and goggles may be appropriate when caring for people who are injured.
3. People with AIDS or asymptomatic individuals who have a positive antibody test may pass the disease on to others and should not donate blood, plasma, body organs, or sperm. From a legal, ethical, and moral standpoint, they should warn any prospective sexual partner of their HIV positive status. They should not exchange body fluids during sexual activity and must use whatever preventative measures (such as a latex condom) that will afford the partner the most protection.
4. HIV positive women should be counseled before becoming pregnant about the risk to their infant and medical advances which may help prevent the ferns from becoming infected.
5. HIV positive women should not breast feed their infant.
Safer sex behaviors may reduce the risk of acquiring the infection. There remains a risk of acquiring the infection even with the use of condoms. Abstinence is the only sure way to prevent sexual transmission of the virus.
SYMPTOMS
- prolonged, unexplained fatigue
- swollen glands (lymph nodes)
- fever lasting more than 10 days
- chills
- excessive sweating especially night sweats
- mouth lesions including yeast lesions and painful, swollen gums
- sore throat
- cough
- shortness of breath
- changes in bowel habits including constipation
- frequent diarrhea
- symptoms of a specific opportunistic infection (such as candida, pneumocystis, and so on)
- tumor (Kaposi sarcoma)
- skin rashes or lesions of various types
- unintentional weight loss
- general discomfort or uneasiness (malaise)
- headache
Additional symptoms that may be associated with this disease:
- speech impairment
- muscle atrophy
- memory loss
- decreasing intellectual function
- joint swelling
- joint stiffness
- joint pain
- cold intolerance
- bone pain or tenderness
unusual or strange behavior
- slow, sluggish, lethargic movement
- anxiety, stress, and tension
- groin lump
- generalized itching (pruritus)
- genital sores (female)
- genital sores (male)
- blurred vision
- double vision (diplopia)
- light sensitivity
- blind spots iu the visiou
- decreased vision or blindness
- chest pain
- flank pain or pain in the sides
- back pain
- abdominal pain
- loss of appetite, indigestion, or other gastrointestinal upset
- muscle pain
- bone pain or tenderness
- numbness and tingling
- seizures
Note: Initial infection may produce no symptoms. Some people with HIV infection remain without symptoms for years between the time of exposure and development of AIDS. Many other symptoms may develop in addition to those listed above.
SIGNS AND TESTS
Development of characteristic infections and tumors, called opportunistic infections of AIDS and AIDS defining manifestations
of immune deficiency, may occur. Sometimes the presence of one of these disorders is the first sign that
AIDS is present.
- HIV antibody test ELISA (Enzyme Linked Immunoabsorbent Assay) and westem blot are positive
- absolute CD4 lymphocyte count is less than 200
- p24 antigen is abnormal
- T (thymus derived) lymphocyte count is abnormal
Treatment Options
- slow, sluggish, lethargic movement
- anxiety, stress, and tension
- groin lump
- generalized itching (pruritus)
- genital sores (female)
- genital sores (male)
- blurred vision
- double vision (diplopia)
- light sensitivity
- blind spots iu the visiou
- decreased vision or blindness
- chest pain
- flank pain or pain in the sides
- back pain
- abdominal pain
- loss of appetite, indigestion, or other gastrointestinal upset
- muscle pain
- bone pain or tenderness
- numbness and tingling
- seizures
Note: Initial infection may produce no symptoms. Some people with HIV infection remain without symptoms for years between the time of exposure and development of AIDS. Many other symptoms may develop in addition to those listed above.
SIGNS AND TESTS
Development of characteristic infections and tumors, called opportunistic infections of AIDS and AIDS defining manifestations
of immune deficiency, may occur. Sometimes the presence of one of these disorders is the first sign that
AIDS is present.
- HIV antibody test ELISA (Enzyme Linked Immunoabsorbent Assay) and westem blot are positive
- absolute CD4 lymphocyte count is less than 200
- p24 antigen is abnormal
- T (thymus derived) lymphocyte count is abnormal
Treatment Options
Treatment Strategy
Antiretroviral treatments attempt to slow progression of HIV infection to AIDS, while antibiotics and other therapies are used to treat or prevent opportunistic infections and other complications as they arise. Alternative treatments may be used to support the immune system, help in coping with disease symptoms and side effects from conventional treatments, and improve quality of life.
Drug Therapies
Appropriate treatment depends on the stage of the infection and presence or absence of opportunistic infections; HIV positive patients are best followed by a specialist in this disease process who will determine the best and most current medical regimen. Antiretrovirals, such as zidovudine (AZT), 200 mg orally tid, or lamivudine, 150 mg orally bid, are generally prescribed, together with protease inhibitors such as indinavir, 800 mg orally tid. These medications have significant side effects, and when to begin administering them to asymptomatic patients is a matter for careful consideration. When prescribing for complications, interactions and contraindications must be carefully considered as well, as HIV/AIDS patients may have a number of medical problems at any one time and are usually taking multiple medications. Compliance with the prescribed regimen is important to avoid encouraging resistant viral strains. The following are a few examples of the most common regimens for prophylaxis. Prophylaxis: ... PCP: trimethoprim-sulfamethoxazole (TMP/SMX) or pentamidine; started at CD4 < 200/ml ... MAC: clarithromycin 500 mg po bid or azithromycin 1200 mg po q week or rifampin 300 mg po qd; started at CD4 < 100/ml ... Toxoplasmosis: TMP/SMX 1 DS tablet qd ... Cryptococcal meningitis: fluconazole 200 mg qd; may start at CD4 < 50/ml ... Candidiasis: fluconazole 200 mg qd; although, primary prophylaxis generally not indicated ... Cytomegalovirus: ganciclovir 1 g po tid with food
Complementary and Alternative Therapies
Many people with HIV turn to complementary and alternative therapies to reduce symptoms of the virus, lessen side effects from medications, and improve overall health and well being. Surveys show that: ... 52 to 68% of HIV-positive patients take vitamins, herbs, or supplements ... 64% do aerobic exercise, while 33% do other forms of exercise such as yoga or strength training ... 22 to 54% obtain bodywork such as massage, energy healing, or acupuncture ... 38 to 56% use prayer or other forms of spiritual practice ... 42% attend group support ... 33 to 46% practice meditation or other forms of relaxation, such as breathing exercises Despite these statistics, only 26% of medical doctors ask patients about these practices; 63% of physicians, though, admit that they would like to know if their HIV positive patients are using such alternatives and believe that these practices are helpful.
Nutrition
As mentioned earlier, weight loss has historically been a serious problem for the HIV population. Treatment with protease inhibitors has lessened the amount of weight loss, but reduction of muscle mass remains a significant concern. Working with a registered dietitian can help prevent both weight loss and muscle breakdown. An article published in November 1999 supports the use of certain supplements for those with HIV, particularly for help in maintaining body weight. In a well-designed study comparing the use of a daily supplement regimen including the amino acid glutamine (40 g per day), vitamin C (800 mg), vitamin E (500 IU), beta-carotene (27,000 IU), selenium (280 mcg), and N-acetylcysteine (2400 mg) to placebo, subjects taking the supplements gained significantly more weight after 12 weeks than those who took the placebo. Vitamins C and E may reduce the oxidative stress of HIV and reduce viral load; this was suggested by a study published in the journal AIDS in September 1998, although it was not definitively proven. If true, it would support the fact that many people with HIV seem to have lower levels of antioxidants such as vitamins C and E in their blood than those without HIV. Related to vitamin C, grapefruit juice may enhance the absorption of protease inhibitors. The antioxidant selenium (100 to 400 mcg per day) and a vitamin B complex (75 to 100 mg per day) may also be useful to reduce physiologic stress of HIV. Cobalamin (vitamin B12) levels are occasionally low with HIV, in which case B12 injections may be required. Doses of vitamins frequently used in the case of HIV: ... Vitamin C 1000 mg per day ... Vitamin E 400 to 800 IU per day ... Selenium 100 to 400 mcg per day ... Vitamin B complex 75 to 100 mg per day
EXPECTATIONS (PROGNOSIS)
At the present time, there is no cure for AIDS. It has proved to be a universally fatal illness. Few patients survive 5 years
At the present time, there is no cure for AIDS. It has proved to be a universally fatal illness. Few patients survive 5 years
The average time from diagnosis of AIDS to death is 18 to 24 months although this is increasing with improvements in treatment techniques. Research continues in drug treatments for AIDS and vaccine development.
COMPLICATIONS
AIDS defining manifestations of immune deficiency, also called the opportunistic infections of AIDS, are illnesses that AIDS patients frequently acquire. Sometimes there will be more than one infection at the same time. Many of these infections are difficult to treat in AIDS patients, and therapy is required indefinitely or the infection will relapse.
- protozoal infections
- pneumocystis carinii pneumonia
- toxoplasmosis
- cryptosporidium enterocolitis
- giardiasis
- flmgal infections
- esophagitis candida
- cryptococcal meningitis
- coccidioidomycosis
- histoplasmosis
- aspergillosis
- bacterial infections
- pulmonary tuberculosis
- atypical mycobacterial infection
- disseminated tuberculosis
- recurrent bacterial pneumonias
- viral infections
- herpes simplex virus
- cytomegalovims
- Epstein-Barr
- varicella - herpes zoster
- malignancies
- Kaposis sarcoma
- lymphoma
- cervical cancer
- AIDS related dementia
- wasting syndrome
COMPLICATIONS
AIDS defining manifestations of immune deficiency, also called the opportunistic infections of AIDS, are illnesses that AIDS patients frequently acquire. Sometimes there will be more than one infection at the same time. Many of these infections are difficult to treat in AIDS patients, and therapy is required indefinitely or the infection will relapse.
- protozoal infections
- pneumocystis carinii pneumonia
- toxoplasmosis
- cryptosporidium enterocolitis
- giardiasis
- flmgal infections
- esophagitis candida
- cryptococcal meningitis
- coccidioidomycosis
- histoplasmosis
- aspergillosis
- bacterial infections
- pulmonary tuberculosis
- atypical mycobacterial infection
- disseminated tuberculosis
- recurrent bacterial pneumonias
- viral infections
- herpes simplex virus
- cytomegalovims
- Epstein-Barr
- varicella - herpes zoster
- malignancies
- Kaposis sarcoma
- lymphoma
- cervical cancer
- AIDS related dementia
- wasting syndrome
Courtesy:
Compiled and Shared By: Habib Anwar
habib.anwar@hotmail.com
No comments:
Post a Comment