Saturday, March 3, 2012

HIV/AIDS


Symptoms of HIV/AIDS :


Many people do not develop symptoms after getting infected with HIV. Some people have a flu-like illness within several days to weeks after exposure to the virus. They complain of fever, headache, tiredness, and enlarged lymph glands in the neck. These symptoms usually disappear on their own within a few weeks.

    * Following initial infection, you may have no symptoms. The progression of disease varies widely among individuals.

          o During this period, the virus continues to multiply actively and infects and kills the cells of the immune system. The immune system allows us to fight against the bacteria, viruses, and other infectious causes.

          o The virus destroys the cells that are the primary infection fighters, called CD4+ or T4 cells.

    * Once the immune system weakens, a person infected with HIV can develop the following symptoms:

          o Lack of energy

          o Weight loss

          o Frequent fevers and sweats

          o Persistent or frequent yeast infections

          o Persistent skin rashes or flaky skin

          o Short-term memory loss

          o Mouth, genital, or anal sores from herpes infections.

    * AIDS is the most advanced stage of HIV infection. The definition of AIDS includes all HIV-infected people who have fewer than 200 CD4+ cells per microliter of blood. The definition also includes 26 conditions that are common in advanced HIV disease but that rarely occur in healthy people. Most of these conditions are infections caused by bacteria, viruses, fungi, parasites, and other organisms. Opportunistic infections are common in people with AIDS. Nearly every organ system is affected. Some of the common symptoms include the following:

          o Cough and shortness of breath

          o Seizures and lack of coordination

          o Difficult or painful swallowing

          o Mental symptoms such as confusion and forgetfulness

          o Severe and persistent diarrhea

          o Fever

          o Vision loss

          o Nausea, abdominal cramps, and vomiting

          o Weight loss and extreme fatigue

          o Severe headaches with neck stiffness

          o Coma

    * People with AIDS are prone to develop various cancers such as Kaposi sarcoma, cervical cancer, and cancers of the immune system known as lymphomas. Kaposi sarcoma causes round, brown, reddish or purple spots that develop in the skin or in the mouth. After the diagnosis of AIDS is made, the average survival time has been estimated to be 2-3 years.


Treatments of HIV/AIDS :


There is no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It's best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:

    * Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
    * Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
    * Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
    * Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
    * Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.



When to start treatment

Current guidelines indicate that treatment should begin if:

    * You have severe symptoms
    * Your CD4 count is under 500
    * You're pregnant
    * You have HIV-related kidney disease
    * You're being treated for hepatitis B


Treatment can be difficult

HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. Side effects can include:

    * Nausea, vomiting or diarrhea
    * Abnormal heartbeats
    * Shortness of breath
    * Skin rash
    * Weakened bones
    * Bone death, particularly in the hip joints


Treatment response

Your response to any treatment is measured by your viral load and CD4 counts. Viral load should be tested at the start of treatment and then every three to four months while you're undergoing therapy. CD4 counts should be checked every three to six months.

HIV treatment should reduce your viral load to the point that it's undetectable. That doesn't mean your HIV is gone. It just means that the test is not sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.