Infectious Disease: HIV/AIDs, Research Paper Example

HIV or Human Immunodeficiency Virus is type of virus that causes progressive decline of the immune system and consequently leading to AIDS or Acquired Immunodeficiency Syndrome (Douek et al. 2009). Because of its effect on the immune system, the person with HIV becomes more susceptible to infections. Furthermore, exposure to even the simplest infection could prove life-threating and cause serious implications. HIV is transmitted through blood, seminal and vaginal fluid as well as through breast milk. Risk factors that predispose individuals in acquiring the HIV infection comprise of risky behaviors such as engaging in unprotected sex, multiple sexual partners, sharing of contaminated needles, and history of a sexually transmitted disease. More importantly, there is a significant increase in HIV positive adolescents and young adults. It was reported by The Centers for Disease Control and Prevention (CDC) that there are 40,049 cumulative cases of AIDS among people ages 13 to 24 through 2004. Proportions have increased since then of adolescents and young adults with an AIDS diagnosis, from 3.9 percent in 1999 to 4.2 percent in 2004.

HIV is diagnosed through the detection of antibodies in the bloodstream, called an ELISA test or enzyme-linked immunosorbent assay (CDC 2001). A person with a positive result in the Elisa test would then be put through a second test and a second positive result would necessitate a confirmatory testing, called the Western Blot test. A positive result in the Western Blot test would then confirm the presence of HIV infection.

Stages of HIV Infection

1. Primary Infection

This stage occurs several weeks after exposure to HIV. Flu-like symptoms are typically experienced at this stage. General body malaise, fever, rashes, headache development of mouth ulcers, and weight loss are but some of the general symptoms and there is some variation in the presented symptoms between individuals. These symptoms usually last for a week and sometimes, even a month (Kahn & Walker 1998). However, due to the non-specific nature of the symptoms, HIV infection is not often considered at this stage and oftentimes, individuals with HIV are misdiagnosed. Recognition of HIV infection is essential at this stage because this is the period when the patient is most infectious (Daar et al. 2001).

2. Clinically asymptomatic stage

This stage has a variable duration, lasting anytime from 2 weeks to 20 years. This stage is usually symptom-free as the HIV levels in the bloodstream decreases. However, individuals still remain infectious and the HIV virus is active in lymph nodes, thus accounting for the occasional swollen glands at this time. Starting antiretroviral therapy at this stage is important as evidence has shown that it significantly improves outcomes (Kitahata et al. 2009).

3. Symptomatic HIV

Over time, the HIV infection causes severe damage on the immune system due to (1) duration of virus activity within the body, (2) mutation of the HIV virus, and (3) inability of the body to replace the lost T-cells. Symptoms again appear as the immune system progressively declines. Individuals become more susceptible at this stage to opportunistic infections that may become life threatening due to the weak immune system.

4. Development of HIV to AIDS

A diagnosis of AIDS is made when an individual’s CD4 count is 200 cells/mm³ or less and upon diagnosis of any condition that is listed within the Clinical stage 4, as published by the World Health Orgaization (1990).

Up to now, there is currently no cure for HIV. Management of HIV infection is done through HAART or Highly active antiretroviral therapy (Department of Health and Human Services 2005). HAART is made of a combination of three drugs, two of which are antiretroviral agents and a protease inhibitor. Although HAART does not cure the infection itself, more individuals with HIV have reported significant improvement in their quality of life and general health status upon treatment with HAART (Wood et al. 2003). Without undergoing HAART, it has been reported that HIV infection developed to full blown AIDS in a matter of nine to ten years. After the development of AIDS, survival period is a mere 9.2 months (Morgan et al. 2002). HAART, however, is far from perfect and it has been known to produce unwanted results and side effects. Individuals undergoing said treatment sometimes reported drug intolerance and severe side effects. In addition, inability of the individual to adhere to the prescribed treatment regimen, acquiring a strain of HIV infection that resists HAART as well as previous history of ineffective drug therapy are some reasons that contribute to HAART’s failure. Individuals may also have psychosocial issues that may hinder them from fully benefitting from retroviral therapy such as lack of a support system, poor healthcare access, the presence of psychiatric conditions as well as continued drug use. These drugs are also very expensive, thus limiting the number of people who can have access to the treatment.

Today, research is focused on improving the treatment for HIV such as making drug regimen simpler and less complicated, decreasing the side effects, and managing the development of drug resistance. Experts are also looking into developing a vaccine to halt the HIV pandemic and would considerably cost less (Ferrantelli et al. 2004)

References:

Centers for Disease Control and Prevention (2001). “Revised guidelines for HIV counseling, testing, and referral”. MMWR Recomm Rep. 50 (RR–19): 1–57.

Daar ES, Little S, Pitt J, et al. (2001) “Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network”. Ann. Intern. Med. 134 (1): 25–9.

Department of Health and Human Services (2005). “A Pocket Guide to Adult HIV/AIDS Treatment January 2005 edition”.

Douek DC, Roederer M, Koup RA (2009). “Emerging Concepts in the Immunopathogenesis of AIDS”. Annu. Rev. Med. 60: 471–84.

Ferrantelli F, Cafaro A, Ensoli B ( 2004). “Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccines”. Curr. Opin. Biotechnol. 15 (6): 543–56.

Kahn, J. O. and Walker, B. D. (1998). “Acute Human Immunodeficiency Virus type 1 infection”. N. Engl. J. Med. 331 (1): 33–39.

Kitahata MM, Gange SJ, Abraham AG, et al. (April 2009). “Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival”. N. Engl. J. Med. 360 (18): 1815–26.

Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA (2002). “HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries?” AIDS 16 (4): 597–632.

WHO; Mahe, C; Mayanja, B; Whitworth, JA (1990). “Interim proposal for a WHO Staging System for HIV infection and Disease.”. Wkly Epidemiol Rec. 65 (29): 221–224.

Wood, E., Hogg, R. S., Yip, B., Harrigan, P. R., O’Shaughnessy, M. V. and Montaner, J. S. (2003). “Is there a baseline CD4 cell count that precludes a survival response to modern antiretroviral therapy?”. AIDS 17 (5): 711–720.