By: Dr. Abhishek Kumar Pandey, Asstt. Editor-ICN
LUCKNOW: AIDS stands for Acquired Immunodeficiency syndrome. It is characterized clinically by an extremely immunocompromised state. It develops on infection with HIV which is a Human Immunodeficiency virus. HIV is a retrovirus that infects the vital organs and cells of the human immune system. AIDS detected first time in US in the year 1987. It is estimated that, more than 64.9 million people are affected from AIDS, across the globe.
CD4 cells play an important role in cell- mediated immune response. HIV virus destroys the CD4 cells and weakens the immune system of affected individual. The normal CD4 cell count of a healthy individual is 500-1600 cells/mm3. If its count falls below 200 cells /mm3, a person is said to have progressed to the stage of AIDS. If left untreated, an AIDS patient cannot survive for more than 3 years.
The transmission of HIV virus is through parental route i.e. through blood. It also spread by unprotected sex, having multiple sex partners, sharing infected needles, razors, syringes, blood transfusion etc. It may also transmit from an infected mother to her child, during pregnancy, breastfeeding, oral sex etc.
HIV infection grows through 3 clinical stages. The first stage presents with acute viremia which occurs within 2-4 weeks after infection with HIV and there is flu- like symptoms occur. During this stage, the virus will continuously multiplicate which leads to rapid destruction of CD4 cells and ultimately drops the immune system of affected individual.
Second stage is the Phase of Dormancy which is known as “Clinical Latency”. After the viral peak has been attained, the CD4 cell counts, again starts increasing though the count remain low as compared to pre-infection levels. The viral load is quite less during the initial phase of this period, but it begins to rise during the middle and end of the latency phase, thereby again causing a decline in the CD4 cell count. In this stage the symptoms of HIV infection may be seen.
The final stage of HIV infection is termed as a condition called AIDS. It is a stage of full-blown HIV infection wherein the immune system has become highly compromised and the body is vulnerable to attack by opportunistic infections due to drop in CD4 cell count below 200cells/mm3.
The clinical symptoms of HIV infection vary according to the stage. Some common symptoms includes- rapid weight loss, pneumonia, dementia, swelling in the lymph nodes, insomnia, soreness in the mouth, genitals, depression etc.
There are many misconceptions about HIV and AIDS. The virus CANNOT be transmitted from: shaking hands, hugging, casual kissing, sneezing, touching unbroken skin, using the same toilet, sharing towels.
The Centre for disease control and prevention (CDC) defines AIDS as a condition in which an individual CD4 cell count drops below 200cells/mm3. This disease is also generally accompanied by one or more conditions like cervical cancer, Kaposi sarcoma, Burkitt’s lymphoma, HIV related encephalopathy etc. The diagnostic tests involved are ELISA, PCR, Western blot, flow cytometry. Western blot is considered as confirmatory test for the detection of HIV.
There is no cure for AIDS, but medications are effective in fighting HIV and it’s complications. The treatment plan depends according to the stage of disease. Our main aim is to reduce the HIV in body, keep immune system as healthy as possible and decrease the complications that may develop.
Nucleoside reverse transcriptase inhibitors (NRTI) drugs interrupt the virus from duplicating and therefore reduce the HIV in the body. It includes the drugs like Didanosine, Zidovudine, Lamivudine, tenofovir. Protease inhibitors like Indinavir, lapinavir also inhibits the viral replication at a later stage.
Other medications like fusion inhibitors, which act by preventing the fusion of virus with the cell, to block replication, Highly active anti retro-viral therapy (HAART), and Non- nucleoside reverse transcriptase inhibitors (NNRTI) like Delveridine, Nevirapine are also used. Because there is no cure or vaccine to prevent HIV, the only way people can prevent infection from the virus is to avoid high-risk behaviors putting them at risk of infection, such as having unprotected sex or sharing needles. Everyone, ages 13 to 64 to get tested for HIV as part of their routine health care. Catching HIV in its early stages can make a lifesaving difference. Earlier HIV antiretroviral treatment is crucial — it improves quality of life, extends life expectancy, and reduces the risk of transmission.
