Left untreated, HIV infection causes progressive and critical damage to the immune system, rendering the host susceptible to potentially fatal opportunistic infections and cancers.
Use of the term AIDS acquired immune deficiency syndrome is now rare, but it was previously used to describe the advanced stage of HIV infection, in which the immune system has declined to such a level that infections and cancers can emerge and proliferate. This phase of the infection is now more commonly called advanced or late-stage HIV infection.
HIV is one of the most devastating infectious diseases to have emerged in recent history, affecting millions of people worldwide. The first major clusters of HIV infection appeared in the US in the early s, when infections and cancers that were normally prevalent in immunosuppressed populations began to emerge in fit and healthy homosexual men.
This unexplained acquired immunodeficiency was initially described by the press as gay-related immune disease because it disproportionately affected homosexuals, although it was also seen in people with haemophilia and those who injected drugs intravenously. By , the virus had been isolated and identified, but had already infected thousands of people across 85 countries worldwide Bureau of Hygiene and Tropical Diseases, In , the global spread of HIV was coined an epidemic, with over , cases reported World Health Organization, In , it was estimated that there were In the UK, estimates suggest there are , people living with HIV — men who have sex with men and Black African populations are disproportionately affected Public Health England, a.
Viruses cannot survive or replicate without a host, and can only do so inside a living cell.
Viral structure is simple. Viruses lack the complex components present in bacterial or human cells, so HIV is solely dedicated to identifying and infecting its target. One commonality of viral, bacterial and human cells is that they possess genetic material that contains all the information needed to build and maintain an organism. In humans and bacteria, this is called deoxyribonucleic acid DNA , which comprises two strands of genetic information twisted into a helix.
The RNA present in a virus is protected by a protein coat called a capsid. Outside the capsid are enzymes the virus uses to infect its host and replicate.
The positive pub crawl bringing HIV+ people together
These are so called because they do not kill or neutralise foreign antigens but, instead, signal to and recruit other immune cells to do so. Once infected, CD4 cells develop a much shorter lifespan and are eventually destroyed; their progressively declining number in the host causes immunological failure and susceptibility to infection. Box 1 lists the stages of HIV infection; these are all targets for HIV medications that interrupt the lifecycle of the virus and inhibit infection and replication.
Use of these medications is known as anti-retroviral therapy. Reverse transcription — the virus converts its single-stranded viral RNA into double-stranded DNA using an enzyme called reverse transcriptase. Replication — the CD4 cell starts to build new copies of the virus; this process can sometimes be clumsy, causing mutations and variations in the new virions. An enzyme called protease helps convert the immature virions into mature, infectious virions.
They then push themselves out of the cell, which is called budding, and seek out other CD4 cells to repeat the process. Several factors determine individual progression of HIV, such as genetics and comorbidities.
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As HIV is very genetically diverse and often mutates, viral factors — such as deletions in certain viral genes, viral subtype and coreceptor usage — can also determine the rate of HIV progression. As such, the phases are used as a guide. It illustrates how the CD4 count declines over time and outlines the trajectory of the viral load. HIV can only be acquired through specific activities.
HIV/AIDS in the United Kingdom
It is vital for health professionals to have a good understanding of the modes of transmission, not only to protect staff and patients, but also to help reduce myths and inaccuracies that drive the social stigma faced by people living with HIV. Only certain bodily fluids can transmit the virus: semen, pre-seminal fluid, blood, rectal fluid, vaginal fluid and breast milk. To transmit HIV, one of these fluids must come into contact with a mucous membrane such as the mouth, vagina or rectum or damaged tissue, or be directly injected into the bloodstream.
HIV is not transmitted through saliva, sweat or tears, and cannot be spread by ticks or mosquitos, social contact, touch or sharing food with somebody who has HIV. People receiving HIV treatment can have a viral load test; this measures the amount of virus per millilitre of blood to determine whether the treatment used is adequately suppressing viral replication. And the individual, who the Sunday Mercury has been barred from naming, said he needed to stay in the Midlands because treatment for HIV positive patients was much more advanced. The Coventry man, who came to the city on a short-term visa, is appealing against a Home Office decision to deport him.
His parents were shocked to learn their son was gay, but were still unaware he was HIV positive, the tribunal was told.
National AIDS Trust |
He told judge SS Chohan that he was in a relationship with a Coventry man and provided pictures of himself at The Rainbow, which he said was a well-known haunt for gay men in the city. The Home Office, however, has questioned whether the individual was , in fact, gay. The treatment of gays in Malawi, a country in south-eastern Africa, has long been a cause of concern for civil rights groups. Campaigners in Malawi say homophobic legislation is driving gays underground, making them hard to reach with information that could protect them from Aids.
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