Good Essay On HIV And AIDS
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Over one million people in the United States are living with HIV (CDC). At one time a fatal diagnosis, HIV, or Human Immunodeficiency Virus, is now a manageable condition for many who have it. From its discovery in the 1980s to the present day, the scientific and medical establishments have made prodigious advancements in our understanding and treatment of HIV and AIDS.
In 1981, a mysterious and unknown illness began affecting gay communities across America. People primarily in California and New York began falling ill with rare forms of cancer and pneumonia. The only thing held in common between these cases were that the people reporting them were gay and had been in otherwise good health.
The first official documentation of the condition now known as AIDS was published by the CDC on June 5, 1981 (Avert). Then it was referred to as “pneumocystis pneumonia.” The report described the cases of five young gay men who had become hosts to multiple infectious diseases. A month later, 36 new cases would be discovered. By the end of the year, five to six new cases were being reported every week.
The virus that causes AIDS would not be discovered until 1983. At first, it was called HTLV-III/LAV, standing for “human T-cell lymphotrophic virus-type III/ lymphadenopathy-associated virus.” This name would later be changed to its current, more succinct form, called Human Immunodeficiency Virus, or HIV.
HIV is a lentivirus, which is a retrovirus subgroup (AIDS). A retrovirus is a virus that multiplies within a host cell through the process of reverse transcription. Inside a host cell, the virus creates DNA from its RNA genome and then incorporates the DNA into the host cell genome. The viral DNA acts as part of the genome of its host, which translates and transcribes the viral genes along with its own genes. In the process, the proteins required to assemble new viruses are produced, leading to the destruction of the host cell.
HIV transmission occurs when the bodily fluid of an infected person comes into contact with a mucous membrane or open wound of a non-infected person. HIV travels in blood, semen, pre-seminal fluid, rectal fluid, vaginal fluid, and breast milk (CDC). If a fluid comes into contact with a mucous membrane, found inside the tip of the penis, the vagina, the rectum, and the mouth, then infection can occur. The most high-risk activities for HIV infection include vaginal and anal sex and sharing needles (for intravenous drug injection) with someone who has HIV.
As of 2001, more than 90% of global HIV infection occurred in the developing world. In the developed world, about fifty thousand new cases of HIV occur every year in the United States alone (AIDS). This is in addition to 1.2 million already existing cases. In the US, HIV is usually transmitted through having sex or sharing needles with an infected person. More rarely, HIV can also be spread by an infected mother to her child during birth, through blood transfusions, and through being stuck with an HIV-contaminated needle or sharp object. As long as one of the six bodily fluids of an HIV+ person comes into contact with a mucous membrane or damaged tissue of an HIV- person, the risk of infection is present.
The stages of HIV progression are: acute retroviral syndrome, clinical latency, and AIDS. Acute retroviral syndrome, or primary HIV infection, occurs within the first two to four weeks of contracting HIV. This stage lasts until the body begins producing antibodies to counteract the virus. Up to ninety percent of people in the acute stage experience symptoms similar to the flu (NIH). These symptoms include fever, skin rash, headache, and pharyngitis, or sore throat. In fact, patients in this stage of HIV are often misdiagnosed as having mononucleosis, strep, or influenza, among other diseases.
It is during the acute stage that HIV is most contagious. At this time, the HIV virus is creating millions of replicas of itself, using white blood cells called CD4 cells as its disposable host. As the virus count rises, the count of CD4 cells falls. CD4 depletion leaves the body vulnerable to a wide range of infections that it would have normally been able to fight. The CD4 count of a healthy adult ranges from 500 cells/mm3 to 1,200 cells/mm3 of blood (AIDS). By the time HIV becomes full-blown AIDS, the person's CD4 count will be less than 200 cells/mm3. Before this happens, during the acute stage, the immune response brings the level of viruses down to a viral set point where the HIV count stabilizes.
Most people who are in the primary stage of infection do not yet realize that they are HIV positive. However, it is at this time that it is most beneficial to begin combination antiretroviral therapy, or ART. The use of ART consists of a regimen of at least three HIV medicines taken every day. These drugs suppress HIV RNA to bellow detectable levels, helping to replenish the supply of CD4 cells. ART is currently recommended for everyone with HIV, as it has been widely observed to reduce the rate of death and suffering in infected persons (WHO).
After the acute stage, the disease passes into the “clinical latency” stage. During this stage, the virus lives in the body without producing any symptoms. This stage is also known as “asymptomatic HIV infection” because people with HIV experience few to no side-effects from the virus. The use of ART can extend this stage for several decades. Without ART, eventually the viral load will again begin to rise and the CD4 count will fall. As the CD4 concentration goes below 200 cells/mm3, the body enters the final stage of decline known as Acquired Immune Deficiency Syndrome, or AIDS. At this point, the body becomes vulnerable to opportunistic infections. People with AIDS usually survive about three years without treatment. With treatment, however, many people will delay this stage for their entire lifetime, and never progress to AIDS. However, each individual case of HIV is unique. The progression of these stages will depend on a variety of factors, including the infected person's genetic makeup and general health, and on how soon treatment was initiated after infection.
In the United States, gay and bisexual men are the most severely affected by HIV (AIDS). Amongst all the ethnic groups, black Americans have the highest and most disproportionate rate of infection. At least one in seven HIV+ people are unaware that they are carrying the virus.
Thankfully, the diagnostic tests for chronic infection with HIV are cheap and widely available. The most commonly administered test is called ELISA, standing for enzyme-linked immuno assay (NIH). ELISA is a blood test that detects the presence of antibodies, the proteins a body produces in response to a harmful substance. A blood sample is usually taken from a prick on the finger. The blood is combined with a test system that contains HIV antigens. If the antibody that fights HIV is present in the blood, it will bind to the antigens in the test system, and the result will be positive. If there is no detectable reaction, the result will be negative. The ELISA test can be inexpensively used to quickly identify the HIV strain in doctors' offices and in sexual health clinics such as Planned Parenthood.
Thanks to great leaps forward in modern medicine over the last thirty years, being diagnosed with HIV is no longer a certain death sentence. With the help of antiretroviral drug therapy, a person who is HIV+ can live a full and healthy life. There are also many ways to prevent HIV transmission at all, and these have been well studied and are now mostly common knowledge. With expanded education efforts and continued improvements in antiretroviral treatments, HIV and AIDS may one day be eradicated.
“HIV Transmission.” CDC. Centers for Disease Control and Prevention, 23 September 2014. Web. 23 January 2015.
“Use of antiretrovirals for treatment and prevention of HIV infection.” WHO. World Health Organization, n. d. Web. 23 January 2015.
“HIV/AIDS Basics.” AIDS. U.S. Department of Health and Human Services, n. d. Web. 23 January 2015.
“Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents.” NIH. National Institutes of Health, 12 February 2013. Web. 23 January 2015.
“History of HIV & AIDS in the USA.” Avert. Avert, n. d. Web. 23 January 2015.
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