The causative agent of AIDS is the Human Immunodeficiency Virus (HIV). HIV is a retrovirus belonging to lentivirus subgroup and consists of a type-D core surrounded by an envelope filled with specified glycoproteins peculiar to the virus, which include gp41 and gp120. HIV has a diameter of about 120 nanometers with two single-stranded Ribonucleic Acid (RNA) that is identical and has a positive polarity. HIV forms proviral RNA through a process known as reverse transcription, making it be the one of the most complex lentiviruses. It has multiple enzymes for reverse transcription and affects lymphocytes specifically (Robert, 2011).
Scientific records show that HIV originated from Kinshasa at around 1920. Although the sporadic cases of AIDS were documented before 1970, available data suggests that the current epidemic started in the late 1970s (Robert, 2011). The first HIV-knowledge was crude and not evidence-based. Over 30 years ago, there were several myths and misconceptions about HIV/AIDS. People believed that having sex with a virgin would cure the disease. Further, there was misconstrued knowledge that AIDS leads to imminent death. Social stigmatization was enormous for those infected because of the widespread belief that kissing, hugging, shaking hands or living with HIV-positive people spread the virus. This is partially due to the mysteries surrounding the disease; which saw some victims being stoned to death in different regions. Today, human understanding of the disease process is better. Almost everyone knows the basic facts about HIV/AIDS. People living with the disease have become part of the society and conduct their business just like anybody else. Scientists have both intensively and extensively explored the disease, and given hope to both affected and infected persons. The discovery of antiretroviral has changed the life of those infected and affected by the illness (Bonuke, 2015).
Delegate your assignment to our experts and they will do the rest.
Since the declaration of AIDS as a global epidemic, more than 71 million people have been infected. As at 2014, the WHO‘s data showed that between 34.3-41.4 million live with the disease. Approximately, over 1.2 million humans have died of AIDS and other AIDS-related illness across the globe. Sub-Saharan Africa has the most casualties estimated at 70% of the total population living with HIV worldwide. Research shows that in every 20 adults, one is HIV+, which translates to 4.8%. Swaziland has the highest HIV prevalence at 27.4%. South Africa follows suit with a mortality rate of 12.51%, only three points behind Nigeria. India is the third with a mortality rate of 11.50% (World Health Organization, 2016). The HIV reservoir includes blood and body fluids such as semen. The illness can be transmitted through unprotected sexual intercourse, infected blood and body fluids, and sharing of contaminated instruments like needles and syringes (Bonuke, 2015)
The pathogen affects the CD4 + T lymphocytes as well as Brain’s monocytes. Once in the body system, HIV entirely destroys helper T cells, causing the suppression of cell-mediated immunity. This predisposes the host to various opportunistic infections and diseases like cancer as a result of weakened immune system. However, HIV is not responsible for the direct cause of these tumors given that its genes are not present in the cancer cells. HIV also infects brain monocytes and macrophages. Further, the damages of HIV-infected cells are partly due to an immunologic attack by CD8 cytotoxic lymphocytes. The effectiveness of the cytotoxic T cells may be limited by the ability of the viral Tat and Nef proteins to reduce class I MHC protein synthesis. HIV indiscriminately activates many helper T cells and leads to their demise (Maxine, 2013).
The incubation period for AIDS in ordinary persons is between 2–4 weeks after infection. In some people, the Prodromal period comes after two weeks, and it is shortly followed by a decline period which paves the way to convalescence period. This period can extend up to ten years in untreated patients before the period of illness starts to manifest. The late stage of HIV infection is AIDS, manifested by a decline in the number of CD4 cells to below 400/L and an increase in the frequency and severity of opportunistic infections (Maxine, 2013). Clinical symptoms of HIV/AIDS include fever with rash, generalized lymphadenopathy, body and Joint pains, headache and sore throat. As the disease progresses patients starts to exhibit signs such as weight loss, chronic diarrhea, meningitis, seizures, pneumonia, peripheral neuropathy, tuberculosis, and herpes zoster. Other features are dependent on the opportunistic infection present. (Nicki & Brian, 2010)
The primary immune response to HIV infection consists of cytotoxic CD8+ T lymphocytes which react to viral antigens presented by APC cells. These cells are generated by CD4+ cells and produce toxins like granzymes and porins necessary to kills the virus. Cytotoxic T cells lose their effectiveness because so many CD4 helper T cells cease to function. Therefore, the supply of lymphokines, such as IL-2, required activating the cytotoxic T cells is no longer sufficient. The mutant class I MHC proteins cannot present HIV epitopes, rendering cytotoxic T cells incapable of recognizing and destroying HIV-infected cells. Antibodies against various HIV proteins, such as p24, gp120, and gp41, are also produced to curb the disease process (Jawetz, 2007).
So far, there is no cure for HIV/AIDS; however, combinations of antiretroviral agents are used to suppress the virus. The use antiretroviral agents are to inhibit viral replication and to manage the opportunistic infections. The ARVs are grouped into protease inhibitors, fusion inhibitors, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and entry inhibitors. The current practice is the use Highly Active Antiretroviral Therapy (HAART) combination drugs. They are very efficient in prolonging life, improving the quality of life, and reducing viral load in HIV+ persons. Discontinuation of HAART always results in viremia, a return of the viral load to its pretreatment set point, and a fall in the CD4 count. (Maxine, 2013)
There is no HIV vaccine, although HIV is highly preventable. Prevention measures include using condoms when having sex, avoiding sharing needles, and blood screening for HIV before transfusion. Drugs such as Post-exposure prophylaxis have been recommended in the case one is has been exposed to the HIV. Lastly, abstinence has been suggested as a preventive measure to unmarried persons as this minimizes the risk of HIV exposure (Jawetz, 2007).
Various sociopolitical issues that have helped in the fight against HIV/AIDS spread such as the voluntary male circumcision. In some affected regions like Kenya, the campaign is widespread. Studies show that this practice reduces the risk of infection by 60%. For instance, it has helped reduce the disease burden by about 15% in Kenya. Also, increased awareness about child delivery via Caesarian-Section other than the vaginal delivery has reduced the risk of transmission (Bonuke, 2015).
The spread of AIDS can be curtailed through numerous measures. The various governments and the concerned stakeholders need to promote exhaustive and free sexual health awareness. The approach will require the states to remove all obstacles restricting open access to health data. For instance, campaigns that advocate for abstinence while limiting information on HIV/AIDS infections subjects young people to risks. Secondly, there should be the provision of free condoms. Without affordable condoms, HIV prevention messages are in a veil. Issuing female condoms can be particularly helpful in lowering HIV transmission rates, prevention costs, and empowering women. Lastly, the program should be developed to encourage voluntary HIV confession. At many times, individuals fear their HIV status for many reasons, such as fear of stigmatization and intimate partner violence. The best conduit geared towards support and counseling of persons with HIV can be obtained by forming community-based organizations that work with HIV-positive people.
Reference
Bonuke, A. (2015). HIV/AIDS Determinants, Prevention, and Management. Kisumu: A.designers.
Jawetz, M. A. (2007). Lange Medical Microbiology. Baltimore: McGraw Hill Medical Publishers.
Maxine, A. P. (2013). Current Medical Diagnosis and Treatment. San Francisco: Mc-Graw Hill.
Nicki, R. C. & Brian, R. W. (2010). Davidsons PrincipleS and Practice of Medicine. Edinburgh: Churchill Livingstone Elsevier.
Robert, S. P. (2011). The Merck Manual of Diagnosis and Therapy. New York: Gary Zelko.
World Health Organization (WHO). (2016). Global Health Observatory (GHO) data: HIV/AIDS. Retrieved from http://www.who.int/gho/hiv/en/
