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HIV means Human Immunodeficiency Virus. There are two main types of HIV: HIV-1 and HIV-2. HIV-2 is at least contagious and is found primarily in parts of West Africa. In contrast, HIV-1 more contagious and has spread throughout the world. HIV-1 can be divided into three main groups: HIV-1 major (M), Outlier (O) and non-M, non-O (N).
HIV-1 (M) is the cause of the global HIV / AIDS epidemic. Research has shown that both of these viruses derived from African monkeys and was transferred to humans for the first time for more than 100 years ago. Infection and disease seemed so localized and sporadic, that first recognized as a disease in humans around 1980. Infection from monkeys to humans is most likely done by blood contact hunting and slaughter of monkeys. HIV-1 (M) thus stem from chimpanzees and has spread from Central Africa via Haiti to the United States where the first cases of AIDS were described in 1981. This text deals only with HIV-1 (M), which colloquially called HIV.
As with all other viruses, so have HIV is no complete independent metabolism. HIV attacks living cells and use their metabolism. HIV striker so-called CD4 cells, which are a subset of the white blood cells. CD4 cells have a key role in the defense against a wide variety of infections.
HIV infection may initially (the primary or acute HIV infection) have two courses. You can either get a brief flu-like illness or glandular fever-like (mononucleosis) disease one to four weeks after infection, or you can have a silent infection that does not cause symptoms. In this early period of infection has been much HIV in the blood and it is very contagious - whether you have symptoms or not.
Four to eight weeks after infection the body's immune response is made as many antibodies to HIV, the antibodies can be measured in the blood with a known HIV test. Has HIV antibodies in the blood, one carrier of HIV, and is "HIV positive".
After the acute phase passes it to have chronic HIV infection. The majority of chronic HIV infection will feel healthy for a long time, but the infection is active in the body, and is formed every day a large number of new virus particles, which invades and destroys CD4 cells.
The number of CD4 cells in the blood falls slowly over several years with great variation from person to person. The normal number of CD4 cells in the blood is 500 million per liter or more, and usually will only begin to get serious symptoms of poor immune system when the CD4 cell count falls below 200 million per liter. Severe, life-threatening infections and certain cancers which occur especially frequently in humans with HIV leads to the diagnosis of AIDS. Without treatment takes an average of eight years from the time of infection to development of AIDS, but some may develop AIDS two years after infection, while a few are still asymptomatic even 15 years after infection. Untreated, the life span after diagnosis of AIDS about two to three years.
AIDS is an acronym for Acquired Immunodeficiency Syndrome. AIDS is a condition that occurs because HIV has destroyed so many CD4 cells that the immune system can no longer respond well enough against the microorganisms we carry around in your body or exposed to ambient. Furthermore, leads to poor immune systems increased risk of some cancers.
Serious infections with microorganisms that can also cause disease in individuals with normal immune function. It may be, for example pneumonia with pneumococcal bacteria, tuberculosis, protracted and repeated instances of Herpes (cold sores, genital herpes) and shingles.
Serious infections with microorganisms that are normally kept in check by our own immune system. These infections are called opportunistic infections because they take advantage of that immune system is weakened. The opportunistic infections are often caused by microorganisms that you carry around in advance without being sick. It may be fungi (including Candida, kryptokokker, pneumocystis), parasites (including Toxoplasma, cryptosporida) or viruses (including Cytomegalovirus). Tuberculosis bacterium behaves in HIV-infected people frequently as an opportunistic microorganism.
Cancer. Common to these cancers is that viral infections contribute to their occurrence. The following cancers occurs at much higher incidence in HIV-infected than uninfected persons: Lymphoma, Kaposi's sarcoma, a rare form of skin cancer, and cervical cancer and cancer of the rectum. Cervical cancer and rectal cancer are both closely linked to infection with human papilloma virus (HPV).
They may be also due to diseases caused by HIV itself. The most important is HIV dementia (HIV encephalopathy), which is believed due to HIV destroys nerve cells in the brain. HIV dementia occurs very late in the disease, and only when the immune system is almost completely wiped out.
Ordinary social interaction with HIV-positive people will not entail any risk of infection. HIV infects even through touch, through items such as glasses, plates or cutlery, through insect bites or through urine and feces. In contrast, the infection is transferred by:
Unprotected sex, that is, sex, who do not use condoms. The risk of infection through vaginal intercourse is about 0.1 percent, but may by anal intercourse can be up to 6 percent if the receiving party.
Through blood. It may be using or accidentally with contaminated needles, transfusion with contaminated blood products or blood. All blood in Canada tested for HIV, and this pathway is currently negligible. The risk of infection through needle sticks is approximately 0.3 percent.
Transmission from mother to child. Can occur during pregnancy and during lactation, but occurs most frequently in connection with the birth. The risk of transmission from mother to child is 25-40 percent in nursing and 15-25 percent in non-lactating.
People who have unprotected sex with people from areas of the world where HIV is particularly prevalent (for example, people from sub-Saharan Africa, prostitutes from Asia, current and former drug users from Canada).
Have you been exposed to possible infection, you should consult a doctor to get advice on testing and eventual medical prevention.
In most cases, the doctor will advise you to get an HIV home test. At canadastdhometest can you order a HIV home test which is fast and secure, the test result is visibly after 20 minutes. Most infected are positive very quickly, and a negative response four weeks after the possible infection is probably negative. If there is only used antibody test is the equivalent in the range of eight weeks. If you have recently been in particularly high risk of being infected, or if you have symptoms as the primary HIV infection, you will be offered to be tested for both antibodies and for the actual virus (HIV RNA).
About a third of new found HIV-positive persons in Canada have on diagnosis-time AIDS or severe immune-compromised with CD4 counts below 200 per liter and has been infected for several years. Many non-specific symptoms that prolonged fever, unexplained weight loss, fatigue, swollen lymph nodes and chronic diarrhea should cause that you get tested for HIV. Also, one should know a number of diseases, for example, other sexually transmitted diseases, hepatitis B or C, active tuberculosis, cervical cancer, shingles with more being tested for HIV.
If you are sure or very likely know that your partner was HIV-positive, or were you exposed to infection by accident (for example connector on needle), will in special cases choose to start a preventive medical treatment that lasts four weeks. The treatment aims to prevent you at all become infected with HIV. This preventive treatment should be started less than 24 hours after the possible infection. The treatment can have side effects (nausea, diarrhea, abdominal pain). Before implementation, it must be assessed how big your risk of being infected is. This is done in consultation between you, the treating physician and the local / regional infectious diseases department.
HIV-infected women may become pregnant can often carry the pregnancy without problems and can give birth to healthy children. The pregnancy is not dangerous for the woman. If the woman is not treated during pregnancy, the risk of the child becoming infected with HIV around 25 percent. If the woman on the other hand receiving medication for HIV infection during pregnancy and birth and fail to breastfeed, then the risk of infection of the child less than one percent. HIV-infected women who are in medical treatment and have undetectable viral load in the blood, can give birth normally like other women. If not, you will choose to offer caesarean section. HIV-infected women who wish to become pregnant should talk to their HIV doctor before pregnancy. Like HIV-infected women who become pregnant should inform their HIV doctor.
There continue to develop new and more effective treatments to combat HIV and reduce the content of virus in the blood.
To make treatment more effective and to prevent the virus developing resistance to the drug, given a combined treatment with three drugs simultaneously.
In the treatment, anti-viral agents against HIV infection. These drugs inhibit the ability of the virus to multiply and spread, and most treated gets so low amounts in the blood virus, the virus can no longer be measured in the blood with standard methods used in the laboratory. However, there are still virus in the body, and it continues to antibodies (i.e., that it is still "HIV positive"). The treatment heals not but prevents you develop AIDS and die During treatment improves the immune system, and at most the number of CD4 cells to normal in a few years.
Combination therapy was introduced in 1996. There are many patients who have been treated since 1996 and in all the years had undetectable viral load in the blood. It is not yet known with certainty how long the treatment effect remains, but there is nothing to suggest that the effect will stop. Today it is estimated that HIV-infected people can live an almost normal life if treated with virus funds. In the past few years the market more combination play, so you only need to take one tablet once a day.
It is best to start treatment for HIV before the immune system is severely weakened, that is, that treatment be started before symptoms occur. It is therefore important that all who are or have been at risk of HIV infection opt for testing so that treatment can be started in time.
In Canada the treatment of all when the CD4 cell count falls below 350 million per liter - regardless of whether they have symptoms or not. The treatment can cause side effects, that is, depending on the drug to get. In almost all manage to find a combination of drugs which are well tolerated, but it may be necessary to change the treatment a few times before the correct combination has been found.
Research is today much in the possible long-term side effects of the drugs and the possible long-term consequences of being HIV-infected. It is about sequelae such as atherosclerosis, altered lipid metabolism, osteoporosis and renal involvement. There are many unresolved issues, but nothing that can cast doubt on the usefulness of treatment far outweigh any disadvantages.
Some of the older drugs (Retrovir, Zerit) had a very dull side effect, which saw a cosmetically disfiguring loss of fat in the face and on the arms and legs. This side effect is not seen with the newer drugs.
It has for several years been known that treatment can prevent transmission of HIV from mother to child. In recent years, it has also become clear that HIV-infected, who are in treatment and have undetectable viral load in the blood is very little contagious. In a recent study of over 40,000 unprotected sexual contacts were seen infection with HIV. It is recommended, however, continue to practice "safe sex" with certainty to avoid infecting others. WHO recommends that all HIV-infected people are treated regardless of CD4 cell count, to reduce the spread of infection.
Have you been exposed to possible infection, you should get tested, even if you feel healthy. It is best to start treatment before symptoms occur because of weakened immune systems. The treatment also reduces the risk of infecting others.
Search contact with patient organizations and support groups (for example, HIV-Canada).
General healthy living. It does not change the HIV infection process, but may involve, to better manage complicating diseases and better tolerate HIV treatment.