AIDS

Overview and facts

Acquired Immune Deficiency Syndrome (AIDS) as the name shows is a medical condition in which the immune system of the body is greatly affected and the lack of immunity will make the patient suffer; as the patient will get certain other diseases due to immunodeficiency. It is caused by Human Immunodeficiency Virus (HIV). When infected with HIV or HIV positive; the virus attacks the white blood cells (T cells/CD4 cells) and destroys them and brings down the immunity of the person. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infections.

• Since 1981 more than 25 million people have died due to AIDS.
• Half of the HIV infections worldwide are amongst young people (under 25 years of age).
• Only in Africa 11.6 million children are orphaned due to AIDS.
• In developing and transitional countries, 9.7 million people are in immediate need of life-saving AIDS drugs; of these, only 2.99 million (31%) are receiving the drugs.
• At the end of 2007, women accounted for 50% of all adults living with HIV worldwide.

Symptoms

There are several symptoms of HIV and AIDS; but you cannot rely on the symptoms to judge whether a person has AIDS or HIV or not.
HIV symptoms include:

• Flu like symptoms including fever, chills, night sweats and rashes.
• While patients suffering from AIDS will experience:
• Severe opportunistic infections
• Serious lethargy and digestive problems
• Sudden weight loss
• Many serious health conditions at a time
• Severe lung/pulmonary infections
• Onset of tumors and cancers

Diagnosis

There are different parameters for the diagnosis of AIDS and HIV. The most preferred ones are that of World Health organization (WHO) and Centers of Disease Control and Prevention (CDC). U.S. Food and Drug Administration (FDA) recommend only these two as the genuine organizations to set the parameters; hence we will only look at their details.
Centers of Disease Control and prevention:

• The older version of the definition refers that a patient suffers from AIDS if he/she has the associated diseases particularly present in AIDS. Most of them have the lymphatic system involvement.
• The recent version however states: All HIV positive people with a CD4+ T cell count below 200 per µL of blood or 14% of all lymphocytes, have AIDS. This criterion is more specific and hence more used worldwide.

World Health Organization: WHO criteria for AIDS diagnosis is based upon the staging and grading system depending upon the extent of the HIV spread.

Stage I: Asymptomatic HIV infection. No AIDS
Stage II: Presence of minor mucocutaneous inflammatory changes and recurrent upper respiratory tract infections. More flu like symptoms. 
Stage III: Chronic diarrhea for more than a month, severe bacterial infections and pulmonary tuberculosis.
Stage IV: Toxoplasmosis of the brain, esophageal, tracheal or pulmonary candidiasis, and Kaposi's sarcoma; indicating fully developed AIDS.

For the diagnosis of HIV there are certain kits and clinical tests done. A brief outline is given below:
Clinical Tests - These include:

• HIV, HTLV and Hepatitis Tests
• Genetic screening tests done by either one of:  Visible Genetics, Inc., TrueGene HIV-1 Genotyping Kit or Open Gene DNA Sequencing System
• Nucleic acid tests
• AMPLICOR HIV-1 MONITOR Test (Roche Molecular Systems, Inc.)
• NucliSens HIV-1 QT (bioMerieux, Inc.)
• OraSure HIV-1 
• Cambridge Biotech HIV-1

Rapid HIV Antibody Test Kits

• Multispot HIV-1/HIV-2 Rapid Test (Bio-Rad Laboratories)
• OraQuick ADVANCE Rapid HIV-1/2 Antibody Test (OraSure Technologies)
• MedMira Reveal Rapid HIV-1 Antibody Test (MedMira Laboratories, Inc.)
• Trinity Biotech Uni-Gold Recombigen HIV, Uni-Gold Recombigen HIV Positive and Negative Controls (Trinity Biotech)

Home Test Kits

• Home Access HIV-1 Test System (Home Access Health Corp.)

Treatment & care

• HIV is found in body fluids including blood, semen, vaginal fluids, breast milk, saliva, intrauterine fluids in pregnancy, fluids in joints and cerebrospinal fluid. Hence any contact with the mentioned fluids leads susceptibility to HIV transfer. 
• Patients suffering from AIDS are susceptible to infections hence more care is required for their health. Food and water safety comes first as this area makes our body to encounter with maximum germs. Cook properly, drink filtered or boiled water, do not eat unwashed raw foods, avoid food at unhygienic and public places, and try to use fresh food, avoid frozen foods and readymade meals. 
• The treatment options include the drug administration in HIV, drug administration in HIV/AIDS complications, and alternative medicine approach.
  Drug administration in HIV: FDA has approved following drug options:
• Multi-class Combination Products (efavirenz, emtricitabine and tenofovir disoproxil fumarate)
• Nucleoside Reverse Transcriptase Inhibitors (NRTIs) including lamivudine, zidovudine, emtricitabine, abacavir, zalcitabine, dideoxycytidine, ddC, tenofovir disoproxil fumarate, and stavudine, d4T
• Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs) 
• Protease Inhibitors (PIs) including amprenavir, tipranavir, indinavir, saquinavir mesylate, lopinavir and ritonavir, and Fosamprenavir Calcium
• Fusion Inhibitors enfuvirtide, T-20
• Entry Inhibitors - CCR5 co-receptor antagonist (maraviroc)
•  HIV integrase strand transfer inhibitors (raltegravir)
• Drug Administration in HIV/AIDS complication: The complications usually arise by occurrence of diseases due to lack of immunity. The medications thus are given according to the induced health condition. Mostly used ones are to treat viral infections, fungal infections, weight loss, Kaposi’s sarcoma, protozoal infections, and symptomatic treatment for inflammation, pain, diarrhea, cough, flu etc.
• Alternative Treatment Approach: Alternative treatments do not control HIV and AIDS but they can be helpful in minimizing the symptoms and effects of associated diseases. Alternative treatment includes acupuncture, yoga, diet and herbalism.

Risk factors

Not only the AIDS patients are themselves at risk of getting diseases but they are also at potential risk of transmitting the disease to other people. They have to be very careful when being in contact with other people as they can easily receive endemics.