3/10/2011
Marcel Firmont

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Introduction .................................................................................................................................................. 2
AIDS (The acquired immune deficiency syndrome) ...................................................................................... 2
A brief history of AIDS ................................................................................................................................... 2
Symptoms ..................................................................................................................................................... 2
Transmission and Infection ........................................................................................................................... 3
Testing ........................................................................................................................................................... 4
Antibody test ......................................................................................................................................... 4
Rapid HIV test........................................................................................................................................ 4
Treatment ..................................................................................................................................................... 4
People at high risk ......................................................................................................................................... 5
Reducing the change of getting HIV ............................................................................................................. 5
New hope for people suffering from HIV and AIDS ...................................................................................... 5

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The acquired immune deficiency syndrome (AIDS) is one of the deadliest diseases of the world and in human history. The World Health Organization (WHO) estimates that worldwide (mostly in Africa) more than 33.4 million people suffer from this illness (2008). Sadly there is no cure for AIDS at this time and people that are infected can only receive treatments that can help to keep the symptoms at bay. The most common transmission of this disease is through sexual intercourse and therefore AIDS is considered to be a Sexual transmitted disease (STD) (Appendix 1).Today AIDS is ranked the sixth most common cause of death among people ages 25 – 44 in the United States and according to WHO’s estimates there are more than 25 million people worldwide that have died from this infection since the start of the epidemic (NCBI 2010).
This research paper is designed to provide a better understanding of what AIDS is, where it comes from, and how people having this disease suffer from it. It furthermore explains how people can get infected, what symptoms they might have, and what treatment options are available for those suffering from this disease.
The acronym AIDS stands for acquired immune deficiency syndrome and describes a disease that causes severe damage to the immune system. AIDS is caused by the Human immunodeficiency virus or
HIV which is attacking the immune system, in particular the T helper cells (Appendix 2).
The first time AIDS was reported was on June 5, 1981 in a report of the Center for disease Control.
According to this report in the period from October 1980 to May 1981 five homosexual men were treated for this disease in 3 different hospitals in Los Angeles, California (CDC 1981). In the early eighties
AIDS was thought to be a disease that is related to homosexual behavior and was also referred to as
GRID (Gay-related immune deficiency).
After someone is infected with HIV he or she might not show any symptoms for 10 years or longer. This person however already can infect other people with this disease during this so called symptom free period. Others experience flu-like symptoms with fever, rash, sore throat, and swollen lymph nodes.
Those symptoms usually occur 2 to 4 weeks after being infected with the virus. If HIV is not treated with

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The primary symptoms of AIDS are not caused by the virus itself but by infections that normally do not develop in people with a healthy immune system. Those infections are called “opportunistic infections”
(Appendix 3) and might cause the following symptoms:

Chills

Fevers

Sweats (particularly at night)

Swollen lymph glands

Weakness

Weight loss
(NCIB 2010)
HIV is a disease that is not spread through skin contact, mosquitoes, or items that were previously touched by a person who is infected with this virus. Transmission of the virus can only occur when body fluids like those listed below are transferred from an infected person to an uninfected person. Those body fluids include:

Blood

Semen

Vaginal secretions

Breast milk
(NCIB 2010)
Common ways in which the virus can be transmitted are:

Sexual contact (especially unprotected sexual contact including oral, vaginal, and anal sex)

Blood exchange (via blood transfusion or needle sharing)

Nursing (from a mothers breast milk to the child)

Organ donations
(NCIB 2010)

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People that think that they might have been exposed to HIV can use the following options to get tested:

HIV antibody test

Rapid HIV test (Appendix 4, Figure 1)
(More tests can be found at http://www.avert.org/testing.htm
)
Antibody test
The antibody test is a very accurate and inexpensive test for HIV and is seen as the “best way” to get tested.
When a body is infected with this virus it responds by producing special proteins called antibodies that attempt to fight the infection. A person’s blood, salvia or urine is tested for HIV antibodies. Those fluids called samples are sent to a laboratory and tested for HIV antibodies. The detection of HIV antibodies means with a very few exceptions that the individual has been infected with HIV.
Rapid HIV test
The rapid HIV tests use a similar technology like the antibody test but the samples are not sent to the laboratory and instead are evaluated at the doctor’s praxis. Such a test is very fast and can produce results within 20 minutes.
(AVERT)
Even though there is currently no cure for AIDS available there are a variety of treatments that can help improve the quality of life to those suffering from AIDS.
The most common treatment for HIV is an antiviral therapy called highly active antiretroviral therapy
(HAART) which suppresses the replication of the HIV virus in the body. HAART can help to prevent the virus from replicating itself and therefore the number of T helper cells can be improved.
Unfortunately HAART also has side effects that can decrease the patient’s quality of life. Some common ones are:

Increasing risk of heart attack (when used over a long time)

Collection of fat on the back (“buffalo hump”) and abdomen

General sick feeling (malaise)

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
Headache

Nausea

Weakness.
When a doctor is describing HAART he or she should be carefully watch the patient for any possible side effects.
People at highest risk for infecting themselves with HIV include:




Injection drug users who share needles
Infants born to mothers with HIV who didn't receive HIV therapy during pregnancy
People engaging in unprotected sex
People who received blood transfusions or clotting products between 1977 and 1985 (prior to when screening for the virus became standard practice)

Sexual partners of those who participate in high-risk activities (such as injuection drug use or anal sex)
(UMM)
In order to prevent or reduce the change of getting HIV the following should be done:

Practice safer sex (not a 100% safe)

Do not use illicit drugs and share needles

Avoid contact with another person’s blood
(NCIB 2010)
A concept that is based on an astonishing case of an AIDS patient in Berlin, Germany might provide a cure for people suffering from AIDS. The patient seemed to be cured after getting blood cells from a donor who had natural immunity to HIV.
Some people (1% white and fewer minorities) are naturally resistant to HIV because they lack both copies of a gene called CCR5. A person lacking that gene donated blood stem cells to an American man living in Berlin who suffered leukemia and HIV. After the transplant of those cells the man seemed to be cured from HIV.

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The problem with this approach is that that there are not enough people lacking this gene and therefore curing everyone using this type of cure is impossible. Furthermore it has to be considered that transplants are medically risky and could have more disadvantages then advantages.
But scientists are currently trying to find a way that could enable a patient’s own cells get rid of the
CCR5 gene and therefore create a resistance to HIV.
(NPR 2011)

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Pub Med Health, NCBI. (2010, May 25). Aids acquired immune deficiency syndrome. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001620/
Centers for Disease Control and Prevention, (1981, June 5). Pneumocystis pneumonia --- los angeles.
Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm
Avert, . (n.d.). The different types of hiv test. Retrieved from http://www.avert.org/testing.htm
University of Maryland Medical Center, UMM. (n.d.). Aids - overview. Retrieved from http://www.umm.edu/ency/article/000594.htm
National Public Radio, NPR. (2011, February 28). Gene therapy raises hope for a future aids cure.
Retrieved from http://www.npr.org/templates/story/story.php?storyId=134134904

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STDs and ecological niches
Many sexually-transmitted diseases (STDs) invade the host and reside for long periods of time without killing the host. A good example is syphilis, which may reside in its host for 30 to 50 years. HIV also can take 10 or more years to kill its host, allowing plenty of time to spread the infection.
Review Date: 5/25/2010.
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine,
Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas,
MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine,
Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001620/

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Helper T cells are essential regulators of adaptive immune responses and inflammatory diseases.
A sub-group of lymphocytes, helper T cells play an important role in establishing and maximizing the capabilities of the immune system. These cells are unusual in that they have little or no cytolytic or phagocytic activity. However, they are involved in activating and directing other immune cells.
After activation by professional antigen-presenting cells (APCs) such as dendritic cells, macrophages, and B cells, antigen-specific CD4
+
T cells differentiate into effector cells that are specialized in terms of the cytokines and effector molecules that they express on their membranes or secrete and their discrete effector functions.
Source: http://www.bdbiosciences.com/research/tcell/about/helper.jsp

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AIDS
AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that leaves the body vulnerable to a host of life-threatening illnesses.
There is no cure for AIDS, but treatment with antiviral medication can suppress symptoms.
AIDS is universally fatal, in large part due to the proliferation of opportunistic infections.
Review Date: 5/25/2010.
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine,
Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas,
MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine,
Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001620/

Rapid HIV test
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Figure 1
Source: http://www.avert.org/media-gallery/image-2288-oraquick-hiv-12-test-kit