Saturday, February 19, 2011

AIDS and HIV


Acquired immune deficiency syndrome  (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV).

It was first widely recognised in 1981.

The immune system is a network of cells, organs and proteins that work together to defend and protect the body from potentially harmful, infectious microorganisms (microscopic life-forms), such as bacteria, viruses, parasites and fungi. 

The immune system also plays a critical role in preventing the development and spread of many types of cancer.When the immune system is missing one or more of its components, the result is an immunodeficiency disorder. 

AIDS is an immunodeficiency disorder. 

The virus primarily attacks the white blood cells (the T-lymphocytes or CD-4 cells) and macrophages of the body. These cells play a key role in maintaining a person's immunity to disease. As a result, HIV infected people become susceptible to illnesses caused by the collapse of the body's immune system. Individuals infected with the virus are infectious for the rest of their lives, and can transmit HIV via blood or sexual fluids.

Sign and Symptoms :
The HIV virus cannot be destroyed and lives in the body undetected for months or years before any sign of illness appears. 
Gradually, over many years or even decades, as the T cells become progressively destroyed or inactivated, other viruses, parasites or cancer cells (called "Opportunistic Diseases") which would not have been able to get past a healthy body's defense, can multiply within the body without fear of destruction. 

Commonly seen opportunistic diseases in persons with HIV infection include,
01. Pneumocystis carinii pneumonia
02. Tuberculosis
03. Candida infection of the mouth, throat or vagina
04. Cytomegalovirus retinitis 
05. Kaposi's sarcoma

Immediately following infection with HIV, most individuals develop a brief, nonspecific viral illness consisting of low grade fever, rash, muscle aches, headache and/or fatigue. Like any other viral illness, these symptoms resolve over a period of five to 10 days. 
Then for a period of several years (sometimes as long as several decades), people infected with HIV are asymptomatic (no symptoms). 

However, their immune system is gradually being destroyed by the virus. 
When this destruction has progressed to a critical point, symptoms of AIDS appear. 

These symptoms are as follows :
01. Extreme fatigue.
02. Rapid weight loss from an unknown cause (more than 10 lbs. in two months for no reason).
03. Appearance of swollen or tender glands in the neck, armpits or groin, for no apparent reason, lasting for more than four weeks.
04. Unexplained shortness of breath, frequently accompanied by a dry cough, not due to allergies or smoking.
05. Persistent diarrhea.
06. Intermittent high fever or soaking night sweats of unknown origin.
07. A marked change in an illness pattern, either in frequency, severity or length of sickness.
08. Appearance of one or more purple spots on the surface of the skin, inside the mouth, anus or nasal passages.
09. Whitish coating on the tongue, throat or vagina.
10. Forgetfulness, confusion and other signs of mental deterioration.
It can take as short as a year to as long as 10 to 15 years to go from being infected with HIV to "full-blown" AIDS.

According to the Center for Disease Control and Prevention, a person is considered to have AIDS when they have a T cell count (also called CD4 cell count) of 200 or less (healthy T cell levels range from 500 to 1500) or they have an AIDS-defining condition. 

The AIDS - defining conditions are :
01. Candidiasis
02. Cervical cancer (invasive)
03. Coccidioidomycosis, Cryptococcosis, Cryptosporidiosis
04. Cytomegalovirus disease
05. Encephalopathy (HIV-related)
06. Herpes simplex (severe infection)
07. Histoplasmosis
08. Isosporiasis
09. Kaposi's sarcoma
10. Lymphoma (certain types)
11. Mycobacterium avium complex
12. Pneumocystis carinii pneumonia
13. Pneumonia (recurrent)
14. Progressive multifocal leukoencephalopathy
15. Salmonella septicemia (recurrent)
16. Toxoplasmosis of the brain
17. Tuberculosis
18. Wasting syndrome

People who are not infected with HIV may also develop these diseases. 
The presence of any one of these conditions does not mean the person has AIDS. 
To be diagnosed with AIDS, a person must be infected with HIV. 

Stages of Infection :
Some people develop an illness resembling an acute glandular fever-like illness within 6 weeks of infection. 
Symptoms include fever, headache, swollen glands, tiredness, aching joints and muscles, and a sore throat. However, most people will not feel unwell or develop any abnormality for years. 
Antibodies to HIV usually develop within 2 to 8 weeks, and almost always by 12 weeks. 

The 12 weeks after initial infection is called the "window period", where a negative test does not necessarily indicate that a person is free of the virus and a follow-up test will be necessary. However, by the end of the window period virtually all infected people will have a positive blood test (i.e. they will test "seropositive" or "HIV-positive"). Developing an HIV-positive test is known as "seroconversion".

HIV-infected individuals can remain physically well for many years after initial infection. However, in general the virus slowly attacks the immune system and, at a critical point, the condition AIDS develops.

Within 5 years of infection, up to 30% of those individuals infected with HIV are likely to develop AIDS (i.e. severe conditions such as cancer and pneumonia). A proportion of people will develop less severe symptoms, such as persistent generalised lymphadenopathy (swollen glands), diarrhoea, fever, and weight loss. Studies indicate that about 50% of adults infected with the virus will develop AIDS within 10 years of infection.

Of individuals diagnosed as having AIDS, 90% are likely to die within 2 years if not treated. 

Transmission :
There are only three significant routes of transmission for HIV,

1. From infected blood or blood products
2. From infected sexual fluids
3. From infected mother to baby during pregnancy and delivery. 

01. Blood Products :
Unsterilised equipment used for tattooing and acupuncture could transmit the infection. It is possible for the virus to be transmitted through needle-stick injuries to health workers, and also during unsafe disposal of needles and syringes.
Blood transmission of HIV is virtually confined to needle and syringe sharing among injecting drug users. Anyone who shares a needle or syringe with an infected person is at high risk of contracting HIV because there are large quantities of the virus in blood, which is then injected directly into the bloodstream.

02. Sexual Activity :
Exact levels of risk for the various forms of sexual activity are not known, but some sexual practices have higher risks associated with them than others.

Vaginal Intercourse :
Transmission can occur in either direction during unprotected vaginal intercourse. 
The risk of infection is greater for the woman - the risk of infection passing from men to women during vaginal intercourse is two to three times greater than the risk of it passing from women to men. HIV can be absorbed into the woman's bloodstream during unprotected vaginal intercourse via tears in the vaginal wall, genital ulceration, an inflamed or traumatised cervix caused by cervicitis, or by absorption through the membrane of the cervical canal. Also, because semen remains in the vagina and around the cervix after intercourse, the risk of transmission is increased. 

Anal Intercourse :
Transmission can occur in either direction, but the receptive partner is at greater risk. Anal intercourse without a condom is the highest risk sexual activity because the rectal lining is fragile and prone to tearing, thus allowing easy access for infected blood and semen.

Oral Sex :
The risks of oral sex are unclear. 
Cuts, infections in the mouth or throat, and gingivitis (infected gums) could pose some risk. The fluid expressed from the urethra before ejaculation is also likely to be infectious. Similarly, menstrual blood contains high concentrations of the virus and should also be avoided.

Non Penetrative Sex :
Mutual masturbation and other forms of non-penetrative sexual activity are safe provided that blood or sexual fluids do not enter a partner's body.

Genital Ulceration :
When there is genital ulceration in either partner, or when an uninfected male partner is uncircumcised, the risk of transmission probably increases. 

03. Mother to Baby Transmission : 
If a pregnant woman is HIV-positive, the baby has a one in 3 chance of being infected.Approximately 30% of infants born to untreated HIV-positive women are infected. It is not known at what stage of the pregnancy the foetus is infected, but recent evidence supports the notion that the infant often becomes infected during the birth process. Further research is being done in this area.

WHO estimates that HIV is spread in the following way:
60% Transmitted through vaginal intercourse
15% Through anal intercourse
10% Through injecting drug use
10% Perinatally (i.e. from mother to baby)
5% Through contaminated blood and other injections

How it is not spread : 
There is no risk of infection through social non-sexual contact such as kissing, sharing utensils (e.g. cups), body contact, or the use of public toilets. HIV is not spread by mosquitoes or other insects.

The Test :
Four blood tests are available: 

1. Enzyme immuno-assay: Enzyme linked immunosorbent assay (EIA, ELISA) 
2. Western blot (WB) 
3. Immunofluorescent assay (IFA) 
4. Radio-immunoprecipitation assay (RIPA)

The most common approach is the use of an EIA test for screening (the initial test) and a western blot for confirmation. 
It usually takes 7 days for the results to be ready.

The HIV antibody test is the blood test that determines whether an individual has HIV antibodies. A positive test means that there are antibodies and that HIV has established itself in the body. As previously described, it can take as long as 3 months - the window period - for antibodies to be produced. 
A negative test can mean that either HIV is not present in the body, or that the body has not had sufficient time to respond to the virus by producing antibodies.

Advantages of Testing :
1. Access to appropriate treatments for HIV-positive individuals early in the infection can delay the onset of AIDS and prolong survival.

2. The detection of infection at an asymptomatic stage may avoid a range of severe physical and social complications that may occur when infection is detected in an emergency situation (e.g. an accident, in a hospital emergency room, or after admission to hospital with advanced disease). Breaches of confidentiality and privacy are more likely in these late stages, and there may not be sufficient time for the individual to benefit from treatments, come to terms with the illness, make any necessary practical living arrangements, or prevent the further spread of infection.

3. A negative test result can relieve anxiety after perceived exposure to infection.

4. A positive result can encourage the practice of safe sex and safe drug use, preventing the spread of infection as well as protecting the infected person from other STDs, or different strains of HIV. 

5. Widespread testing helps to determine the extent and distribution of infection, which in turn can assist in planning support and prevention strategies. 

6. A positive result may affect a person's important life decisions, for example, about whether or not to have children. 

7. Individuals may make other lifestyle changes that improve their health status and life expectancy.

Treatment :
Anti-HIV (also called antiretroviral) medications are used to control the reproduction of the virus and to slow or halt the progression of HIV-related disease. 
When used in combinations, these medications are termed Highly Active Antiretroviral Therapy (HAART). HAART combines three or more anti-HIV medications in a daily regimen, sometimes referred to as a "cocktail". Anti-HIV medications do not cure HIV infection and individuals taking these medications can still transmit HIV to others.

Anti-HIV medications approved by the U.S. Food and Drug Administration (FDA) fall into four classes: 

1. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs), such as nevirappine (Viramune) and efavirenz (Sustiva), bind to and block the action of reverse transcriptase, a protein that HIV needs to reproduce.

2. Nucleoside Reverse Transcriptase Inhibitors (NRTIs), such as zidovudine (Retrovir), tenofovir DF (Viread), and stavudine (Zerit), are faulty versions of building blocks that HIV needs to make more copies of itself. When HIV uses an NRTI instead of a normal building block, reproduction of the virus is stalled.

3. Protease Inhibitors (PIs), such as lopinavir/ritonavir (Kaletra), disable protease, a protein that HIV needs reproduce itself.

4. Fusion Inhibitors, such as enfuvirtide (Fuzeon ), are newer treatments that work by blocking HIV entry into cells.

How many pills you will need to take and how often you will take them depends on what medications you and your doctor choose. 

Side Effects :
The side-effects of zidovudine treatment can include anaemia, vomiting, insomnia, and myalgia (muscle pain). However, these side-effects are more common on high-dose regimes. The new low-dose regimes have fewer side-effects.
Side-effects of ddI and ddC include inflammation of the pancreas and damage to nerves.

Prevention :
Here are some tips to help you prevent this disease.

01. Avoid having unprotected sex with multiple partners. Never reuse condoms.

02. Be careful to take only HIV free blood, if you ever need to take blood at all.

03. Never pick up any needle from the ground and never let it enter your body.

04. Always use disposable needles and syringes.

05. Be careful not to share needle at the time of body piercing or tattooing.

06. In the salon, never share razor.

07. You can kiss an AIDS patient in the cheek, but do not go for deeper kiss, as AIDS virus can be sometimes found in the saliva.

Ayurvedic View :
According to Ayurveda the AIDS disease may be correlated with "Kshaya' or "Ojakshaya' meaning loss of energy. 

The Symptoms and causative factors and treatment for the latter are found mentioned in many ancient Ayurvedic tests like, Charaka Samhitha, Bhavaprakasha,Vaidyachintamani and Chakradatta etc., 

Shosha is another condition, which results from loss of energy that is similar to AIDS.  
The disease is caused by the dominant kapha dosha along with the other doshas tends to block the path for the flow of rasadi dhatus in their respective locations thus resulting in the deterioration of saptha dhatu Rasa(plasma), Rakta (blood cells),Mansa ( muscular tissue), Meda (adipose tissue), Asthi (bony tissue), Majja (bone marrow) and the Shukra (reproductive tissue). thus resulting into the disease. 

The major symptoms are :   
01. Loss of appetite, drastic loss of weight-emaciation   
02. Fatigue and lethargy   
03. Susceptibility to allergies and contagious diseases   
04. Skin irritations  
05. Bronchial disorders, often leading to tuberculosis of the lungs   
06. Damage to intestinal flora resulting in diarrhoea, dysentery, gastritis and   
07. Wide fluctuations in body temperature and prolonged fever.   
08. Sleeplessness etc. 

Treatment : 
All seems not lost for the HIV infected persons as the Ayurvedic supplements are proven to be harmless without any side effects and there can only be improvement and not deterioration.

01. The first step to stem the disease is to ensure a good and healthy atmosphere for the patient. 
He should be surrounded by well meaning friends and relatives who must affirm that the disease state is totally curable.
Nothing negative should be discussed before the patient.
 
02. The patient should be given nourishing food which is easily digestible. 

03. Patient is advised to do regular exercise. 
He should be encouraged to do easy exercise which does not strain his fragile health. 
He should be kept engaged in fruitful activities which strengthen the good tendencies inherent in him.

04. Initially, the patient is given tonics and rejuvenators (Rasayanas) to boost immunity levels and to strengthen the system and stimulate appetite.

05. After gaining some strength, shodhana (elimination) techniques are used to expel toxins from the body through enemas, purgation and emesis. 
The medications administered at this stage are not hard or drastic, but soft, ghee-based so that the patient withstands them with ease.

06. Secondly the blood is purified with appropriate medications. 

07. Liver corrective measures also play an important role.

08. A strengthening diet along with medicated ghee preparations and soups is recommended. 
But spicy, oily and acidic foods are to be avoided. 
Aishtas are recommended as anupana (carrier) to aid the digestive process, and also remove blockages in the flow of Rasadi dhatus, i.e. srothorodha.

09. Experience has shown that certain herbo-mineral compounds prepared as per the formulae prescribed by sages like Agasthya, Charaka, Sarangadhara and others for the treatment of Kshaya have brought about significant results in improving the condition of AIDS patients. The Rasayana and Vajikara effects of the these medicines are good for the patients. 

Classical Preparations :
01. Gulgulu Thiktham kashayam
02. Vidharyadhi kashayam
03. Ashwagandhaarishtam
04. Balarishtam
05. Dashamoolaarishtam
06. Mrithasanjivani
07. Chyavanaprasha Rasayanam
08. Agasthya Rasayanam
09. Brahma Rashayanam
10. Ashwagandhaadhi Lehyam
11. Vidhaaryaadhi Lehyam
12. Thriphala Choornam
13. Vidharyadhi Gritham
14. Ashwagandhaadhi Gritham  

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