Preventing Sexual Transmission Of HIV

Preventing Sexual Transmission Of HIV

 

Answer. HIV means human immunodefiiency virus.

• HIV was discovered in 1983 and first case was detected in UK
• It was discovered by Barre-Sinoussi and Montagnier
• HIV virus is classifid under HTLV-III
• HIV is of two types, i.e. HIV-1 and HIV-2 which are the retroviruses.

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Mode of transmission of HIV

• Sexual intercourse either vaginal or anal.
• Needle pricks, i.e. using unsterilized needles for injections,In IV drug abusers, careless handling
• Mother to child: During birth through vaginal secretion,transplacental, through breast milk
• Through blood transfusions and organ transplantations

Pathogenesis

The envelope glycoprotein of HIV binds with surface molecules of CD4 cells of T-lymphocytes, monocytes, macrophages,

• Langerhans cells and dendritic cells of all tissues.
• CD4 of lymphocytes and T helper cells control normal immune response.
• HIV suppresses immune response completely suppressing B-cell.
• Finally, it dismantles and destroy immune system making the individual prone to opportunistic infections.

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Clinical Classification of HIV

• Acute infections
• Asymptomatic but positive HIV.
• Persistent generalized lymphadenopathy
• AIDS (HIV-related diseases):

• Constitutional diseases such as weight loss, fever,diarrhea
• Neurological diseases such as dementia, neuropathy, myelopathy
• Opportunistic infections
• Malignancies: Kaposi’s sarcoma, non-Hodgkins lymphoma
• Other diseases attibutable to HIV infection.

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Test For HIV

• ELISA test (Screening test)
• Western blot (Diagnostic test)
• Polymerase chain reaction
• Anti-HIV antibody reaction
• Viremia quantification—to start the treatment and to see the response of anti-viral drugs.
• CD4 cell count:

• Normal value > 500/mm3
• Values between 200 to 500/mm3 is seen in Kaposi’s sarcoma, Candida infection and M. tuberculosis
• Values between 50 to 200/mm3 is seen in Pneumocystis carinii and Toxoplasma infection
• Values< 50/mm3 is seen in atypical mycobacteria,cytomegalovirus and lymphomas.

After the HIV infection, there is time gap for the patient to become reactive to tests. This time is known as “Window period”.

This period is variable and during this period an individual is infective.

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Treatment Of HIV

• Antiviral therapy or HAART therapy
  Nucleoside reverse transcriptase inhibitor (NRTI): Zidovudine,didanosine, abacavir, lamivudine, stavudine.
  Non-nucleoside reverse transcriptase inhibitor (NNRTI): Nevirapine, delavirdine.
  Protease inhibitors: Ritonavir, indinavir, amprenavir.
• Treatment of opportunistic infections.
• Treatment of tumors.
• Immunotherapy:
  Alpha and gamma interferons.
  Interleukins.
• Bone marrow transplantation.
• Anti-CD3 or IL-2 after HAART (Highly Active Anti- Retroviral Therapy).
• Psychotherapy
• Counseling of HIV patients and their families.
• Life expectancy after initial HIV infection is 8–l0 years.