Acquired Immunodeficiency Syndrome - Essay Example

? Acquired Immunodeficiency Syndrome Institute Acquired Immunodeficiency Syndrome is a pathological condition which is led to by the human immunodeficiency virus. The condition follows a global trend and people all around the world have presented with this syndrome. It has been analyzed that 900,000 people in the United States were suffering from AIDS in the year 2002. Out of the total number of cases, 2 percent were reported amongst the children. There are many underlying causes of this pathology. The disease is led to by sexual transmission between heterosexuals as well as homosexuals. It can also be transmitted through infected blood transfusions. Drug addicts who use syringes are also at a high risk of developing the disease. It can be transmitted to the fetus from the mother during pregnancy as well as during birth and nursing. The disease affects the major systems of the human body owing to the suppression of immunity by the virus. It can result in severe conditions which include pneumonia as well as cancers like Kaposi’s sarcoma. The treatment for the condition is mainly antiretroviral therapy. Prevention is aimed at awareness. Acquired Immunodeficiency Syndrome Acquired Immunodeficiency Syndrome is a pathological condition which is referred to as a syndrome owing to the fact that this disease affects many systems of the human body and is characterized by many secondary infectious diseases as well as cancers arising from different cells. It may also affect the nervous system of the patient and hence the patient presents with signs and symptoms of nervous disease. This syndrome is led to by the human immunodeficiency virus. This virus and the resulting disease were identified in the year 1981. The virus possesses the ability to decrease the efficacy of the immune system of the human body and hence it puts a person at risk of the development of many diseases that would not occur in a normal healthy person. The pathology has led to increased attention from international health organizations due to the severity of the disease accompanied by the fact that the number of infected people keeps on increasing every year (Davidson et al 2006, Levinson 2008, Robbins et al 2005). Acquired Immunodeficiency Syndrome has been ranked as the second most common pathological condition across the world which explains the fact that this disease follows a global pattern. It has been labeled as an epidemic due to the increased presentation of the number of cases. In Africa it has been identified as the first most common reason of death and has been reported to lead to more than 20 percent of deaths in the region. Ever since the disease has been identified, it has been linked to greater than 20 million deaths around the world. The World Health Organization presented with the findings that 39.4 million people had AIDS or were infected with the human immunodeficiency virus in the year 2004 (Davidson et al 2006, Levinson 2008). 70 percent of the people who suffer from this disease belong to Africa. In the year 2002, it was identified that 900,000 residents of the United States were suffering from the disease. Amongst the residents of the U.S., it is considered to be the second reason of death amongst the males of the age group 25 to 44. On the other hand, amongst the females of this age group, it is ranked as the third life taking reason. The pathology is also found to affect young children below the age of 13 years. It has been analyzed that 2 percent out of the total cases of the disease affects these children. In 2002, 800,000 more children were affected with this syndrome (Robbins et al 2005, Levinson 2008). There are many underlying causes that can result in AIDS. The human immunodeficiency virus which is the causative organism for this disease prevails in the fluids of the human body which include the blood, semen, saliva as well as milk from the mammary glands. Thus contact with infected body fluids increases the susceptibility of contracting the disease (Davidson et al 2006). Sexual transmission between males and females has been considered to be the most common way of transferring the disease and is the reason for 75 percent of the cases across the world amongst adults (Royce et al 1997). On the other hand, the major cause for the infection amongst children is transfer of the causative viral organism from the mother to the infant. This can occur during the period of pregnancy or it may occur at the time of birth and nursing can also result in the transfer of the virus from the mother’s milk to the child. In the United States the disease occurs mainly in men due to sex between males and is reported highly amongst homosexuals. The link between homosexuality and AIDS has been reported to be very high and it has been indicated that half of the cases of the disease in the United States are present mainly amongst homosexuals. Apart from sexual transmission the second most important way of spread of the virus is through the parenteral route. This is highly susceptible in people suffering from haemophilia and other pathologies that require transfusion of blood. Infected transfusion of blood and its components was an important route of the transfer of the virus before the year 1985 owing to the fact that screening methods were not employed before blood transfusions. It still accounts for a few cases but mainly in the developing countries. The drug addicts who use needles and syringes are also at risk of contracting the virus and one fourth of all the cases in the United States have been linked to the use of intravenous route for drug addiction. An important aspect that has been highlighted in many researches is that regular daily contact with the AIDS patients is not related to the transmission of the virus (Davidson et al 2006, Robins et al 2005, Levinson 2008). The virus that leads to Acquired Immunodeficiency Syndrome is referred to as human immunodeficiency virus (HIV) and this virus is a human retrovirus mainly derived from the group of lentivirus. An important characteristic of this virus is that it does not tend to change its types and form new serotypes and there have been two basic forms of this virus that have been identified. These include HIV-1 and HIV-2 (Robbins et al 2005, Levinson 2008). A very important aspect about this disease is that every person infected with the virus may not develop the Acquired Immunodeficiency Syndrome and these infected people may live without any clinical presentations of this disease for many years. Thus HIV positive patients may develop the condition after many years of latency (Kane 2008). The HIV virus mainly attacks the immune system as well as the nervous system of the individuals. The virus possesses the capability of binding to the CD4 cells of the immune system and leads to a reduction in the number of these CD4 T helper cells. This leads to cascade of further events affecting the immune system and preventing the multiplication of the CD8 and B cells (Ganong 2005, Katzung et al 2007). After 4 to 11 days of infection with the virus, it is found in the bloodstream. The first cells to be affected are the CD4 T helper cells. The cells initially become infected and are then destructed by the cytotoxic CD8 white blood cells but the cytotoxic CD8 cells also lose their efficiency after a period of time and it is at this stage that the person presents with all the symptoms of the acquired immunodeficiency syndrome. The virus also has the capability of affecting the monocytes and macrophages of the brain. The virus keeps on multiplying within the cells of the human body which is mainly due to the incorporation of the genes of the virus into the DNA of the host and hence a person who once becomes infected with the virus retains the infection for his entire life (Levinson 2008). The normal CD4 helper T cell count in a person who has proper health lies in the range of 500-1500 cells/mm3 but for a person infected with the virus, the range can drop to levels of 5-500 cells/mm3. This indicates the profound effect that the virus can lay on the immune system of an individual (Kane 2008). The progression of the disease is classified in three grades which include the initial acute phase followed by a period of latency which later develops into a terminal stage. The first clinical manifestations begin 2 to 4 weeks after the virus invades the cells in the human body. The patient may complain of pyrexia, feeling of being unwell and throat infection. This is accompanied by enlargement of lymph nodes. Rashes can also be seen on the limbs and on the trunk of the person. This period resolves in about 14 days. This is followed by the period of latency when the patient may not have any complains and this period can continue for as long as 11 years. It is then followed by the final stage which is characterized by an extremely low immunity of the person which makes him susceptible to develop serious infections (Levinson 2008, Weiss 1993). There is the susceptibility of the involvement of the major organ systems of the human body at this stage. This includes involvement of the lung with the development of either pneumonia due to the organism pneumocystis cairnii or tuberculosis due to mycobacterium tuberculosis. The oral cavity may also get affected and the patient may present with oral thrush, hairy leukoplakia or ulcerations. Inflammation of the esophagus or thrush may also be seen. Reduced immunity leads to repeated disturbances of the gastrointestinal tract presenting with diarrhea which may be due to salmonella, shigella and other organisms. Retinitis, enlargement of lymph nodes and enlargement of spleen are other symptoms that may be seen. Inflammation of the meninges and abscess in the brain provide for the nervous system manifestations of these patients. They also have a high risk of developing cancer in particular Kaposi’s sarcoma of the skin which is caused by human herpes virus 8 (Levinson 2008, Robbins et al 2005). A research indicated the fact that pneumonia by pneumocystis carnii is the most common presentation of AIDS patients with approximately 63.6 percent of the patients presenting with this associated disease. This is followed by oral candidiasis, Kaposi’s sarcoma and esophageal candidiasis with the frequency of presentation being 44.8, 20.8 and 10.8 percent respectively (Selik et al 1987). The diagnosis of Acquired Immunodeficiency Syndrome is based on checking for the antibodies against the human immunodeficiency virus in the blood samples of the patients. Tests include OraQuick which is the quickest testing method that provides with the result in 20 minutes. ELISA is also another test for checking the antibodies. All tests are confirmed with the Western blot analysis (Levinson 2008). The management of Acquired Immunodeficiency Syndrome is basically directed towards increasing the life expectancy of the patient accompanied by reduction in the virus in the cells as well as prevention in the further spread of the virus to other people. It is also attempted to improve the immune status of the patient. It is judged that treatment is only to be started if the levels of CD4 helper cells decrease below the level of 350 cells/mm3. HAART therapy which basically stands for “highly active antiretroviral therapy” is the treatment given to the patients. This comprises of a combination of 3 drugs which include efavirenz accompanied with either zidovudine or abacavir and lamivudine. If these drugs fail to respond, alternate therapy is prescribed. Thus there should be close monitoring of the prognosis of the drugs (Davidson et al 2006, Levinson 2008, Katzung et al 2007). No vaccination is present to prevent this disease. Prevention is hence mainly directed towards awareness amongst high risk groups. Condoms, proper screening of blood as well as proper disposal of used needles are included amongst the most important preventive measures (Robbins et al 2005, Levinson 2008). References Top of Form Boon, N. A., & Davidson, S. (2006). Davidson's principles & practice of medicine. Edinburgh: Elsevier/Churchill Livingstone. Top of Form Ganong, W. F. (2005). Review of medical physiology. New York: McGraw-Hill Medical. Top of Form Kane, B. M. (2008). HIV/AIDS treatment drugs. New York, NY: Chelsea House Publishers. Top of Form Katzung, B. G., Masters, S. B., & Trevor, A. J. (2009).Basic & clinical pharmacology. New York: McGraw-Hill Medical. Bottom of Form Bottom of Form Bottom of Form Bottom of Form Top of Form Kumar, V., Abbas, A. K., Fausto, N., Robbins, S. L., & Cotran, R. S. (2005). Robbins and Cotran pathologic basis of disease. Philadelphia: Elsevier Saunders. Top of Form Levinson, W. (2008). Review of medical microbiology and immunology. New York: McGraw-Hill Medical. Bottom of Form Top of Form Royce, R. A., Sena, A., Cates, J. W., & Cohen, M. S. (January 01, 1997). Current Concepts: Sexual Transmission of HIV. The New England Journal of Medicine, 336, 15, 1072. Bottom of Form Bottom of Form Top of Form Selik, R. M., Starcher, E. T., & Curran, J. W. (January 01, 1987). Opportunistic diseases reported in AIDS patients: frequencies, associations, and trends. Aids (london, England), 1, 3, 175-82. Bottom of Form Top of Form Weiss, R. A. (January 01, 1993). How does HIV cause AIDS?. Science (new York, N.y.), 260, 5112, 1273-9. Bottom of Form Read More