Blogs

Here's some blogs and links to check out to get more information!

http://blog.aids.gov/

http://www.aids.gov

http://aidsinfo.nih.gov/

References

Hepatitis B vaccine. (2014). Retrieved from AIDS info website: http://aidsinfo.nih.gov/

Microbicides. (2012). Retrieved from AIDS.gov website: http://www.aids.gov/hiv-aids-basics/prevention/prevention-research/microbicides/

Tortora, G., Funke, B., & Case, C. (2013). Microbiology an Introduction (11th ed.) Glenview, Il: Pearson Education.

Public Awareness

When HIV/AIDS was first seen in U.S. it was labeled as a "gay disease" because it was concentrated in a certain area and seen in men who had homosexual partners. Gay men were ridiculed and outcasted from society because the cause of the disease was unknown. In general people fear what they do not understand, and at this time little to nothing was known about HIV, where it came from, how it was transmitted, or how to cure it. Since the causative agent of HIV has been identified we have been able to begin to treat patients while educating the public. There are many organizations available to those interested in learning about HIV, support for those who have HIV, and ways to donate to research on the disease. It is now known that it is not a gay disease, that anyone can contract the disease if exposed to infected body fluids. By educating adolescence about HIV and other sexually transmitted disease before they become sexually active we can help to lower the incidence of disease.

Prevention & Treatment

For many at risk to HIV/AIDS in Africa treatment isn't a likely option, due to lack of healthcare and economic status. The most important thing to may of these individuals is prevention by refraining from unprotected sex and promiscuity. It is more likely that a man transmits HIV to a woman during vaginal intercourse than vice versa. In developed countries like the U.S. treatment is available and has transformed a certainly fatal disease into a chronic disease. However, the availability and management of AIDS has led to a relaxed attitude toward safe sex practices and it is often forgot that this disease is treatable, but not curable (Tortora et al, 2013, p. 552).

There are multiple forms of treatment for HIV/AIDS. Chemotherapies are used to control reproduction of the virus. Revers transcriptase inhibitors targets the  reverse transcriptase enzyme which is not present in human cells and is only used to fight HIV infections, terming it antiretroviral. These drugs cause the termination of the viral DNA. Protease inhibitors target HIV proteases by ceasing essential process of creating mature proteins. Cell entry inhibitors function in preventing the necessary step of the virus attaching to the CD4+ receptors. Integrase receptors target HIV integrase enzymes that functions in creating the HIV provirus. For best treatment success a cocktail of drugs are used to stop viral replication at all stages of the process, it is known as highly active antiretroviral therapy (HAART). As many as 40 pills a day can be used with a complex schedule for best outcomes (Tortora et al, 2013, p. 552-553).

The most ideal form of treatment would be  a vaccine, but currently there are no vaccines available to prevent against infection of the virus. Like all vaccines it would have to produce antibodies against the virus, but because this virus mutates at such a high rate it makes doing this very difficult. Another form of treatment being researched is the use of vaginal and anal microbicides. "Microbicides are gels, fils, or suppositories that can kill or neutralize viruses and bacteria" (Microbicides, 2012).  Microbicides have started to be used in clinical trials, and the results are showing a decrease in infection when women used the microbicide gels before and after sex.

This video has a great animated depiction of how antiretroviral drugs work!!!
http://youtu.be/mzfnxCEsck4

Transmission & Infection

Transmission of HIV is primarily through sexual intercourse, where infected body fluid such as blood and semen come in contact with unaffected body fluids. Blood contains 1,000 - 100,000 viruses/ mL, and semen contains 10 - 50 viruses/ mL. The virus is not transmitted by casual contact, sharing household items, and generally kissing cannot spread the virus, saliva only contains 1 virus/mL, but there is always a risk (Tortora et al, 2013, p. 551).

For healthcare workers such as myself risk for infection from a needle-stick injury is 0.03%. It is suggested that healthcare workers be vaccinated against Hepatitis-B (HBV). HBV is an opportunistic infection, where those infected with HIV already have a compromised immune system making it more likely for them to have HBV. So by protecting yourself against HBV it can lower your risk for infection if you were to be exposed to body fluids (Hepatitis B vaccine, 2014).

In order to be infected with HIV the virus must go through steps of attachment, fusion, and entry. The virus has a strong correlation with immune system, particularly T helper cells. Helper T cells are the cells in the body that respond and regulate the immune response. On these helper T cells are specific receptors known as CD4+ that are the main target for the HIV infection. As these helper T cells become infected they go through a period of latency within cells that can last for decades, allowing it to hide from the immune system, this is known as latency infected macrophages. There is then the activated macrophage where new viruses are produced and released. These viruses are constantly undergoing rapid antigenic changes forming new variations of the virus making it extremely difficult to treat.

There are 3 clinical phases of HIV infection:

Phase 1- In the first few weeks after infection over 1 billion CD4+ cells will be infected. The infection may be asymptomatic, or cause lymphadenopathy (swollen lymph nodes). 

Phase 2- CD4+ T cells decline rapidly. HIV remains latent in cells, only a few infected cells are released. A few symptoms may appear indicating a decline in immune function.

Phase 3- CD4+ T cell count drops below 350 cells/mcL, indicating need for treatment. In a healthy individual a normal T cell count is between 800 and 1,000 cells/mcL. Less than 200 cells/mcL is considered diagnostic for AIDS.

                             

Origin

The origin of AIDS is thought to have been first contracted from humans who ate non-game animals such as chimpanzees. Animals such as chimpanzees and mangabey monkeys in west Africa are naturally infected with the SIV virus that is genetically related to the HIV virus. The first case of a man who died from AIDS was in 1959 in what is known today as the Democratic Republic of the Congo. We first started seeing this disease in the U.S. in 1981 as multiple people in California, particularly homosexual males, were coming down with cases of pneumocystis pneumonia, and a rare form of skin cancer know as Kaposi's sarcoma. These cases were found only in individuals with compromised immune systems, and by 1983 the virus causing the loss of immune function had been identified as HIV. Today approximately 33 million people in the world are infected with HIV, 67% of those people live in sub-Saharan Africa.

About Me

My name is Courtney Wissbroecker and I am a nursing student at Alverno College currently enrolled in a microbiology course. I am writing this blog to investigate and inform on the relationship between the microbial world and the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). AIDS is the disease that is progressed from the HIV infection that targets T helper cells causing a loss of immune function (Tortora et al, 2013, p. 545). Most people in the world today have heard of this disease, but may not really understand the disease, so I am here to help explain what the disease is, how it is spread, how it affects our bodies, and what type of treatments are out there.