HIV

Laird Boulden **HIV** **Basic Information & History** HIV stands for Human Immunodeficiency Virus and is well known as the precursor to AIDS or Acquired Immune Deficiency Syndrome. It is estimated by the Center for Disease Control that in 2006, 56,000 Americans contracted HIV. While not well known, there actually two types of HIV, HIV-1 and HIV-2. However, referring to HIV in the United States primarily means HIV-1. The HIV virus primarily affects a person by attacking their CD4+ T cells, which are integral to a person’s ability to fight diseases. HIV is commonly confused with AIDS and while they are related, AIDS refers to a late stage of HIV when the body is no longer able to fight diseases due to a severally damaged immune system (Department of Health, 2010). The history of the HIV virus and its identification dates back to1981 in the United States. Homosexual men in Los Angeles and New York were the first to display symptoms that we now associate with HIV and AIDS. These symptoms included skin tumors called Kaposi’s sarcomas and an unusual form of the lung infection pneumonia. To go along with these symptoms, these men were also noted as having severely low levels of CR4 cells, which greatly compromised their immune systems (Daar, M.D.) In 1983 doctors were able to trace HIV back to West Africa, specifically to chimpanzees who they identified as the source of the virus. The simian version of HIV, or SIV, was transmitted and consequently mutated to HIV to the humans who hunted chimpanzees for food and had come into contact with their blood (Department of Health, 2010).

**Causes, Symptoms and Diagnosis** HIV is primarily a sexually transmitted disease, but even though this is the main mode of infection, it is still possible to contract HIV through other means. The main modes of infection include:

· //Sexual Contact// -This includes all methods of sexual interaction: vaginal, anal, or oral, anything where the blood, semen, or bodily fluids enter the body. · //Blood Transfusions// · //Sharing Needles// · //Mother-to-Child// -This includes not only pregnancy and delivery, but also breastfeeding as well (Mayo Clinic Staff, 2010) It is important to note that while there are symptoms of HIV, most people who are HIV-positive never actually experience any symptoms. Also most of the symptoms directly caused by HIV are very similar to those experienced by common sicknesses, such as the flu. As early as 2-4 weeks and up to 3 months since infection, HIV-positive people may experience flu like symptoms. This initial sickness is the caused by the primary HIV infection, or acute retroviral syndrome, and is the body’s natural response to the infection. It is also worth noting at this time, that people are much more easily able to transmit the disease to others during this period (Department of Health). The next phase of the infection is referred to as the latency period of HIV and during this period patients may not experience any HIV caused symptoms at all. This period can last as long as 10 or more years and is due to the fact that the virus is less active in the body. The last stage of HIV is the AIDS stage and varies in its symptoms greatly. The signs and symptoms come from various opportunistic diseases that attack the immune damaged immune system (Department of Health). The most common way of testing to see if a patient is HIV-positive is to test the blood or saliva to look to for HIV antibodies. The only downfall of this method is that antibodies develop slowly and it could take as long as 12 weeks for a positive patient to return a positive test. There is however a newer test that checks for HIV antigen, which is a protein produced immediately after infection. The use of this method could be beneficial in reducing the spread of the virus (Mayo Clinic Staff). Early detection is a very good way to prevent the further spread of HIV. This is why, if you are sexually active with more than one person, it is important that you talk to your doctor and regularly get tested for HIV. **Treatment** While there is currently no cure for the HIV virus, there are currently treatment methods that allow people to live lives long past their diagnosis. There currently five different classes of drugs used in treatment, and these drugs are classified in how they attack the virus. It is usually recommended that you take multiple different drugs from different classes; as this is the best way to make sure that you attack the virus in multiple different ways and ensure that your body doesn’t develop a resistance to the drugs (Department of Health). The five classes of drugs are as follows: · //Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)// : These drugs block an important phase of the HIV’s replication. · //Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)// : Very similar to NRTIs, but work by blocking replication in a different way. · //Protease Inhibitors (PIs)// : This drug stops an enzyme, protease, from cutting the HIV’s genetic material into usable pieces. · //Entry/Fusion Inhibitors// : This drug blocks the HIV virus from ever entering your cells at all. · //Integrase Inhibitors// : This drug blocks the enzyme integrase, which is responsible for combining its DNA to CDR cells (Department of Health) It should be noted that while there are multiple methods of treatment, the ultimate decision of treatment comes down to the patient and their doctors. This is why it very important for you to speak with your caregiver about your options in regards to types of treatment, side effects, and how to take them. It is important for a patient’s preferences to be heard, but a doctor must also take into account needs and medical history when assigning a regimen (Department of Health). Finding a doctor with experience working with a HIV patient will make this process much easier. It was help the patient feel more comfortable discussing their condition with their caregiver and give them a better understanding of their options. **Emotional Needs and Support** People living with HIV have great emotional needs to go along with the medical attention that they also need. People commonly experience shock, anger, and fear after diagnosis as well as throughout the rest of their lives. It’s for these reasons and others that HIV-positive people have a depression rate twice as high as that of the general population (HIV & AIDS). This is why communication with friends and family, as well as other HIV-positive people, is very important. One of the first issues facing a person after they have been diagnosed is how they are going to tell people about it and this can cause great emotional stress. In fact, the World Health Organization states that post-test counseling is very important to the emotional needs of the newly infected. Talking about the disease through counseling is a good way to come to terms with the news and serves as a good precursor for the resulting treatment. It has been show that counseling before reviewing treatment options is actually better for the patient in terms of picking the right option (HIV & AIDS). While disclosing this information to partners, spouses, friends, family, etc. can be a very tough process, it is vitally important to preventing spreading infection as well as encouraging others to be safe. Although a certain stigma around HIV sometimes prevents disclosure, patients should know that communicating this information to others is usually met with a positive reaction. On the flipside of things, it is sometimes harder for the loved ones of a HIV-positive person to accept things than the patient themselves. In this case, it is important for friends and family to reactout to the patient to become more comfortable with the situation. In a Canadian study, it was actually found that loved ones who decided to use other methods of coping other than accepting it, reported higher levels of grief (HIV & AIDS).

Discussing the feeling of grief with others can also be a very helpful experience to the infected. In many countries there are support call centers that can provide advice and put callers in touch with local groups. Peer groups for people with HIV can help the affected know that they are not alone and in most cases can offer the best advice (HIV & AIDS).

**Reference:** Daar, M.D., Eric S. (n.d.). //Human immunodeficiency virus (hiv management)//. Retrieved from http://www.medicinenet.com/human_immunodeficiency_virus_hiv_aids/article.htm Department of Health and Human Services, CDC. (2010). //Basic information about hiv and aids// Atlanta, GA: Retrieved from [] Department of Health and Human Services, aids.gov. (n.d.). //Hiv/aids basics// Washington, DC: Retrieved from http://aids.gov/hiv-aids-basics/ //Hiv & aids treatment and care//. (n.d.). Retrieved from [] Mayo Clinic Staff, Initials. (2010, August 11). //Hiv/aids//. Retrieved from []