Diagnosing And Treating Aids Dementia
There is no single test that can confirm the diagnosis of HIV encephalopathy. Diagnosis is made largely by exclusion, ruling out other possible causes of the impairment. A full assessment must be made by an experienced clinician, examining the patient’s history, lab tests , brain scans , and a review of the so-called “stage characteristics.”
Stage characteristics determine the severity of impairment on a scale of 0 to 4, as follows:
- Stage 0: Normal motor and mental function.
- Stage 0.5: Minimal dysfunction with normal gait and strength. Person is able to work and perform regular day-to-day routines.
- Stage 1: Functional impairment of motor and/or mental skills. Person can still walk without assistance and carry on all but the most demanding daily tasks.
- Stage 2: Cannot work and has problems coping with more difficult aspects of daily life. However, the person is still able to care for himself/herself and is able to walk .
- Stage 3: Major mental and/or motor incapacity. Person is unable to care for himself/herself.
- Stage 4: Near vegetative state.
While the more severe manifestations of ADC have decreased greatly in numbers since the advent of combination antiretroviral therapy , mild neurocognitive impairment is still seen in about 30% of those with asymptomatic HIV and 50% of those with AIDS.
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Facts On Dementia Due To Hiv Infection
Decline in mental processes is a common complication of HIV infection .
- Although the specific symptoms vary from person to person, they may be part of a single disorder known as AIDSdementia complex, or ADC. Other names for ADC are HIV-associated dementia and HIV/AIDSencephalopathy.
- Common symptoms include decline in thinking, or cognitive, functions such as memory, reasoning, judgment, concentration, and problem solving.
- Other common symptoms are changes in personality and behavior, speech problems, and motor problems, such as clumsiness and poor balance.
- When these symptoms are severe enough to interfere with everyday activity, a diagnosis of dementia may be warranted.
AIDS dementia complex typically occurs as CD4+ count falls to less than 200 cells/microliter. It may be the first sign of AIDS. With the advent of highly active antiretroviral therapy , the frequency of ADC has declined from 30-60% of people infected with HIV to less than 20%. HAART may not only prevent or delay the onset of AIDS dementia complex in people with HIV infection, it can also improve mental function in people who already have ADC.
Stage : Clinical Latency
In this stage, the virus still multiplies, but at very low levels. People in this stage may not feel sick or have any symptoms. This stage is also called chronic HIV infection.
Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this stage faster.
If you take HIV medicine exactly as prescribed and get and keep an undetectable viral load, you can live and long and healthy life and will not transmit HIV to your HIV-negative partners through sex.
But if your viral load is detectable, you can transmit HIV during this stage, even when you have no symptoms. Its important to see your health care provider regularly to get your viral load checked.
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How Is Hiv Treated
There is no vaccine or cure for HIV infection. However, there are effective treatments that can prevent the transmission of HIV and the progression to AIDS, and help ensure a near-normal life expectancy.
These treatments are known as antiretroviral therapy . They stop the virus from reproducing itself, which leads to a lower viral load. The treatment involves a combination of drugs used together.
HIV-positive people who take ART daily exactly as prescribed and achieve an undetectable viral load cant sexually transmit the virus to an HIV-negative partner.
Thanks to the improvements in treatment, HIV infection is now a manageable chronic disease for many people in countries like Australia.
Living With Hiv: What To Expect And Tips For Coping
The most important thing is to start antiretroviral treatment as soon as possible. By taking medications exactly as prescribed, people living with HIV can keep their viral load low and their immune system strong.
Its also important to follow up with a healthcare provider regularly.
Other ways people living with HIV can improve their health include:
- Make their health their top priority. Steps to help people living with HIV feel their best include:
- fueling their body with a well-balanced diet
- exercising regularly
- avoiding tobacco and other drugs
- reporting any new symptoms to their healthcare provider right away
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Phases Of Hiv Infection
Clinical HIV infection undergoes 3 distinct phases: acute seroconversion, asymptomatic infection, and AIDS. Each is discussed below.
Animal models show that Langerhans cells are the first cellular targets of HIV, which fuse with CD4+ lymphocytes and spread into deeper tissues. In humans, rapid occurrence of plasma viremia with widespread dissemination of the virus is observed 4 days to 11 days after mucosal entrance of the virus.
There is no fixed site of integration, but the virus tends to integrate in areas of active transcription, probably because these areas have more open chromatin and more easily accessible DNA. This greatly complicates eradication of the virus by the host, as latent proviral genomes can persist without being detected by the immune system and cannot be targeted by antivirals.
During this phase, the infection is established and a proviral reservoir is created. This reservoir consists of persistently infected cells, typically macrophages, and appears to steadily release virus. Some of the viral release replenishes the reservoir, and some goes on to produce more active infection.
The proviral reservoir, as measured by DNA polymerase chain reaction , seems to be incredibly stable. Although it does decline with aggressive antiviral therapy, the half-life is such that eradication is not a viable expectation.
Asymptomatic HIV infection
What Are Hiv And Aids
The human immunodeficiency virus is a virus that affects the immune system. It gradually destroys cells called CD4 cells, which usually help the body stay healthy by fighting off disease.
If HIV is not treated, most people will develop severe immune deficiency within 10 years. At this point, the body is no longer able to fight infection and stop cancer from developing. This late stage of HIV infection is called acquired immunodeficiency syndrome .
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Analysis Techniques And Outcome Measures
We report the percentage of individuals diagnosed with chronic condition for each subgroup for individuals enrolled between 20072016. Logistic regressions were used to estimate odds ratios of developing each chronic condition by HIV status the odds ratio would then provide an estimate of the relative likelihood of that chronic disease for a PLWHA compared to a HIV- individual. We performed this regression for each of our three definitions of having HIV: inclusion in HIV Cohort 1 , Cohort 2 , or Cohort 3 . The dependent variable was whether the individual would develop the chronic disease by 2, 5, or 10 years from baseline only individuals without the disease at baseline were used in each regression. Other control variables included age at enrollment, sex, race/ethnicity, annual household income level at baseline, behavioral risk factors , and the other chronic disease groups at baseline not being used as the dependent variable.
Basic Facts About Hiv/aids
What is HIV?
HIV stands for human immunodeficiency virus. It is the virus that causes AIDS. When a person is infected with HIV, the virus enters the body and then resides and multiplies primarily in the white blood cellsthe immune cells that normally protect us from disease.
What is AIDS?
AIDS stands for acquired immunodeficiency syndrome.As HIV grows in an infected person, it damages or kills specific immune cells, weakening the immune system and leaving the person vulnerable to infections and illnesses ranging from pneumonia to cancer.Only when someone with HIV begins to experience one or more of these conditions or loses a significant amount of immune cells are they diagnosed with AIDS.
How do I know if Im infected?
Soon after infection, some people may develop mild, temporary flu-like symptoms, or persistently swollen glands. Even if you look and feel healthy, you may be infected.
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Epidemiology Of Pulmonary Infections In Hiv
Few studies have systematically described the full spectrum of HIV-associated pulmonary infections . Most investigators have focused on pneumonias of specific aetiologies. Therefore, there is no consensus on any diagnostic algorithm of pulmonary infections in HIV patients. The diagnostic decision should be different depending on the epidemiological features in a specific geographical area . Thus, the incidence of TB in HIV patients varies considerably in different geographical areas, depending on the prevalence of disease in the general population. In Africa, TB could be the most common pulmonary complication of HIV, followed by community-acquired pneumonia . However, PCP is uncommon in Africa, although the incidence seems to be increasing . It remains speculative whether this trend denotes a true increase in the prevalence of PCP or whether the early reports underestimated the actual prevalence . In Western Europe in the 1990s, PCP was the commonest AIDS-defining illness, whereas pulmonary TB was more common in Eastern Europe. Within Western Europe, TB remains more common in the south than in the north . Endemic fungi are common in HIV patients who live in endemic areas, but are exceptional in patients that have never resided in or travelled to endemic regions .
Signs And Symptoms According To Hiv Infection Stage
An HIV infection progresses through three stages, each presenting different sets of symptoms and complications. Not all HIV positive individuals will progress through all three stages. Some never develop full-blown AIDS. An HIV infection, however, lasts the remainder of a persons life once contracted and cannot be cured. The three stages and their associated symptoms are:
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Whats The Hiv Window Period
As soon as someone contracts HIV, it starts to reproduce in their body. The persons immune system reacts to the antigens by producing antibodies .
The time between exposure to HIV and when it becomes detectable in the blood is called the HIV window period. Most people develop detectable HIV antibodies within 23 to 90 days after transmission.
If a person takes an HIV test during the window period, its likely theyll receive a negative result. However, they can still transmit the virus to others during this time.
If someone thinks they may have been exposed to HIV but tested negative during this time, they should repeat the test in a few months to confirm . And during that time, they need to use condoms or other barrier methods to prevent possibly spreading HIV.
Someone who tests negative during the window might benefit from post-exposure prophylaxis . This is medication taken after an exposure to prevent getting HIV.
PEP needs to be taken as soon as possible after the exposure it should be taken no later than 72 hours after exposure but ideally before then.
Another way to prevent getting HIV is pre-exposure prophylaxis . A combination of HIV drugs taken before potential exposure to HIV, PrEP can lower the risk of contracting or transmitting HIV when taken consistently.
Timing is important when testing for HIV.
Can We Achieve An Aids
People with human immunodeficiency virus/acquired immunodeficiency syndrome now have more support and understanding although this is not universal. The life expectancy of people with HIV/AIDS has increased dramatically over time.
- Between 1988 and 1995, the death rate was 78 percent, but it fell to about five percent between 2005 and 2020.
- People with HIV can now expect to live normal lives if antiretroviral drugs are started early.
- They can expect to be able to live normal lives. The World Health Organization recommends that people infected with a virus should be given a cocktail of antiretroviral medications.
- Drugs such as tenofovir, emtricitabine, lamivudine, and efavirenz are used in combination to combat the patient’s viral load or amount of virus in the body.
- According to research, HIV-positive people with undetectable viral loads do not spread the virus to others.
The Joint United Nations Programme on HIV/AIDS emphasizes that although significant progress has been made, there is still much more to be done.
The next step for HIV researchers is to develop a reliable vaccine. Studies and tests are already underway. Although preliminary results are promising, there is no timetable for a widely available HIV vaccine.
Because of the way the virus replicates in the infected host’s body, a cure may take time.
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Early Detection And Treatment Play An Important Role In Keeping Hiv At Bay Todays Antiretroviral Drugs Are So Effective That Most People With Hiv Live Long And Relatively Healthy Lives
How many people are living with HIV?
Nearly 38 million people are living with HIV worldwide. Many of them do not know they are infected and may be spreading the virus to others. In the U.S., approximately 1.2 million people are living with HIV, and almost 37,000 Americans receive diagnoses each year.
Simplified Hiv Life Cycle
HIV attaches to and penetrates host T cells, then releases HIV RNA and enzymes into the host cell. HIV reverse transcriptase copies viral RNA as proviral DNA. Proviral DNA enters the host cells nucleus, and HIV integrase facilitates the proviral DNAs integration into the hosts DNA. The host cell then produces HIV RNA and HIV proteins. HIV proteins are assembled into HIV virions and budded from the cell surface. HIV protease cleaves viral proteins, converting the immature virion to a mature, infectious virus.
Infected CD4+ lymphocytes produce > 98% of plasma HIV virions. A subset of infected CD4+ lymphocytes constitutes a reservoir of HIV that can reactivate .
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Early Symptoms In Primary Hiv
The first noticeable stage is primary HIV infection. This stage is also called acute retroviral syndrome , or acute HIV infection.
It usually causes flu-like symptoms, so its possible for someone in this stage to think they have severe flu or another viral illness rather than HIV. Fever is the most common symptom.
Other symptoms include:
Side Effects And Costs
Side effects of antiretroviral therapy vary and may include nausea, headache, and dizziness. These symptoms are often temporary and disappear with time.
Serious side effects can include swelling of the mouth and tongue and liver or kidney damage. If side effects are severe, the medications can be adjusted.
Costs for antiretroviral therapy vary according to geographic location and type of insurance coverage. Some pharmaceutical companies have assistance programs to help lower the cost.
To develop AIDS, a person has to have contracted HIV. But having HIV doesnt necessarily mean that someone will develop AIDS.
Cases of HIV progress through three stages:
- stage 1:acute stage, the first few weeks after transmission
- stage 2: clinical latency, or chronic stage
- stage 3: AIDS
As HIV lowers the CD4 cell count, the immune system weakens. A typical adults CD4 count is 500 to 1,500 per cubic millimeter. A person with a count below 200 is considered to have AIDS.
How quickly a case of HIV progresses through the chronic stage varies significantly from person to person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it can last indefinitely.
Theres currently no cure for HIV, but it can be managed. People with HIV often have a near-normal lifespan with early treatment with antiretroviral therapy.
Also, treatment can typically help manage opportunistic infections.
HIV and AIDS are related, but theyre not the same thing.
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Definition Of Hiv And Aids
The human immunodeficiency virus has infected tens of millions of people around the globe in the past three decades, with devastating results. In its advanced stageacquired immunodeficiency syndrome the infected individual has no protection from diseases that may not even threaten people who have healthy immune systems. While medical treatment can delay the onset of AIDS, no cure is available for HIV or AIDS.
The human immunodeficiency virus kills or impairs the cells of the immune system and progressively destroys the bodys ability to protect itself. Over time, a person with a deficient immune system may become vulnerable to common and even simple infections by disease-causing organisms such as bacteria or viruses. These infections can become life-threatening.
The term AIDS comes from acquired immunodeficiency syndrome. AIDS refers to the most advanced stage of HIV infection. Medical treatment can delay the onset of AIDS, but HIV infection eventually results in a syndrome of symptoms, diseases, and infections. The diagnosis of AIDS requires evidence of HIV infection and the appearance of specific conditions or diseases beyond just the HIV infection. Only a licensed medical provider can make an AIDS diagnosis. A key concept is that all people diagnosed with AIDS have HIV, but an individual may be infected with HIV and not yet have AIDS.